Chen Hailing, Li Jufen, Wang Qian
Medicine (Baltimore). 2018 Apr;97(17):e0432. doi: 10.1097/MD.0000000000010432.
Insufficient evidence is available to reliably compare the roles of bone alkaline phosphatase (BAP) and bone mineral density (BMD) in diabetes. This study aimed to compare associations between BAP and BMD in adults with and without diabetes to elucidate fracture risk in diabetes.Data were extracted from the National Health and Nutrition Examination Survey (NHANES), 2001-2004, including 4197 adults aged 20 to 49 years, 143 with diabetes (DM group), and 4054 without (non-DM group). Main outcome measure was BMD and regression analyses were performed to identify serum BAP and other covariates associated with total BMD.BMD decreased significantly in DM patients when BAP was increased. In the non-DM group, all BMD results were significantly decreased when BAP was increased. Factors associated with total BMD varied with DM status. Lifestyle measures such as smoking and physical activity were also associated with BMD in the non-DM group.BAP and BMD are inversely associated in DM and non-DM patients. BAP is significantly associated with BMD after controlling for other variables, suggesting that BAP may interact with other factors altering bone metabolism in DM patients.
目前尚无足够证据来可靠地比较骨碱性磷酸酶（BAP）和骨密度（BMD）在糖尿病中的作用。本研究旨在比较有糖尿病和无糖尿病成年人中BAP与BMD之间的关联，以阐明糖尿病患者的骨折风险。数据来自2001 - 2004年的美国国家健康与营养检查调查（NHANES），包括4197名20至49岁的成年人，其中143人患有糖尿病（糖尿病组），4054人无糖尿病（非糖尿病组）。主要结局指标是骨密度，并进行回归分析以确定血清BAP和其他与总骨密度相关的协变量。当BAP升高时，糖尿病患者的骨密度显著降低。在非糖尿病组中，当BAP升高时，所有骨密度结果均显著降低。与总骨密度相关的因素因糖尿病状态而异。在非糖尿病组中，吸烟和体育活动等生活方式因素也与骨密度有关。在糖尿病患者和非糖尿病患者中，BAP与BMD呈负相关。在控制其他变量后，BAP与骨密度显著相关，这表明BAP可能与其他改变糖尿病患者骨代谢的因素相互作用。
