Dumitru Nicoleta, Carsote Mara, Cocolos Andra, Petrova Eugenia, Olaru Maria, Caragheorgheopol Andra, Dumitrache Constantin, Ghemigian Adina
"C.I. Parhon" National Institute of Endocrinology, Bucharest,Romania.
"Carol Davila" University of Medicine and Pharmacy, Bucharest,Romania.
Rom J Intern Med. 2019 Mar 1;57(1):61-67. doi: 10.2478/rjim-2018-0036.
Current studies support the implication of metabolic changes associated with type 2 diabetes in altering bone metabolism, structure and resistance.
We conducted a cross-sectional study on postmenopausal women aimed to analyze the differences in metabolic and bone profile in patients with and without type 2 diabetes Methods. We analyzed the metabolic and bone profile in postmenopausal women with and without type 2 diabetes (T2DM). Clinical, metabolic, hormonal parameters, along with lumbar, hip and femoral bone mineral density (BMD) and trabecular bone score (TBS) were evaluated.
56 women with T2DM(63.57±8.97 years) and 83 non-T2DM (60.21±8.77 years) were included. T2DM patients presented a higher value of body mass index (BMI) and BMD vs. control group (p = 0.001; p = 0.03-lumbar level, p = 0.07-femoral neck and p = 0.001-total hip). Also, BMI correlated positively with lumbar-BMD and glycated hemoglobin (HbA1c) (r = 0.348, p = 0.01; r = 0.269, p = 0.04), correlation maintained even after age and estimated glomerular filtration rate (eGFR) adjustment (r = 0.383, p = 0.005; r = 0.237, p = 0.08). Diabetic patients recorded lower levels of 25(OH)D(p = 0.05), bone markers (p ≤ 0.05) and TBS(p = 0.07). For the entire patient group we found a negative correlation between HbA1c level and bone markers: r = -0.358, p = 0.0005-osteocalcin, r = -0.40, p = 0.0005-P1NP, r = -0.258, p = 0.005-crosslaps.
Our results indicate the presence of altered bone microarchitecture in T2DZ patients according to the TBS score, combined with lower levels of bone markers, with a statistically significant negative correlation between HbA1c level and bone markers.
目前的研究支持2型糖尿病相关的代谢变化对骨代谢、结构和抵抗力产生影响。
我们对绝经后女性进行了一项横断面研究，旨在分析2型糖尿病患者与非2型糖尿病患者在代谢和骨骼状况方面的差异。方法：我们分析了患有和未患有2型糖尿病（T2DM）的绝经后女性的代谢和骨骼状况。评估了临床、代谢、激素参数，以及腰椎、髋部和股骨的骨矿物质密度（BMD）和小梁骨评分（TBS）。
纳入了56名T2DM女性（63.57±8.97岁）和83名非T2DM女性（60.21±8.77岁）。与对照组相比，T2DM患者的体重指数（BMI）和BMD值更高（p = 0.001；腰椎水平p = 0.03，股骨颈p = 0.07，全髋p = 0.001）。此外，BMI与腰椎BMD和糖化血红蛋白（HbA1c）呈正相关（r = 0.348，p = 0.01；r = 0.269，p = 0.04），即使在调整年龄和估计肾小球滤过率（eGFR）后，这种相关性仍然存在（r = 0.383，p = 0.005；r = 0.237，p = 0.08）。糖尿病患者的25（OH）D水平较低（p = 0.05），骨标志物水平较低（p≤0.05），TBS较低（p = 0.07）。对于整个患者组，我们发现HbA1c水平与骨标志物之间存在负相关：骨钙素r = -0.358，p = 0.0005；I型前胶原N端前肽（P1NP）r = -0.40，p = 0.0005；交联C末端肽（crosslaps）r = -0.258，p = 0.005。
我们的结果表明，根据TBS评分，T2DZ患者存在骨微结构改变，同时骨标志物水平较低，HbA1c水平与骨标志物之间存在统计学上显著的负相关。
