中国骨质疏松杂志

脂质运载蛋白2和老年2型糖尿病患者骨密度和骨转换标志物的相关性研究

The association of serum lipocalin 2 with bone mineral density and bone turnover marker in elderly patients with type 2 diabetes mellitus

DOI：10.3969/j.issn.1006-7108.2018.06.004

中文关键词: 脂质运载蛋白2 2型糖尿病骨密度骨转换标志物老年骨质疏松

英文关键词:Lipocalin 2 Type 2 diabetes mellitus Bone mineral density Bone turnover marker Elderly Osteoporosis

基金项目:国家自然科学基金青年基金（81100558）；国家重点研发计划（2016YFB1000905）；安徽省中央引导地方科技发展专项资金（2017070802D147）；安徽省公益性技术应用研究联动计划（1704f0804012）

作者	单位
王炜1，2* 叶山东1，2 钱立庭3 任安1 陈超1 邢学农1 李素梅1 徐将1 刘茜1 周婉1	1.中国科学技术大学附属第一医院（安徽省立医院）内分泌科，安徽合肥 230001 2.中国科学技术大学附属第一医院（安徽省立医院）糖尿病研究室，安徽合肥 230001 3.中国科学技术大学附属第一医院（安徽省立医院）肿瘤放疗科，安徽合肥 230001

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中文摘要:

目的探讨脂质运载蛋白2（lipocalin 2，LCN2）对老年2型糖尿病（type 2 diabetes mellitus，T2DM）患者骨代谢的影响。方法研究对象共119例，其中84例为老年T2DM患者，35例为非T2DM对照。采取静脉血检测空腹血糖（serum fasting glucose，FPG）、糖化血红蛋白（glycosylated hemoglobin，HbAlc）、25-羟维生素D3[25(OH)D3]、I型胶原交联羧基末端肽（collagen type 1 cross-linked C-telopeptide，CTX）、Ⅰ型前胶原氨基端延长肽（type 1 N-terminal procollagen，P1NP）、全段甲状旁腺素以及肌酐、血钙（Ca）、血磷（P）等指标，用ELISA法检测血清LCN2。用双能X线骨密度仪检测股骨颈和腰椎1～4(L1～4)的骨密度（bone mineral density，BMD）。结果老年T2DM患者血清LCN2水平高于非T2DM对照组（197.13±42.15 ng/mL vs 172.29±54.71，P=0.01）。按照血清LCN2水平三分位数将T2DM患者分为3组。其中腰椎BMD、股骨颈BMD、P1NP和CTX伴随LCN2水平增高而增高，而FPG和HbA1c伴随LCN2水平增高而降低（所有趋势P＜0.05）。Pearson相关性分析显示，LCN2和T2DM患者BMD呈正相关（股骨颈：r=0.350，P=0.001；腰椎：r=0.355，P=0.001），和骨转换标志物呈正相关（P1NP：r=0.354，P=0.001；CTX：r=0.438，P＜0.001），和糖代谢指标呈负相关（FPG：r=-0.321，P=0.003；HbA1c：r=-0.342，P=0.002）。进一步回归分析显示，LCN2是T2DM患者腰椎BMD的影响因素（P＜0.05）。结论血清LCN2水平和老年T2DM患者骨代谢相关，LCN2水平增高可能有助于BMD的增加。

英文摘要:

Objective This study was aimed to explore the relationship between lipocalin 2 (LCN2) and bone mineral density (BMD) as well as bone turnover marker (BTM) in elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 119 subjects were included in this study, including 84 elderly patients with T2DM and 35 non-T2DM subjects as control. The BMDs of the lumbar spine 1-4 and femoral neck were measured using duaI energy X-ray absorptiometry. Venous blood samples were collected and serum 25-hydroxyvitamin D3 (25-OH-D3), fasting plasma glucose (FPG), type 1 N-terminal procollagen (P1NP), collagen type 1 cross-linked C-telopeptide (CTX) and other biochemical parameters were assayed. Results Serum LCN2 levels were significantly higher in T2DM subjects than those without T2DM (197.13±42.15 vs.172.29 ±54.71 ng/mL, P=0.01). The subjects were divided into three groups according to tertiles of serum LCN2 level. With the increase in LCN2 levels, both BMDs and BTMs increased significantly (all P<0.05). LCN2 positively correlated with BMDs (femoral neck: r=0.350, P=0.001; lumbar spine: r=0.355, P=0.001), and BTMs (P1NP, r=0.354, P=0.001; CTX, r=0.438, P<0.001), and negatively correlated with the indexes of glucose metabolism (FPG, r=-0.321; P=0.003; HbA1c, r=-0.342, P=0.002). Regression analysis showed that LCN2 was an independent predictor for lumbar spine BMD (P<0.05). Conclusion LCN2 was related to bone metabolism in elderly patients with T2DM and increased LCN2 was associated with higher BMD.

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