血清骨转换标志物与中国糖尿病患者估算肾小球滤过率的相关性。
Correlation between Serum Bone Turnover Markers and Estimated Glomerular Filtration Rate in Chinese Patients with Diabetes.
机构信息
Department of Clinical Laboratory, Wuxi People's Hospital Affiliated with Nanjing Medical University, Wuxi, Jiangsu Province, China.
出版信息
Dis Markers. 2021 Jan 6;2021:6731218. doi: 10.1155/2021/6731218. eCollection 2021.
OBJECTIVE
Diabetes is a growing global public health concern with many significant disease complications. Multiple studies show that bone turnover markers (BTMs) are decreased in diabetes patients, indicating impaired bone metabolism in diabetes patients. A recent study also showed that in diabetes patients, BTMs are correlated with urine albumin to creatinine ratio, an indicator of nephropathy. However, whether BTMs are correlated with estimated glomerular filtration rate (eGFR) in diabetes remains unknown. This retrospective study accessed correlations between serum BTMs and eGFR in Chinese patients with diabetes and compare levels of BTMs and eGFR between diabetic patients and healthy individuals.
METHODS
This study analyzed data from 221 diabetic patients (include type1 and type 2 diabetes) and 155 healthy individuals. Serum BTM levels and eGFR were compared between diabetic patients and healthy individuals. Pearson correlation analysis was used to assess correlations between BTMs and eGFR. Multiple logistic regression analysis adjusted for gender and age was performed to measure odd ratio (OR) and 95% confidence interval (95% CI) of BTMs on diabetes.
RESULTS
Patients with diabetes had significant lower 25-hydroxyvitamin D (25(OH)D) levels (15.07 ± 6.20 ng/mL) than healthy group (17.89 ± 6.41 ng/mL) ( < 0.05). For patients with diabetes, eGFR was negatively correlated with osteocalcin (OC) ( = -0.434, < 0.05), procollagen type 1 intact N-terminal propeptide (P1NP) ( = -0.350, < 0.05), and -carboxy-terminal cross-linking telopeptide of type I collagen (-CTX) ( = -0.179, < 0.05) levels. For healthy people, eGFR was negatively correlated with 25(OH)D ( = -0.290, < 0.05) levels. Multiple logistic regression analysis adjusted for age and gender (mean age of diabetes was 64.9 years and the percentage of female was 66.9%, mean age of healthy people was 48.4 years and the percentage of female was 37.4%) showed that 25(OH)D (OR = 0.909, 95%CI = 0.862 - 0.959, < 0.05) was protective factors for diabetes.
CONCLUSIONS
In the stage of diabetic nephropathy, bone turnover may accelerate. It is important to detect BTMs in the stage of diabetic nephropathy.
目的
糖尿病是一个日益严重的全球性公共卫生问题，存在许多严重的疾病并发症。多项研究表明，糖尿病患者的骨转换标志物（BTMs）水平降低，表明糖尿病患者的骨代谢受损。最近的一项研究还表明，在糖尿病患者中，BTMs 与尿白蛋白与肌酐比值（反映肾病的指标）相关。然而，BTMs 是否与糖尿病患者的估计肾小球滤过率（eGFR）相关仍不清楚。本回顾性研究旨在探讨中国糖尿病患者血清 BTMs 与 eGFR 之间的相关性，并比较糖尿病患者与健康人群之间 BTMs 和 eGFR 的水平。
方法
本研究分析了 221 例糖尿病患者（包括 1 型和 2 型糖尿病）和 155 名健康个体的数据。比较了糖尿病患者和健康个体的血清 BTM 水平和 eGFR。采用 Pearson 相关分析评估 BTMs 与 eGFR 之间的相关性。采用多元逻辑回归分析调整性别和年龄，以测量 BTMs 对糖尿病的比值比（OR）和 95%置信区间（95%CI）。
结果
糖尿病患者的 25-羟维生素 D（25（OH）D）水平（15.07±6.20ng/mL）显著低于健康组（17.89±6.41ng/mL）（<0.05）。对于糖尿病患者，eGFR 与骨钙素（OC）（=-0.434，<0.05）、I 型前胶原氨基端前肽（P1NP）（=-0.350，<0.05）和 I 型胶原羧基端交联肽（-CTX）（=-0.179，<0.05）水平呈负相关。对于健康人群，eGFR 与 25（OH）D 水平呈负相关（=-0.290，<0.05）。经年龄和性别调整的多元逻辑回归分析（糖尿病患者的平均年龄为 64.9 岁，女性比例为 66.9%，健康人群的平均年龄为 48.4 岁，女性比例为 37.4%）显示，25（OH）D（OR=0.909，95%CI=0.862-0.959，<0.05）是糖尿病的保护因素。
结论
在糖尿病肾病阶段，骨转换可能会加速。在糖尿病肾病阶段检测 BTMs 很重要。
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