血清铁蛋白与 2 型糖尿病合并非酒精性脂肪性肝病患者骨转换标志物水平的相关性。
Association between serum ferritin and bone turnover marker levels in type 2 diabetes mellitus patients with non-alcoholic fatty liver disease.
机构信息
The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China.
Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
出版信息
Postgrad Med. 2024 Apr;136(3):292-301. doi: 10.1080/00325481.2024.2333718. Epub 2024 Mar 25.
OBJECTIVE
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).
METHODS
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.
RESULTS
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)].
CONCLUSION
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.
目的
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。
方法
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。
结果
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）]。
结论
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。
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