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2型糖尿病患者肾功能与骨密度之间的关联

Association between renal function and bone mineral density in patients with type 2 diabetes mellitus.

作者信息

Ye Yangli, Yi Xilu, Zhang Yao, Xu Guiping, Yu Mingxiang, Qu Xinhua

机构信息

Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China.

Department of Endocrinology and Metabolism, Central Hospital of Songjiang District, Shanghai, China.

出版信息

Heliyon. 2023 May 2;9(5):e15967. doi: 10.1016/j.heliyon.2023.e15967. eCollection 2023 May.

Abstract

BACKGROUND

This study evaluated the association between renal function, assessed by serum creatinine and estimated glomerular filtration rate (eGFR) according to the Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) equations, and bone mineral density (BMD) in Chinese patients with type 2 diabetes mellitus (T2DM).

METHODS

1322 patients with T2DM were included, and their basic clinical information, serum biochemical tests, and BMD at the total hip and femur neck were collected. Multivariate adjusted linear regression, smooth curve fitting and a piecewise linear regression model were used to analyze linear and nonlinear associations. Age, BMI, drinking, smoking, systolic blood pressure and diastolic blood pressure, FBG, HbA1C, course of diabetes, hsCRP, TC, TG, HDL-C, LDL-C, Ca, P, PTH, ALP, OC, P1NP, β-CTX and 25(OH)D were adjusted.

RESULTS

After adjusting the variables, no correlation between eGFR CG and eGFR MDRD and femur neck BMD was observed in women, men, or the total population. The eGFR CG and eGFR MDRD had a significant positive association with total hip BMD in men and the total population with T2DM. With a 10-unit decrease in eGFR CG, total hip BMD reduced by 0.012 g/cm in men and 0.010 g/cm the total population. Total hip BMD reduced by 0.014 g/cm in men and 0.022 g/cm in the total population with a 10-unit decrease in eGFR MDRD. There was no correlation between eGFR CG or eGFR MDRD and total hip BMD in female participants.

CONCLUSION

Impaired renal function was associated with decreased total hip BMD in men and the total population with T2DM. No associated between renal function with femur neck BMD was observed.

摘要

背景

本研究评估了根据Cockcroft-Gault(CG)和肾脏病饮食改良(MDRD)公式通过血清肌酐和估算肾小球滤过率(eGFR)评估的肾功能与中国2型糖尿病(T2DM)患者骨密度(BMD)之间的关联。

方法

纳入1322例T2DM患者,收集其基本临床信息、血清生化检查结果以及全髋和股骨颈的骨密度。采用多变量调整线性回归、平滑曲线拟合和分段线性回归模型分析线性和非线性关联。对年龄、体重指数、饮酒、吸烟、收缩压和舒张压、空腹血糖、糖化血红蛋白、糖尿病病程、高敏C反应蛋白、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、钙、磷、甲状旁腺激素、碱性磷酸酶、骨钙素、I型前胶原氨基端前肽、β-交联羧基端肽和25(羟)维生素D进行了调整。

结果

调整变量后,在女性、男性或总体人群中,未观察到eGFR CG和eGFR MDRD与股骨颈骨密度之间存在相关性。eGFR CG和eGFR MDRD与男性和T2DM总体人群的全髋骨密度呈显著正相关。eGFR CG每降低10个单位,男性全髋骨密度降低0.012g/cm,总体人群降低0.010g/cm。eGFR MDRD每降低10个单位,男性全髋骨密度降低0.014g/cm,总体人群降低0.022g/cm。在女性参与者中,eGFR CG或eGFR MDRD与全髋骨密度之间无相关性。

结论

肾功能受损与男性和T2DM总体人群的全髋骨密度降低有关。未观察到肾功能与股骨颈骨密度之间存在关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc77/10195895/2432b8f20cbc/gr1.jpg

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