| 冯 燕,李 萌,杨建成,唐清华,师 杰,李青梅,曾玉红.2型糖尿病合并骨质疏松症患者骨代谢标志物的特点及发病危险因素分析[J].,2024,(16):3098-3102 |
| 2型糖尿病合并骨质疏松症患者骨代谢标志物的特点及发病危险因素分析 |
| Characteristics of Bone Metabolic Markers and Risk Factors in Type 2 Diabetes Patients with Osteoporosis |
| 投稿时间：2024-01-05 修订日期：2024-01-28 |
| DOI：10.13241/j.cnki.pmb.2024.16.019 |
| 中文关键词: 2型糖尿病 骨质疏松症 骨代谢标志物 危险因素 骨钙素 |
| 英文关键词: Type 2 diabetes Osteoporosis Bone metabolism markers Risk factors osteocalcin |
| 基金项目:陕西省重点研发计划项目（2023-YBSF-360） |
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| 中文摘要: |
| 摘要 目的：分析2型糖尿病合并骨质疏松症患者骨代谢标志物的变化特点，并分析发病危险因素。方法：选取我院2022年1月到2022年12月收治的80例2型糖尿病合并骨质疏松症患者作为研究对象，将其分为骨质疏松组，选取同期我院收治的80例2型糖尿病非骨质疏松患者作为非骨质疏松组，另选取同期来我院体检的80名健康志愿者作为对照组。对比三组受检者骨代谢标志物表达水平，并以双能X线吸收法作为诊断骨质疏松的"金标准"，建立受试者工作特征（ROC）曲线，分析相关骨代谢标志物对2型糖尿病合并骨质疏松症的诊断临界值。最后分析发病危险因素。结果：三组受检者碱性磷酸酶（ALP）、血磷（P）、血钙（Ca）水平对比无显著差异（P＞0.05），三组受检者尿1型胶原C端肽（CTX-1）、骨钙素、甲状旁腺激素（PTH）对比差异显著，骨质疏松组CTX-1、PTH明显高于非骨质疏松组及对照组，骨钙素较非骨质疏松组及对照组低（P＜0.05）；CTX-1对2型糖尿病合并骨质疏松症的诊断临界值为525.74 μg/mmoL Cr，灵敏度83.35%、特异性67.95%，骨钙素的诊断临界值为14.12 ng/L，灵敏度81.27%、特异性79.46%，PTH的诊断临界值为45.75 pmol/L，灵敏度74.84%、特异性81.36%；骨质疏松组与非骨质疏松组患者性别、糖尿病病程、合并其他基础疾病、周围神经病变、空腹血糖对比无明显差异（P＞0.05），骨质疏松组与非骨质疏松组患者年龄、BMI、周围血管病变、糖尿病肾病、视网膜病变、糖化血红蛋白、CTX-1、骨钙素、PTH水平对比差异显著（P＜0.05）；年龄、糖尿病肾病、视网膜病变、糖化血红蛋白、CTX-1、骨钙素、PTH为2型糖尿病合并骨质疏松症的独立危险因素（P＜0.05）。结论：2型糖尿病合并骨质疏松症患者CTX-1、PTH水平升高，骨钙素降低，三者对2型糖尿病合并骨质疏松症的临床诊断可提供重要参考意见，且年龄、糖尿病肾病、视网膜病变、糖化血红蛋白、CTX-1、骨钙素、PTH为2型糖尿病合并骨质疏松症的独立危险因素。 |
| 英文摘要: |
| ABSTRACT Objective: To analyse the changes of bone metabolic markers in type 2 diabetes patients with osteoporosis, and analyze the risk factors. Methods: Eighty patients with type 2 diabetes and osteoporosis admitted to our hospital from January 2022 to December 2022 were selected as the research objects, and they were divided into osteoporosis group. Eighty patients with type 2 diabetes and non osteoporosis admitted to our hospital in the same period were selected as the non osteoporosis group, and 80 healthy volunteers who came to our hospital for physical examination in the same period were selected as the control group. The expression level of bone metabolic markers in three groups of subjects was compared, and dual energy X-ray absorptiometry was used as the "gold standard" for the diagnosis of osteoporosis. The ROC curve of subjects was established, and the critical value of related bone metabolic markers for the diagnosis of type 2 diabetes with osteoporosis was analyzed. Finally, the disease risk factors were analyzed. Results: There was no significant difference in the levels of alkaline phosphatase (ALP), blood phosphorus (P), and calcium (Ca) among the three groups of subjects (P>0.05). However, there were differences in the levels of urinary type 1 collagen C-terminal peptide (CTX-1), osteocalcin, and parathyroid hormone (PTH) among the three groups of subjects. There were also differences in the levels of CTX-1, osteocalcin, and parathyroid hormone (PTH) among the three groups of subjects PTH was higher than that of the non osteoporosis group and control group, while osteocalcin was lower than that of the non osteoporosis group and control group(P<0.05); The critical value of CTX-1 for the diagnosis of type 2 diabetes with osteoporosis was 525.74 μg/mmoL Cr, the sensitivity was 83.35%, the specificity was 67.95%, the critical value of osteocalcin was 14.12ng/L, the sensitivity was 81.27%, the specificity was 79.46%, and the critical value of PTH was 45.75 pmol/L, the sensitivity was 74.84%, the specificity was 81.36%; There was no difference between the osteoporosis group and the non osteoporosis group in terms of gender, duration of diabetes, combined with other basic diseases, peripheral neuropathy, and fasting blood glucose (P>0.05). There were differences between the osteoporosis group and the non osteoporosis group in terms of age, BMI, peripheral vascular disease, diabetes nephropathy, retinopathy, glycosylated hemoglobin, CTX-1, osteocalcin, and PTH levels(P<0.05); Age, diabetes nephropathy, retinopathy, glycosylated hemoglobin, CTX-1, osteocalcin, PTH were independent risk factors for type 2 diabetes with osteoporosis (P<0.05). Conclusion: The levels of CTX-1 and PTH in type 2 diabetes patients with osteoporosis increase and osteocalcin decreases. The three can provide important reference for the clinical diagnosis of type 2 diabetes patients with osteoporosis. Age, diabetes nephropathy, retinopathy, glycosylated hemoglobin, CTX-1, osteocalcin and PTH are independent risk factors for type 2 diabetes patients with osteoporosis. |
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