2型糖尿病患者血清骨钙素与心血管代谢危险因素关联中的年龄和性别特异性差异。
Age- and sex-specific differences in the association of serum osteocalcin and cardiometabolic risk factors in type 2 diabetes.
作者信息
Li Wei, Wang Yan, Dong Jie, Di Ruiqing, Liu Xiaojun, Liu Shengyun
机构信息
Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, NO. 1, Jianshe East Road, Zhengzhou, 450052, Henan, China.
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, NO. 1, Jianshe East Road, Zhengzhou, 450052, Henan, China.
出版信息
Diabetol Metab Syndr. 2023 Mar 16;15(1):48. doi: 10.1186/s13098-023-01021-0.
BACKGROUND
Serum osteocalcin levels are closely related to metabolic syndrome and cardiovascular disease. This study aimed to investigate the relationship between serum osteocalcin levels and cardiometabolic risk factors in patients with type 2 diabetes (T2D) according to age and sex.
METHODS
This cross-sectional study included 1500 patients with T2D (991 men and 509 women) aged ≥ 18 years old. The age- and sex-specific disparities in glycemic and lipid control, as well as cardiometabolic risk factors were evaluated.
RESULTS
The levels of serum osteocalcin were significantly higher in women aged > 50 years compared with women aged ≤ 50 years (15.6 ± 6.5 ng/mL vs. 11.3 ± 4.5 ng/mL, p < 0.0001). However, this was lower in men aged > 50 years than men aged ≤ 50 years (12.2 ± 4.2 ng/mL vs. 12.9 ± 4.3 ng/mL, p = 0.0081). We performed correlation analyses of serum osteocalcin and cardiometabolic parameters. Serum osteocalcin concentrations were negative associated with FBG and HbA1c levels in women and men ≤ 50 years old, but not in men aged > 50 years old. Serum osteocalcin were negatively correlated with TG and positively correlated with HDL-C and LDL-C only in men aged ≤ 50 years. In binary logistic regression analysis, serum osteocalcin levels were associated with multiple cardiovascular risk factors, as follows: overweight/obese (odds ratio [OR], 0.944; 95% confidence interval [CI], 0.9-0.991, p = 0.02) in men aged > 50 years; high HbA1C and high FBG in women and men aged ≤ 50 years, but not in men aged > 50 years; after adjustment for confounding factors, high TG (OR, 0.905; 95% CI 0.865-0.947, p < 0.0001), metabolic syndrome (OR, 0.914; 95% CI 0.874-0.956, p < 0.0001), and low high-density lipoprotein cholesterol (OR, 0.933; 95% CI, 0.893-0.975, p = 0.002) were seen in men aged ≤ 50 years only.
CONCLUSIONS
Serum osteocalcin level has significant relationships with cardiometabolic risk factors and several age- and sex-related differences in patients with T2D. Decreased serum osteocalcin levels are associated with a worse cardiometabolic risk profile.
背景
血清骨钙素水平与代谢综合征及心血管疾病密切相关。本研究旨在根据年龄和性别，探讨2型糖尿病（T2D）患者血清骨钙素水平与心脏代谢危险因素之间的关系。
方法
这项横断面研究纳入了1500例年龄≥18岁的T2D患者（991例男性和509例女性）。评估了血糖和血脂控制方面以及心脏代谢危险因素的年龄和性别特异性差异。
结果
年龄>50岁的女性血清骨钙素水平显著高于年龄≤50岁的女性（15.6±6.5 ng/mL vs. 11.3±4.5 ng/mL，p<0.0001）。然而，年龄>50岁的男性血清骨钙素水平低于年龄≤50岁的男性（12.2±4.2 ng/mL vs. 12.9±4.3 ng/mL，p=0.0081）。我们对血清骨钙素与心脏代谢参数进行了相关性分析。年龄≤50岁的女性和男性中，血清骨钙素浓度与空腹血糖（FBG）和糖化血红蛋白（HbA1c）水平呈负相关，但在年龄>50岁的男性中无此相关性。仅在年龄≤50岁的男性中，血清骨钙素与甘油三酯（TG）呈负相关，与高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）呈正相关。在二元逻辑回归分析中，血清骨钙素水平与多种心血管危险因素相关，具体如下：年龄>50岁的男性中，超重/肥胖（比值比[OR]，0.944；95%置信区间[CI]，0.9 - 0.991，p=0.02）；年龄≤50岁的女性和男性中，高HbA1C和高FBG，但在年龄>50岁的男性中无此情况；调整混杂因素后，仅在年龄≤50岁的男性中出现高TG（OR，0.905；95% CI 0.865 - 0.947，p<0.0001）、代谢综合征（OR，0.914；95% CI 0.874 - 0.956，p<0.0001）和低高密度脂蛋白胆固醇（OR，0.933；95% CI，0.893 - 0.975，p=0.002）。
结论
血清骨钙素水平与T2D患者的心脏代谢危险因素及一些年龄和性别相关差异存在显著关系。血清骨钙素水平降低与更差的心脏代谢风险状况相关。
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