2型糖尿病男性和绝经后女性骨转换标志物与血清尿酸肌酐比值的关系
Relationship of Bone Turnover Markers with Serum Uric Acid-to-Creatinine Ratio in Men and Postmenopausal Women with Type 2 Diabetes.
作者信息
Xing Yuling, Liu Jing, Liu Huanxin, Ma Huijuan
机构信息
Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People's Republic of China.
Graduate School of Hebei Medical University, Shijiazhuang, People's Republic of China.
出版信息
Diabetes Metab Syndr Obes. 2022 Oct 19;15:3205-3217. doi: 10.2147/DMSO.S384694. eCollection 2022.
PURPOSE
Accumulating evidence has shown that serum uric acid (UA) is associated with some chronic diseases owing to its antioxidant capacity; however, previous research has discrepant results regarding the relationship between UA and bone health. UA normalized by renal function can reflect endogenous UA levels more precisely than SUA levels. This study assessed the relationship between serum UA-to-creatinine (SUA/Cr) ratio and bone turnover markers (BTMs) in men and postmenopausal women with type 2 diabetes mellitus (T2DM).
PATIENTS AND METHODS
Overall, 1691 patients (1028 males and 663 postmenopausal females) with T2DM admitted to Hebei General Hospital between January and December 2020 were selected and divided into two groups according to their SUA/Cr ratio. One-way analysis of variance was used to compare groups. The relationship between the SUA/Cr ratio and BTMs (including osteocalcin [OC], procollagen I N-terminal peptide [PINP], and β-isomerized type I collagen C-telopeptide breakdown products [β-CTX]) was analyzed using multiple linear regression. Furthermore, subgroup analyses were performed to explore the differences between men and women in the relationship between SUA/Cr and BTMs. Mediation analysis was used to explore whether insulin resistance mediated the association between SUA/Cr and BTMs.
RESULTS
β-CTX and PNIP levels of patients with T2DM in the low SUA/Cr group were significantly higher than those in the high SUA/Cr group, and the difference between the two groups was statistically significant (P < 0.05). Correlation analysis showed that SUA/Cr was negatively correlated with β-CTX and PNIP. After adjusting for confounding factors, multivariate linear regression analysis revealed that the SUA/Cr level was negatively correlated with PINP and β-CTX in male patients and postmenopausal women with T2DM. Stronger correlations were found in patients with 25(OH)D3 < 20ng/mL, course ≥ 5 years, HbA1c > 7%, or BMI < 28 kg/m2.
CONCLUSION
SUA/Cr ratio was an independent influencing factor of BTMs in patients with T2DM.
目的
越来越多的证据表明，血清尿酸（UA）因其抗氧化能力而与一些慢性疾病相关；然而，先前关于UA与骨骼健康之间关系的研究结果存在差异。经肾功能校正的UA比血清尿酸（SUA）水平能更准确地反映内源性UA水平。本研究评估了2型糖尿病（T2DM）男性患者和绝经后女性血清尿酸与肌酐比值（SUA/Cr）与骨转换标志物（BTMs）之间的关系。
患者与方法
选取2020年1月至12月在河北医科大学第一医院住院的1691例T2DM患者（1028例男性和663例绝经后女性），并根据其SUA/Cr比值分为两组。采用单因素方差分析比较各组。使用多元线性回归分析SUA/Cr比值与BTMs（包括骨钙素[OC]、I型前胶原N端肽[PINP]和I型胶原β-异构化C端肽降解产物[β-CTX]）之间的关系。此外，进行亚组分析以探讨SUA/Cr与BTMs关系在男性和女性之间的差异。采用中介分析探讨胰岛素抵抗是否介导了SUA/Cr与BTMs之间的关联。
结果
低SUA/Cr组T2DM患者的β-CTX和PNIP水平显著高于高SUA/Cr组，两组间差异具有统计学意义（P < 0.05）。相关性分析显示，SUA/Cr与β-CTX和PNIP呈负相关。校正混杂因素后，多元线性回归分析显示，SUA/Cr水平与T2DM男性患者和绝经后女性的PINP和β-CTX呈负相关。在25(OH)D3 < 20ng/mL、病程≥5年、糖化血红蛋白> 7%或体重指数< 28 kg/m2的患者中发现更强的相关性。
结论
SUA/Cr比值是T2DM患者BTMs的独立影响因素。
Zotero 插件