2型糖尿病老年患者中血清Fetuin-A水平与骨密度及骨代谢标志物相关性研究

发布时间：2018-12-15 17:53

【摘要】：目的：探索2型老年糖尿病(T2DM)患者血清中fetuin-A水平与骨密度(BMD)、骨代谢标志物的相关性及其相关性是否存在性别差异。方法：以103例老年T2DM患者(女性48例,男性55例)为研究对象进行横断面研究,采用夹心酶联免疫吸附法检测血清fetuin-A水平；BMD采用双能X线吸收测定法(DEXA)测定腰椎L2-4及股骨两个部位的BMD值。受试者均进行骨代谢指标、性激素血清水平及其他临床指标检测。利用偏性相关性分析评估血清fetuin-A与骨密度、骨代谢标志物及性激素等其他临床指标的相关性。结果：血清fetuin-A水平在老年T2DM患者中不存在性别差异。老年男性的腰椎及股骨总骨密度值均高于老年女性；同时老年女性T2DM患者中的骨代谢指标均高于老年男性T2DM患者,两者均存在统计学意义(P0.05)。双变量相关性分析显示在老年男性T2DM患者中,血清fetuin-A与β-CTX呈负相关性(r=-0.307,P=0.024,95%置信区间-0.620,0.077),而与两个部位的骨密度及相应的T值均无相关性；老年女性T2DM患者中,血清fetuin-A与股骨颈总骨密度呈负相关性(r=-0.336,P=0.020,95%置信区间-0.563,-0.084),而与腰椎总骨密度、腰椎T值及股骨T值均无相关性。控制年龄、腰围、BMI、糖尿病病程、大小血管病变、C肽、HOMA-IR、CRP、PTH、HbA1c、eGFR、纠正后总血钙、脂肪肝、E2、FTI及SHBG影响因素后,在老年男性患者中,血清fetuin-A与β-CTX相关性仍存在(r=-0.348,P=0.047)；而在老年女性中,血清fetuin-A与股骨总密度相关性无统计学意义(r=-0.279,P=0.152)。该研究未发现老年T2DM患者中血清fetuin-A与E2、T、FTI及SHBG水平存在相关性。总结：该研究结果提示血清中fetuin-A在骨骼低转化状态下存在促进生理性矿化的作用。
[Abstract]:Objective: to investigate the relationship between serum fetuin-A level and bone metabolism markers of bone mineral density (BMD),) in elderly patients with type 2 diabetes mellitus (T2DM). Methods: a cross-sectional study was conducted in 103 elderly patients with T2DM (48 female and 55 male). Serum fetuin-A levels were measured by sandwich enzyme linked immunosorbent assay (Elisa). BMD was used to measure the BMD values of L2-4 and femur by dual energy X-ray absorptiometry (DEXA). Bone metabolism index, sex hormone serum level and other clinical indexes were measured. The correlation between serum fetuin-A and bone mineral density (BMD), bone metabolism markers and sex hormones was evaluated by partial correlation analysis. Results: there was no gender difference in serum fetuin-A level in elderly patients with T2DM. The total bone mineral density of lumbar vertebrae and femur in elderly men was higher than that in elderly women, and the bone metabolism indexes in elderly women with T2DM were higher than those in elderly men with T2DM (P0.05). Bivariate correlation analysis showed that serum fetuin-A was negatively correlated with 尾-CTX in elderly male patients with T2DM (r-0.307), the 95% confidence interval (-0.620 ~ 0.077). There was no correlation with bone mineral density (BMD) and T value of the two sites. In elderly women with T2DM, there was a negative correlation between serum fetuin-A and total femoral neck bone mineral density (r-0.336), but there was no correlation between serum fetuin-A and total lumbar bone mineral density, lumbar T value and femoral T value. Control of age, waist circumference, course of BMI, diabetes, angiopathy, C peptide, total serum calcium after HOMA-IR,CRP,PTH,HbA1c,eGFR, correction, fatty liver, E2T FTI and SHBG influencing factors in elderly male patients, There was still a correlation between serum fetuin-A and 尾-CTX (r-0.348 P0.047). However, there was no significant correlation between serum fetuin-A and total femoral density in elderly women (r = -0.279, P = 0.152). In this study, no correlation was found between serum fetuin-A and E _ 2 ~ (2 +) T _ (TO) FTI and SHBG levels in elderly patients with T2DM. Conclusion: the results suggest that fetuin-A in serum may promote physiologic mineralization in the condition of low bone transformation.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1

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