Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
Nutr Metab Cardiovasc Dis. 2020 Jan 3;30(1):49-55. doi: 10.1016/j.numecd.2019.08.018. Epub 2019 Sep 9.
The aim of this study is to evaluate the relationship between OPG and the degree of glycaemic control in a population of elderly subjects.
Data presented included 172 elderly subjects, of whom 107 were hospitalized for a hip fracture and 65 were non fractured outpatients. All participants received a multidimensional geriatric evaluation and underwent blood sampling. HbA1c, OPG, CTX and OC were measured and DXA scans were performed. Carotid intima-media thickness (IMT) was measured in all outpatients. Diabetic patients had more comorbidities, higher mean values of lumbar spine and femoral neck BMD and T-score, lower circulating levels of OC and CTX, and higher circulating levels of OPG compared to non-diabetic subjects. OPG was directly correlated with HbA1c. This association was most evident in non-fractured elderly subjects. Moreover, diabetic patients with IMT>1.5 mm had greater mean values of OPG than non-diabetic subjects with high IMT and than elderly subjects with IMT < 1.5 mm, with and without T2DM.
Diabetic patients have reduced circulating levels of OC and CTX, and elevated serum levels of OPG, suggesting a state of low bone turnover. Reduced bone turnover causes an increase of BMD and could lead to a poor bone quality. OPG and HbA1c were directly correlated and OPG mean values were higher in diabetic patients with poor glucose control. Diabetic osteopathy could be considered a late complication of T2DM, directly related with the degree of glucose control and the duration of the disease.
本研究旨在评估老年人群中 OPG 与血糖控制程度之间的关系。
本研究纳入了 172 名老年受试者，其中 107 名因髋部骨折住院，65 名非骨折门诊患者。所有参与者均接受了多维老年评估，并进行了血液采样。测量了糖化血红蛋白（HbA1c）、骨保护素（OPG）、CTX 和 OC，并进行了 DXA 扫描。所有门诊患者均进行了颈动脉内中膜厚度（IMT）测量。与非糖尿病患者相比，糖尿病患者合并症更多，腰椎和股骨颈 BMD 及 T 评分更高，OC 和 CTX 循环水平更低，OPG 循环水平更高。OPG 与 HbA1c 呈正相关。这种相关性在非骨折老年受试者中最为明显。此外，IMT>1.5 mm 的糖尿病患者的 OPG 均值高于非糖尿病高 IMT 患者和 IMT<1.5 mm 的老年患者，无论是否合并 T2DM。
糖尿病患者的 OC 和 CTX 循环水平降低，OPG 血清水平升高，提示低骨转换状态。骨转换减少导致 BMD 增加，并可能导致骨质量差。OPG 与 HbA1c 直接相关，血糖控制不佳的糖尿病患者的 OPG 均值更高。糖尿病性骨病可被视为 T2DM 的晚期并发症，与血糖控制程度和疾病持续时间直接相关。
