Yang Yinqiu, Liu Guangwang, Zhang Yao, Xu Guiping, Yi Xilu, Liang Jing, Zhao Chenhe, Liang Jun, Ma Chao, Ye Yangli, Yu Mingxiang, Qu Xinhua
Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Orthopaedics, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou Clinical Medical College of Nanjing University of Chinese Medicine, Xuzhou, China.
Front Endocrinol (Lausanne). 2018 Nov 6;9:646. doi: 10.3389/fendo.2018.00646. eCollection 2018.
The association between bone mineral density (BMD), bone turnover markers, and serum cholesterol in healthy population has already been proved. However, in patients with type 2 diabetes mellitus (T2D), it has not been adequately analyzed. In this study, we investigated the correlation between BMD, bone turnover markers, and serum cholesterol levels in people with T2D. We enrolled 1,040 men and 735 women with T2D from Zhongshan Hospital between October 2009 and January 2013. Their general condition, history of diseases and medication, serum markers, and BMD data were collected. We used logistic regression analysis to identify the association between serum cholesterol levels and BMD as well as bone turnover markers. In multivariate regression analysis, we observed that in men with T2D, high high-density lipoprotein-cholesterol and total cholesterol levels were significantly associated with low total lumbar, femur neck, and total hip BMD, while low-density lipoprotein-cholesterol level was only inversely associated with total lumbar and femur neck BMD. Total cholesterol and low-density lipoprotein-cholesterol levels were also negatively associated with osteocalcin, procollagen type I N-terminal propeptide, and β-crosslaps. In women with T2D, high-density lipoprotein-cholesterol level was observed to be negatively correlated with total lumbar, femur neck, and total hip BMD, while total cholesterol and low-density lipoprotein-cholesterol levels were only associated with BMD at the total lumbar. Furthermore, total cholesterol was also negatively associated with osteocalcin, procollagen type I N-terminal propeptide, and β-crosslaps; high-density lipoprotein-cholesterol was only related to osteocalcin and parathyroid hormone, while low-density lipoprotein-cholesterol was only related to β-crosslaps in women. Our study suggests a significantly negative correlation between serum cholesterol levels and BMD in both men and women with T2D. The associations between serum cholesterol levels and bone turnover markers were also observed in T2D patients.
健康人群中骨矿物质密度（BMD）、骨转换标志物和血清胆固醇之间的关联已得到证实。然而，在2型糖尿病（T2D）患者中，尚未对此进行充分分析。在本研究中，我们调查了T2D患者中BMD、骨转换标志物和血清胆固醇水平之间的相关性。我们纳入了2009年10月至2013年1月期间来自中山医院的1040名男性和735名女性T2D患者。收集了他们的一般情况、疾病史和用药情况、血清标志物以及BMD数据。我们使用逻辑回归分析来确定血清胆固醇水平与BMD以及骨转换标志物之间的关联。在多变量回归分析中，我们观察到，在男性T2D患者中，高密度脂蛋白胆固醇和总胆固醇水平高与腰椎、股骨颈和全髋部BMD低显著相关，而低密度脂蛋白胆固醇水平仅与腰椎和股骨颈BMD呈负相关。总胆固醇和低密度脂蛋白胆固醇水平也与骨钙素、I型前胶原N端前肽和β-交联C末端肽呈负相关。在女性T2D患者中，观察到高密度脂蛋白胆固醇水平与腰椎、股骨颈和全髋部BMD呈负相关，而总胆固醇和低密度脂蛋白胆固醇水平仅与腰椎BMD相关。此外，总胆固醇也与骨钙素、I型前胶原N端前肽和β-交联C末端肽呈负相关；在女性中，高密度脂蛋白胆固醇仅与骨钙素和甲状旁腺激素相关，而低密度脂蛋白胆固醇仅与β-交联C末端肽相关。我们的研究表明，男性和女性T2D患者的血清胆固醇水平与BMD之间存在显著负相关。在T2D患者中也观察到了血清胆固醇水平与骨转换标志物之间的关联。
