循环骨钙素与2型糖尿病患者通过持续葡萄糖监测评估的血糖达标时间及其他指标相关。
Circulating osteocalcin is associated with time in range and other metrics assessed by continuous glucose monitoring in type 2 diabetes.
作者信息
Liu Jun, Wei Yinghua, Zang Pu, Wang Wei, Feng Zhouqin, Yuan Yanyu, Zhou Hui, Zhang Zhen, Lei Haiyan, Yang Xinyi, Liu Jun, Lu Bin, Shao Jiaqing
机构信息
Department of Endocrinology, Jinling Hospital, Southern Medical University, Nanjing, China.
Department of Endocrinology, School of Medicine, Jinling Hospital, Nanjing University, Nanjing, China.
出版信息
Diabetol Metab Syndr. 2022 Aug 4;14(1):109. doi: 10.1186/s13098-022-00863-4.
BACKGROUND
Osteocalcin, a protein secreted mainly by mature osteoblasts, has been shown to be involved in glucose metabolism through various pathways. However, few studies has explored the association between osteocalcin and Time in range (TIR). Continuous glucose monitoring (CGM) -derived metrics, such as TIR and other indexes have been gradually and widely used in clinical practice to assess glucose fluctuations. The main purpose of this study was to investigate the correlation between osteocalcin and indexes from CGM in patients with type 2 diabetes mellitus (T2DM).
METHOD
The total number of 376 patients with T2D were enrolled, all of them performed three consecutive days of monitoring. They were divided into four groups on account of the quartile of osteocalcin. Time in range, Time below range (TBR), Time above range(TAR) and measures of glycemic variability (GV) were assessed for analysing. After a 100 g standard steamed bread meal, blood glucose (Glu0h Glu0.5 h, Glu1h, Glu2h, GLu3h), C-peptide (Cp0h, Cp0.5 h, Cp1h, Cp2h, Cp3h), serum insulin (INS0h, INS0.5 h, INS1h, INS2h, INS3h) concentrations at different time points were obtained. HOMA-IS, HOMA-βwas calculated to evaluate insulin sensitivity and insulin secreting of the participants.
RESULTS
Patients with higher osteocalcin level had higher TIR (P < 0.05). Spearman correlation analysis showed that osteocalcin was positively correlated with TBR (although the P value for TBR was greater than 0.05) (r = 0.227, P < 0.001 r = 0.068, P = 0.189) and negatively correlated with TAR (- 0.229, P < 0.001). Similarly, there was a negative correlation between osteocalcin and glycemic variability (GV) indicators, including SD, MBG, MODD, ADDR, and MAGE (P value of MAGE > 0.05). Multiple stepwise regression showed that osteocalcin was an independent contributor to TIR, TAR and HOMA-IS.
CONCLUSION
Circulating osteocalcin is positively correlated with TIR and negatively correlated with MODD, ADDR, and MAGE. Osteocalcin may have a beneficial impact on glucose homeostasis in T2DM patients.
背景
骨钙素是一种主要由成熟成骨细胞分泌的蛋白质，已被证明通过多种途径参与葡萄糖代谢。然而，很少有研究探讨骨钙素与血糖达标时间（TIR）之间的关联。连续血糖监测（CGM）得出的指标，如TIR和其他指标，已在临床实践中逐渐得到广泛应用，以评估血糖波动情况。本研究的主要目的是调查2型糖尿病（T2DM）患者骨钙素与CGM指标之间的相关性。
方法
纳入376例T2D患者，所有患者均连续进行三天监测。根据骨钙素四分位数将他们分为四组。评估血糖达标时间、血糖低于范围时间（TBR）、血糖高于范围时间（TAR）和血糖变异性（GV）指标进行分析。给予100g标准馒头餐，测定不同时间点的血糖（Glu0h、Glu0.5h、Glu1h、Glu2h、GLu3h）、C肽（Cp0h、Cp0.5h、Cp1h、Cp2h、Cp3h）、血清胰岛素（INS0h、INS0.5h、INS1h、INS2h、INS3h）浓度。计算HOMA-IS、HOMA-β以评估参与者的胰岛素敏感性和胰岛素分泌情况。
结果
骨钙素水平较高的患者TIR较高（P＜0.05）。Spearman相关性分析显示，骨钙素与TBR呈正相关（尽管TBR的P值大于0.05）（r = 0.227，P＜0.001；r = 0.068，P = 0.189），与TAR呈负相关（-0.229，P＜0.001）。同样，骨钙素与血糖变异性（GV）指标之间存在负相关，包括标准差（SD）、平均血糖（MBG）、平均血糖波动幅度（MODD）、血糖波动均值（ADDR）和血糖平均绝对差（MAGE）（MAGE的P值＞0.05）。多元逐步回归显示，骨钙素是TIR、TAR和HOMA-IS的独立影响因素。
结论
循环骨钙素与TIR呈正相关，与MODD、ADDR和MAGE呈负相关。骨钙素可能对T2DM患者的葡萄糖稳态有有益影响。
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