中国医学创新2019，Vol.16Issue(2)：42-46,5.DOI:10.3969/j.issn.1674-4985.2019.02.011
基于肠促胰素效应的2型糖尿病骨代谢异常的致病机制探究
The Pathogenic Mechanism of Bone Metabolism Abnormality in Type 2 Diabetes Based on the Effect of Incretin
摘要
Abstract
Objective:To investigate the mechanism of bone metabolism abnormality in type 2 diabetic patients based on the effect of incretin.Method:A total of 210 patients with type 2 diabetes admitted to our hospital from January 2016 to June 2017 were selected.There were 104 cases in the with abnormal bone metabolism (osteopenia/osteoporosis) group and 106 cases in the without abnormal bone metabolism group.Detection of general biochemical indicators such as liver and kidney function of patients glycosylated hemoglobin (HbA1c), the indexes of bone metabolism include: (1) biochemical indexes of calcium and phosphorus metabolism:blood calcium and phosphorus. (2) bone metabolism regulation hormone:parathyroid hormone (PTH), 25 hydroxyvitamin D3[25- (OH) VD3]. (3) biochemical indexes of bone formation:n-terminal osteocalcin (N-BGP), type I procollagen n-terminal propeptide (PINP).Biochemical parameters of bone resorption:c-terminal peptide crosslinked with collagen beta type Ⅰ (β-CTX).The glucose tolerance test of 2 steamed buns was conducted to determine fasting and postprandial blood glucose, as well as Insulin and Incretin (GIP, GLP-1 and GLP-2).Result:The HbA1 C, PTH, β-CTX of type 2 diabetes mellitus with bone metabolism abnormality group were significantly higher than those of type 2 diabetes mellitus without bone metabolism abnormality group, 25- (OH) VD3, N-BGP and PINP were lower than those of type 2 diabetes mellitus without abnormal bone metabolism group, the differences were statistically significant (P＜0.05).There were no statistically significant differences in serum calcium and phosphorus between the two groups (P＞0.05).Both groups had elevated blood glucose at fasting and 1, 2 h after meal.Insulin, GIP, GLP-1, GLP-2 increased first and then decreased;the blood glucose of type 2 diabetes mellitus with abnormal bone metabolism group was higher than that of type 2 diabetes mellitus without abnormal bone metabolism group at the same time, however, Insulin, GIP, GLP-1, GLP-2 were lower than those of type 2 diabetes mellitus without abnormal bone metabolism group, the differences were statistically significant (P＜0.05).Conclusion:Incretin regulates osteoblast and osteoclast function, Insulin and Incretin levels decrease, bone resorption increases, and bone formation decreases in type 2 diabetes patients, which may be related to abnormal bone metabolism (osteoporosis or osteopenia) in patients.关键词
肠促胰素效应/2型糖尿病/骨代谢异常Key words
Incretin effect/Type 2 diabetes/Bone metabolism abnormality引用本文复制引用
刘虹丽,张帆,洪小瑜,戴亚丽,卢东晖,韩令川,吴佩娴,彭卫群,林秋讯..基于肠促胰素效应的2型糖尿病骨代谢异常的致病机制探究[J].中国医学创新,2019,16(2):42-46,5.基金项目
深圳市卫生计生委2015年重点学科建设能力提升项目(201506039) （201506039）
