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非骨质疏松绝经后女性血清维生素D和骨钙素水平与代谢综合征关系的评估

Assessment of the Relationship between Serum Vitamin D and Osteocalcin Levels with Metabolic Syndrome in Non-Osteoporotic Postmenopausal Women.

作者信息

Guney Gurhan, Sener-Simsek Bilge, Tokmak Aytekin, Yucel Aykan, Buyukkagnici Umran, Yilmaz Nafiye, Engin-Ustun Yaprak, Ozgu-Erdinc A Seval

机构信息

Sakarya University Education and Research Hospital, Department of Obstetrics and Gynecology, Sakarya, Turkey.

University of Health Sciences, Zekai Tahir Burak Women's Health Research and Education Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.

出版信息

Geburtshilfe Frauenheilkd. 2019 Mar;79(3):293-299. doi: 10.1055/a-0767-6572. Epub 2019 Jan 22.

Abstract

The aim of this study was to compare serum vitamin D and osteocalcin levels in non-osteoporotic postmenopausal women with and without metabolic syndrome and to analyze the relationship between serum vitamin D and osteocalcin levels and the relationships between these two factors and other clinical/biochemical parameters. This cross-sectional study was carried out in 191 postmenopausal non-osteoporotic (T-score > - 2.5) women. Patients were divided into two groups according to the presence or absence of metabolic syndrome. Blood samples were obtained and evaluated for 25-hydroxyvitamin D, osteocalcin, insulin resistance (using a homeostatic model assessment of insulin resistance), glycosylated hemoglobin (HbA ), calcium, phosphorus, deoxypyridinoline, thyroid-stimulating hormone, lipid profile, fasting insulin, fasting glucose and HbA levels. Demographic and laboratory parameters were recorded for each woman. Vitamin D was found to be lower in women with metabolic syndrome compared to controls (16.1 ± 11.2 vs. 20.4 ± 13.1 mg/dL; p = 0.013). Similarly, osteocalcin was found to be significantly lower in the metabolic syndrome group compared to the control group (4.2 ± 2.1 vs. 5.5 ± 3.0; p < 0.001). A significant positive correlation was observed between vitamin D and osteocalcin levels (r = 0.198; p = 0.008). There was an inverse correlation between vitamin D and some of the lipid parameters. However, osteocalcin levels were negatively correlated with C-reactive protein, insulin resistance, and HbA in both groups (p = 0.003, p = 0.001 and p = 0.048, respectively). Vitamin D deficiency is common in postmenopausal women, even in women who are non-osteoporotic. Serum levels of vitamin D are significantly decreased in cases with metabolic syndrome. Vitamin D may directly improve serum lipid profiles and may indirectly decrease insulin resistance and subclinical systemic inflammation through the impact on the metabolic functions of osteocalcin.

摘要

本研究的目的是比较患有和未患有代谢综合征的非骨质疏松绝经后女性的血清维生素D和骨钙素水平,并分析血清维生素D和骨钙素水平之间的关系,以及这两个因素与其他临床/生化参数之间的关系。这项横断面研究在191名绝经后非骨质疏松(T值> -2.5)女性中进行。根据是否存在代谢综合征将患者分为两组。采集血样并评估25-羟维生素D、骨钙素、胰岛素抵抗(使用胰岛素抵抗稳态模型评估)、糖化血红蛋白(HbA )、钙、磷、脱氧吡啶啉、促甲状腺激素、血脂谱、空腹胰岛素、空腹血糖和HbA 水平。记录每位女性的人口统计学和实验室参数。结果发现,与对照组相比,患有代谢综合征的女性维生素D水平较低(16.1±11.2 vs. 20.4±13.1mg/dL;p = 0.013)。同样,与对照组相比,代谢综合征组的骨钙素水平显著降低(4.2±2.1 vs. 5.5±3.0;p < 0.001)。观察到维生素D和骨钙素水平之间存在显著正相关(r = 0.198;p = 0.008)。维生素D与一些脂质参数之间存在负相关。然而,两组中骨钙素水平均与C反应蛋白、胰岛素抵抗和HbA 呈负相关(分别为p = 0.003、p = 0.001和p = 0.048)。维生素D缺乏在绝经后女性中很常见,即使在非骨质疏松女性中也是如此。代谢综合征患者的血清维生素D水平显著降低。维生素D可能直接改善血清脂质谱,并可能通过对骨钙素代谢功能的影响间接降低胰岛素抵抗和亚临床全身炎症。

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