| 马凌云,刘德峰,宋佳桐,卞伟煜,李文东,迟秀娥,韩中千.2型糖尿病合并骨质疏松症患者外周血炎性因子表达与骨代谢、骨密度丢失的关系[J].,2024,(8):1560-1565 |
| 2型糖尿病合并骨质疏松症患者外周血炎性因子表达与骨代谢、骨密度丢失的关系 |
| The Relationship between Peripheral Blood Inflammatory Factors Expression and Bone Metabolism, Bone DensityLoss in Patients with Type 2 Diabetes Mellitus Complicated with Osteoporosis |
| 投稿时间：2023-09-23 修订日期：2023-10-17 |
| DOI：10.13241/j.cnki.pmb.2024.08.031 |
| 中文关键词: 2型糖尿病 骨质疏松症 炎性因子 骨代谢 骨密度 |
| 英文关键词: Type 2 diabetes mellitus Osteoporosis Inflammatory factors Bone metabolism Bone density |
| 基金项目:河北省中医药管理局科研计划项目（2021351） |
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| 中文摘要: |
| 摘要 目的：探讨2型糖尿病合并骨质疏松症患者外周血中炎性因子NLR、IL-1β、TNF-α与骨代谢指标骨密度、活性维生素D、PTH、ALP及生化指标FPG、2hPG、HbA1c、空腹C肽、BMI、血脂、血尿酸之间的关系，为该类患者的诊断和治疗提供参考。方法：选取2020年9月至2021年9月在本院内分泌科就诊的2型糖尿病合并骨质疏松症患者80例作为观察组，同时选取同期健康体检者80例作为对照组。比较两组患者的一般资料，采用ELISA法检测两组患者外周血中NLR、IL-1β、TNF-α的水平，采用双能X线吸收法（DEXA）检测两组患者的骨密度，采用放射免疫法检测两组患者外周血中活性维生素D、PTH的水平，采用生化分析仪检测两组患者外周血中ALP、FPG、2hPG、HbA1c、空腹C肽、BMI、血脂、血尿酸的水平。结果：观察组患者外周血中NLR、IL-1β、TNF-α的水平均高于对照组（P<0.05），观察组患者骨密度低于对照组（P<0.05），观察组患者外周血中活性维生素D水平低于对照组（P<0.05），观察组患者外周血中PTH水平高于对照组（P<0.05），观察组患者外周血中ALP水平高于对照组（P<0.05），观察组患者外周血中FPG、2hPG、HbA1c水平高于对照组（P<0.05），观察组患者空腹C肽水平低于对照组（P<0.05），观察组患者BMI高于对照组（P<0.05），观察组患者血脂异常率高于对照组（P<0.05），观察组患者血尿酸水平高于对照组（P<0.05）。观察组患者外周血中NLR、IL-1β、TNF-α与骨密度呈负相关（P<0.05），与活性维生素D呈负相关（P<0.05），与PTH、ALP呈正相关（P<0.05），与FPG、2hPG、HbA1c、空腹C肽、BMI、血脂、血尿酸无显著相关性（P>0.05）。结论：2型糖尿病合并骨质疏松症患者外周血中炎性因子NLR、IL-1β、TNF-α水平升高，可能与骨代谢紊乱和骨密度丢失有关，提示该类患者存在慢性低度炎症状态，应加强对其骨代谢和骨密度的监测和干预，以降低骨折风险和改善生活质量。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the relationship between peripheral blood inflammatory factors NLR, IL-1β, TNF-α and bone metabolism indicators bone density, active vitamin D, PTH, ALP and biochemical indicators FPG, 2hPG, HbA1c, fasting C-peptide, BMI, blood lipids, blood uric acid in patients with type 2 diabetes mellitus complicated with osteoporosis, and to provide reference for the diagnosis and treatment of such patients. Methods: 80 patients with type 2 diabetes mellitus complicated with osteoporosis who visited the endocrinology department of our hospital from September 2020 to September 2021 were selected as the observation group, and 80 healthy physical examination subjects in the same period were selected as the control group. The general data of the two groups of patients were compared. The levels of NLR, IL-1β and TNF-α in peripheral blood of the two groups of patients were detected by ELISA method. The bone density of the two groups of patients was detected by dual-energy X-ray absorptiometry (DEXA). The levels of active vitamin D and PTH in peripheral blood of the two groups of patients were detected by radioimmunoassay. The levels of ALP, FPG, 2hPG, HbA1c, fasting C-peptide, BMI, blood lipids and blood uric acid in peripheral blood of the two groups of patients were detected by biochemical analyzer. Results: The levels of NLR, IL-1β and TNF-α in peripheral blood of the observation group were higher than those of the control group (P<0.05). The bone density of the observation group was lower than that of the control group (P<0.05). The level of active vitamin D in peripheral blood of the observation group was lower than that of the control group (P<0.05). The level of PTH in peripheral blood of the observation group was higher than that of the control group (P<0.05). The level of ALP in peripheral blood of the observation group was higher than that of the control group (P<0.05). The levels of FPG, 2hPG and HbA1c in peripheral blood of the observation group were higher than those of the control group (P<0.05). The level of fasting C-peptide in peripheral blood of the observation group was lower than that of the control group (P<0.05). The BMI of the observation group was higher than that of the control group (P<0.05). The abnormal rate of blood lipids in the observation group was higher than that of the control group (P<0.05). The level of blood uric acid in the observation group was higher than that of the control group (P<0.05). The levels of NLR, IL-1β and TNF-α in peripheral blood of the observation group were negatively correlated with bone density (P<0.05) and active vitamin D (P<0.05), and positively correlated with PTH and ALP (P<0.05). There was no significant correlation between NLR, IL-1β and TNF-α in peripheral blood of the observation group and FPG, 2hPG, HbA1c, fasting C-peptide, BMI, blood lipids and blood uric acid (P>0.05). Conclusion: The levels of inflammatory factors NLR, IL-1β and TNF-α in peripheral blood of patients with type 2 diabetes mellitus complicated with osteoporosis are elevated, which may be related to bone metabolism disorder and bone density loss. It suggests that such patients have chronic low-grade inflammation state, and should strengthen the monitoring and intervention on their bone metabolism and bone density, so as to reduce the risk of fracture and improve their quality of life. |
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