男性2型糖尿病患者血清白蛋白水平与骨密度关系的研究OA北大核心CSTPCD
Correlation between serum albumin level and bone mineral density in male patients with type 2 diabetes
目的 探讨50岁以上男性2型糖尿病(diabetes mellitus type 2,T2DM)患者血清白蛋白(albu-min,ALB)水平与骨密度(bone mineral density,BMD)的相关性.方法 选取 2021 年 7 月～2022 年 3 月兰州大学第一医院内分泌科住院的202例50 岁以上男性T2DM患者及体检中心的 30 名男性健康对照者,根据血清ALB水平将T2DM患者分为3组:低ALB水平组(T1组,＜40.0 g/L),ALB水平在正常范围者再根据二分位数水平分为两组,即T2组(40.0～43.3 g/L)和T3 组(43.4～51.0 g/L),比较 3 组T2DM患者不同部位BMD水平和骨质疏松(osteoporosis,OP)/骨量减少患病率的差异,Pearson相关性分析血清ALB与不同部位BMD之间的相关性,多元线性回归分析血清ALB水平与不同部位BMD的独立相关性.结果 T3组全髋和L2～L4的BMD水平显著高于T1组(均P＜0.05).T2组L2～L4的BMD水平显著高于T1组(P＜0.05).T3组L2～L4的OP/骨量减少的患病率显著低于T1组(8.9%vs.25.0%,P＜0.05).血清ALB水平与全髋和L2～L4 的BMD水平呈正相关(r=0.204、0.143,均P＜0.05).多元线性回归分析显示,调整年龄、体质量指数(body mass index,BMI)、肾小球滤过率(estimated glomerular filtration rate,eGFR)、血清游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、促甲状腺激素(thyroid-stimulating hormone,TSH)、γ-谷氨酰转移酶(γ-glutamyl transferase,GGT)、乳酸脱氢酶(lactate dehydrogenase,LDH)、肌酸激酶(creatine kinase,CK)、天冬氨酸转氨酶(aspartate transaminase,AST)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、钙(calcium,Ca)、磷(phosphorus,P)、尿酸(uric acid,UA)及尿白蛋白排泄率(urinary albumin excretion rates,UAER)等混杂因素后,血清ALB水平与全髋的BMD水平独立正相关(β=0.229,95%CI:0.000～0.019).结论 50岁以上男性T2DM患者血清ALB水平与BMD密切相关,中老年男性T2DM患者应该早期关注血清ALB水平的变化,为OP的防治提供线索.
Objective To investigate the correlation between serum albumin(ALB)level and bone mineral density(BMD)in male patients with type 2 diabetes mellitus(T2DM)over 50 years old.Methods Totally 202 male T2DM patients over 50 years old hospitalized in the Department of Endocrinology of The First Hospital of Lanzhou Univer-sity and 30 male healthy controls from the physical examination center were selected from July 2021 to March 2022,and the T2DM patients were divided into three groups according to the level of serum ALB.Group T1 was low serum ALB lev-el group(serum ALB level＜40.0 g/L).Patients with normal serum ALB level were divided into two groups by the di-chotomy as T2 group(serum ALB level 40.0-43.3 g/L)and T3 group(serum ALB level 43.4-51.0 g/L).The BMD levels in various parts of body and the prevalence of osteoporosis(OP)/osteopenia among the three groups were com-pared,Pearson correlation analysis was used to analyze the correlation between serum ALB and BMD,and multiple lin-ear regression analysis was used to analyze the independent correlation between serum ALB level and BMD.Results The BMD at total hip and the second to fourth lumbar vertebrae(L2-L4)in the T3 group were significantly higher than those in the T1 group(all P＜0.05).The BMD at L2-L4 in the T2 group was significantly higher than that in the T1 group(P＜0.05).The prevalence of OP and osteopenia in L2-L4 in the T3 group were significantly lower than that of T1 group(8.9%vs.25.0%,P＜0.05).Serum ALB levels were positively correlated with BMD at total hip and L2-L4(r=0.204,0.143;all P＜0.05).Multiple linear regression analysis showed that after adjusting for age,body mass in-dex(BMI),estimated glomerular filtration rate(eGFR),serum free triiodothyronine(FT3),thyroid-stimulating hor-mone(TSH),γ-glutamyl transferase(GGT),lactate dehydrogenase(LDH),creatine kinase(CK),aspartate trans-aminase(AST),glycosylated hemoglobin(HbA1c),calcium(Ca),phosphorus(P),uric acid(UA),and urinary albumin excretion rates(UAER),serum ALB level was independently and positively correlated with BMD at total hip(β=0.229,95%CI:0.000-0.019).Conclusion Serum ALB level is closely related to BMD of male T2DM pa-tients over 50 years old,and middle-aged and elderly male T2DM patients should pay attention to changes in serum ALB level which could provide clues for osteoporosis prevention and treatment.
韩梅;昝晓晖;马邓荣;郭馨远;赵阳婷;李凯;陈重阳;王亚雯;刘靖芳
730000 兰州,兰州大学第一临床医学院730000 兰州,兰州大学第一临床医学院||730000 兰州,兰州大学第一医院内分泌科
临床医学
2型糖尿病骨质疏松血清白蛋白骨密度
diabetes mellitus type 2osteoporosisserum albuminbone mineral density
《中华骨质疏松和骨矿盐疾病杂志》 2024 (003)
203-212 / 10
国家自然科学基金(82360161、81960155);甘肃省兰州市科技计划项目(2022-3-46);兰州大学第一医院院内基金(ldyyyn2020-01)
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