Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China.
Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Endocrinol (Lausanne). 2021 Mar 25;12:554604. doi: 10.3389/fendo.2021.554604. eCollection 2021.
The interrelation between glucose and bone metabolism is complex and has not been fully revealed. This study aimed to investigate the association between insulin resistance, β-cell function and bone turnover biomarker levels among participants with abnormal glycometabolism.
A total of 5277 subjects were involved through a cross-sectional study (METAL study, http://www.chictr.org.cn, ChiCTR1800017573) in Shanghai, China. Homeostasis model assessment of insulin resistance (HOMA-IR) and β-cell dysfunction (HOMA-%β) were applied to elucidate the nexus between β-C-terminal telopeptide (β-CTX), intact N-terminal propeptide of type I collagen (P1NP) and osteocalcin (OC). β-CTX, OC and P1NP were detected by chemiluminescence.
HOMA-IR was negatively associated with β-CTX, P1NP and OC (regression coefficient (β) -0.044 (-0.053, -0.035), Q4vsQ1; β -7.340 (-9.130, -5.550), Q4vsQ1 and β -2.885 (-3.357, -2.412), Q4vsQ1, respectively, all P for trend <0.001). HOMA-%β was positively associated with β-CTX, P1NP and OC (β 0.022 (0.014, 0.031), Q4vsQ1; β 6.951 (5.300, 8.602), Q4vsQ1 and β 1.361 (0.921, 1.800), Q4vsQ1, respectively, all P for trend <0.001).
Our results support that lower bone turnover biomarker (β-CTX, P1NP and OC) levels were associated with a combination of higher prevalence of insulin resistance and worse β-cell function among dysglycemia patients. It is feasible to detect bone turnover in diabetes or hyperglycemia patients to predict the risk of osteoporosis and fracture, relieve patients' pain and reduce the expenses of long-term cure.
葡萄糖和骨代谢之间的相互关系很复杂,尚未完全揭示。本研究旨在探讨糖代谢异常患者中胰岛素抵抗、β细胞功能与骨转换生物标志物水平之间的关系。
采用横断面研究(METAL 研究,http://www.chictr.org.cn,ChiCTR1800017573),在中国上海纳入了 5277 名受试者。采用稳态模型评估胰岛素抵抗(HOMA-IR)和β细胞功能障碍(HOMA-%β)来阐明 C 端β-肽(β-CTX)、I 型胶原氨基端前肽(P1NP)和骨钙素(OC)之间的关系。采用化学发光法检测β-CTX、OC 和 P1NP。
HOMA-IR 与β-CTX、P1NP 和 OC 呈负相关(回归系数(β)-0.044(-0.053,-0.035),Q4vsQ1;β-7.340(-9.130,-5.550),Q4vsQ1;β-2.885(-3.357,-2.412),Q4vsQ1,趋势 P<0.001)。HOMA-%β 与β-CTX、P1NP 和 OC 呈正相关(β0.022(0.014,0.031),Q4vsQ1;β6.951(5.300,8.602),Q4vsQ1;β1.361(0.921,1.800),Q4vsQ1,趋势 P<0.001)。
我们的研究结果支持以下观点,即较低的骨转换生物标志物(β-CTX、P1NP 和 OC)水平与糖代谢异常患者中胰岛素抵抗和β细胞功能更差的组合相关。在糖尿病或高血糖患者中检测骨转换以预测骨质疏松和骨折风险是可行的,可以减轻患者的痛苦并降低长期治疗的费用。