[1]刘 纳,李玉兰,许明芳,等.2型糖尿病临床期肾病与骨密度及骨代谢标记物的相关性研究[J].医学信息,2020,33(08):70-72.[doi:10.3969/j.issn.1006-1959.2020.08.023]
　LIU Na,LI Yu-lan,XU Ming-fang,et al.Study on the Relationship Between Bone Mineral Density and Bone Metabolism Markers in Stage IV Nephropathy of Type 2 Diabetes Mellitus[J].Medical Information,2020,33(08):70-72.[doi:10.3969/j.issn.1006-1959.2020.08.023]
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2型糖尿病临床期肾病与骨密度及骨代谢标记物的相关性研究()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年08期
页码:
70-72
栏目:
论著
出版日期:
2020-04-15

文章信息/Info

Title:
Study on the Relationship Between Bone Mineral Density and Bone Metabolism Markers in Stage IV Nephropathy of Type 2 Diabetes Mellitus
文章编号:
1006-1959（2020）08-0070-03
作者:
刘 纳; 李玉兰; 许明芳; 等
（广西柳州市人民医院内分泌科，广西 柳州 545000）
Author(s):
LIU Na; LI Yu-lan; XU Ming-fang; et al
(Department of Endocrinology,Liuzhou People’s Hospital,Liuzhou 545000,Guangxi,China)
关键词:
2型糖尿病; 糖尿病肾病Ⅳ期; 骨质疏松症; 骨代谢标记物
Keywords:
Type 2 diabetes; Diabetic nephropathy stage IV; Osteoporosis; Bone metabolism markers
分类号:
587.2；R692.9
DOI:
10.3969/j.issn.1006-1959.2020.08.023
文献标志码:
A
摘要:
目的 分析2型糖尿病Ⅳ期肾病与骨密度及骨代谢标志物[（25-羟维生素D2、D3，（25-（OH）D2、D3]、甲状旁腺激素（PTH）、总1型胶原氨基端延长肽（P1NP）、β-胶原降解产物（β-CTX）]水平的关系。方法 选取2019年1月~10月我院收治的120例确诊为2型糖尿病患者，依据尿微量白蛋白/肌酐比值（UAER）将其分为单纯糖尿病（DM）组、2型糖尿病Ⅳ期肾病（DN）组，各60例，检测两组血Ca2+、P、25-（OH）D2、D3、PTH、P1NP、β-CTX及BMD的水平，比较两组骨量减少及骨质疏松的发病率及影响因素。结果 两组BMI、HbA1c、血Ca2+、P比较，差异无统计学意义（P＞0.05）；DN组PTH、P1NP、β-CTX高于DM组、25-（OH）D2、D3低于DM组，差异有统计学意义（P＜0.05）；DN组骨量减少及骨质疏松发病率高于DM组，差异有统计学意义（P＜0.05）。Logistic回归分析显示，25-（OH）D2、25-（OH）D3[OR=0.78，95%CI：0.01~0.58；OR=0.879，95%CI：0.802~0.964]是DN的保护因素。结论 2型糖尿病Ⅳ期肾病患者可发生骨密度变化和骨转化加速，而骨转化加速可发生在骨密度变化之前。因此，在2型糖尿病Ⅳ期肾病监测骨代谢指标非常重要。
Abstract:
Objective To analyze type 2 diabetes stage Ⅳ nephropathy and bone mineral density and bone metabolism markers [(25-hydroxyvitamin D2,D3,(25-（OH）D2,D3], parathyroid hormone (PTH), total type 1 collagen amino acid terminal prolongation Peptide (P1NP) and β-collagen degradation products (β-CTX)] levels.Methods From January to October 2019, 120 patients diagnosed with type 2 diabetes in our hospital were selected and divided into simple diabetes (DM) group based on urine microalbumin/creatinine ratio (UAER),the levels of blood Ca2+,P,25-（OH）D2,D3、PTH,P1NP,β-CTX and BMD were measured in 60 cases of type 2 diabetic stage IV nephropathy (DN) group and the incidence and influencing factors of osteopenia and osteoporosis were compared.Results There was no significant difference in BMI, HbA1c, blood Ca2+, P between the two groups(P>0.05); PTH, P1NP, β-CTX in DN group were higher than DM group, 25-OH-D was lower than DM group,the difference was statistically significant(P<0.05); the bone mass reduction and osteoporosis incidence in the DN group was higher than that in the DM group,the difference was statistically significant(P<0.05).Logistic regression analysis showed that 25-（OH）D2 and 25-（OH）D3 [OR=0.780,95%CI:0.010~0.580;OR=0.879,95%CI: 0.802~0.964] are the protective factors of DN.Conclusion Type 2 diabetes with stage Ⅳ nephropathy patients can have changes in bone density and accelerated bone transformation, and accelerated bone transformation can occur before changes in bone density. Therefore, it is very important to monitor bone metabolism indexes in type 2 diabetes stage IV nephropathy.

参考文献/References:

[1]Liu J,Curtis EM,Cooper C,et al.State of the art in osteoporosis risk assessment and treatment[J].Journal of Endocrinological Investigation,2019.[2]Conserva F,Gesualdo L,Papale M.A Systems Biology Overview on Human Diabetic Nephropathy:From Genetic Susceptibility to Post-Transcriptional and Post-Translational Modifications[J].Experimental Diabesity Research,2016 (2016):7934504.[3]Picke AK,Campbell G,Napoli N,et al.Update on the impact of type 2 diabetes mellitus on bone metabolism and material properties[J].Endocrine Connections,2019,8(3):R55-R70.[4]Kazama JJ,Matsuo K,Iwasaki Y,et al.Chronic kidney disease and bone metabolism[J].Journal of Bone&Mineral Metabolism,2015,33(3):245-252.[5]陈巧云,鄢新民,胡继红,等.糖尿病合并骨质疏松与糖尿病微血管并发症的相关性研究[J].中国骨质疏松杂志,2017,23(3):411-415.[6]Wongdee K,Charoenphandhu N.Update on type 2 diabetes-related osteoporosis[J].World J Diabetes,2015,6(5):673-678.[7]Ardeshir M,Mahmoud M,Seyedeh M,et al.Fracture risk in patients with type 2 diabetes mellitus and possible risk factors:a systematic review and meta-analysis[J].Therapeutics&Clinical Risk Management,2017(13):455-468.[8]Epstein S,Defeudis G,Manfrini S,et al.Diabetes and disordered bone metabolism(diabetic osteodystrophy):time for recognition[J].Osteoporosis International,2016,27(6):1931-1951.[9]蓝海云.微血管并发症与2型糖尿病患者骨质疏松的关系[J].内科,2016,11(3):383-385.[10]Lim Y,Chun S,Lee JH,et al.Association of bone mineral density and diabetic retinopathy in diabetic subjects:the 2008–2011 Korea National Health and Nutrition Examination Survey[J].Osteoporosis International,2016,27(7):2249-2257.[11]Eshraghian A.Bone metabolism in non-alcoholic fatty liver disease:vitamin D status and bone mineral density[J].Minerva Endocrinol,2017,42(2):164-172.[12]张萌萌,张秀珍,周惠琼.骨代谢生化指标临床应用专家共识(2019)[J].中国骨质疏松杂志,2019,25(10):1357-1372.[13]迟海燕.周玉萍.2型糖尿病肾病不同分期骨代谢物和骨密度的变化[J].山西医药杂志,2016,45(13):1574-1576.[14]周宏,邓小华.不同分期2型糖尿病肾病患者骨密度及骨代谢水平变化及临床意义[J].中国现代医药杂志,2018,20(07):27-30.[15]Chaiban JT,Nicolas KG.Diabetes and Bone:Still a Lot to Learn[J].Clinical Reviews in Bone&Mineral Metabolism,2015,13(1):20-35.

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更新日期/Last Update: 2020-04-15