The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China.
Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
Postgrad Med. 2024 Apr;136(3):292-301. doi: 10.1080/00325481.2024.2333718. Epub 2024 Mar 25.
To investigate the correlation between serum ferritin (SF) and bone turnover markers in type 2 diabetes mellitus (T2DM) patients with non-alcoholic fatty liver disease (NAFLD).
Seven hundred and forty-two people with T2DM were selected. Serum bone turnover markers: osteocalcin (OC), type I procollagen N-terminal peptide (PINP), β-I type collagen carboxy-terminal peptide (β-CTx), and 25-hydroxyvitamin D3 (25-[OH]-D) levels were detected. High SF (HF) was defined as the indicated SF levels above 400 ng/mL in males and more than 150 ng/mL in females. Patients were divided into four groups: T2DM+normal SF (non-HF); T2DM+high SF (HF); T2DM+NAFLD+non-HF; andT2DM+NAFLD+HF. Relationships between SF and bone turnover markers were analyzed.
Compared with the T2DM+non-HF group, β-CTx levels were higher in the T2DM+HFgroup. Compared with the T2DM+NAFLD+non-HF group, β-CTx levels were increased and 25-(OH)-D levels decreased in the T2DM+NAFLD+HF group (all < 0.05). SF was positively correlated with β-CTx [β = 0.074; 95% CI (0.003, 0.205)] and negatively correlated with 25-(OH)-D [β=-0.108; 95%CI (-0.006, -0.001)]. Compared with the T2DM+non-HF group, an independent positive correlation was found between β-CTx and SF in the T2DM+NAFLD+HF group [OR = 1.002; 95% CI (1.001, 1.004)]. Among males, SF was positively correlatedwith β-CTx [β = 0.114; 95% CI (0.031, 0.266)]. SF was negatively correlated with 25-(OH)-D levels in both male and female patients [β=-0.124; 95% CI (0.007,0.001) and β=-0.168; 95% CI (-0.012, -0.002)]. Among those >50 years of age and postmenopausal females, SF was negatively correlated with 25-(OH)-D levels [β=-0.117; 95% CI (-0.007, -0.001) and β=-0.003; 95% CI (-0.013, -0.003)].
SF level was positively correlated with β-CTx in T2DM patients with NAFLD, which may promote bone resorption and increase the risk of bone loss.
探讨 2 型糖尿病（T2DM）合并非酒精性脂肪性肝病（NAFLD）患者血清铁蛋白（SF）与骨转换标志物的相关性。
选取 742 例 T2DM 患者，检测血清骨转换标志物：骨钙素（OC）、I 型前胶原 N 端肽（PINP）、β-Ⅰ型胶原羧基端肽（β-CTX）和 25-羟维生素 D3（25-（OH）-D）水平。高 SF（HF）定义为男性 SF 水平高于 400ng/ml，女性 SF 水平高于 150ng/ml。将患者分为四组：T2DM+正常 SF（非 HF）；T2DM+高 SF（HF）；T2DM+NAFLD+非 HF；和 T2DM+NAFLD+HF。分析 SF 与骨转换标志物之间的关系。
与 T2DM+非 HF 组相比，T2DM+HF 组β-CTX 水平升高。与 T2DM+NAFLD+非 HF 组相比，T2DM+NAFLD+HF 组β-CTX 水平升高，25-（OH）-D 水平降低（均<0.05）。SF 与β-CTX 呈正相关[β=0.074；95%置信区间（0.003，0.205）]，与 25-（OH）-D 呈负相关[β=-0.108；95%置信区间（-0.006，-0.001）]。与 T2DM+非 HF 组相比，T2DM+NAFLD+HF 组β-CTX 与 SF 之间存在独立的正相关[OR=1.002；95%置信区间（1.001，1.004）]。在男性中，SF 与β-CTX 呈正相关[β=0.114；95%置信区间（0.031，0.266）]。SF 与男性和女性患者的 25-（OH）-D 水平均呈负相关[β=-0.124；95%置信区间（0.007，0.001）和β=-0.168；95%置信区间（-0.012，-0.002）]。在年龄>50 岁和绝经后女性中，SF 与 25-（OH）-D 水平呈负相关[β=-0.117；95%置信区间（-0.007，-0.001）和β=-0.003；95%置信区间（-0.013，-0.003）]。
T2DM 合并 NAFLD 患者 SF 水平与β-CTX 呈正相关，可能促进骨吸收，增加骨丢失风险。
