中国骨质疏松杂志

不同骨量状态下绝经后初诊2型糖尿病患者血清中MMP-2水平及意义

Determination of matrix metalloproteinases-2 in serum of patients with type 2 diabetes mellitus in postmenopausal women with different bone mass status

DOI：10.3969/j.issn.1006-7108.2018.08.008

中文关键词: 绝经后 2 型糖尿病骨量基质金属蛋白酶2

英文关键词:Postmenopausal Type 2 diabetes mellitus Bone mass status Matrix metalloproteinase 2

基金项目:国家自然科学基金（81460168）；贵州省科学技术基金项目（黔科合J字LKZ[2013]19号）

作者	单位
樊思桐陈先丹陈丽芬阳琰* 李琪王哲刘贝贝	遵义医学院附属医院内分泌科，贵州遵义　563099

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中文摘要:

目的通过检测不同骨量状态下绝经后初诊2型糖尿病（type 2 diabetes mellitus，T2DM）女性患者血清中25羟维生素D[25-hydroxyvitamin D，25（OH）D]、基质金属蛋白酶2(matrix metalloproteinases-2，MMP-2)水平，初步探讨它们在T2DM合并骨质疏松发生发展过程中的作用及意义。方法收集2016年10月至2017年10月我院内分泌科住院的绝经后T2DM患者130例，据骨密度分3组：T2DM骨量正常组（A组45例）、T2DM骨量减少组（B组40例）、T2DM骨质疏松组（C组45例），收集同期我院体检中心年龄、性别相匹配的健康体检者为正常对照组（NC组50例)。采用酶联免疫吸附(ELISA)法测定所有受试者血清MMP-2。Pearson相关分析绝经后T2DM合并骨质疏松（osteoporosis,OP）患者血清MMP-2与各指标的相关性；Logistic回归分析绝经后T2DM患者骨密度的影响因素。结果 ①A组与B组比较，25(OH)D、PINP、HDL-C水平明显升高，而MMP-2、β-CTX、BGP、HbA1c、HOMA-IR明显降低，差异有统计学意义（P＜0.05），FBG、LDL-C、TC、TG、FINS、病程比较，差异无统计学意义（P＞0.05）；② C组与NC组比较，MMP-2、FBG、HbA1c、HOMA-IR、LDL-C、TG、TC、β-CTX水平明显升高，而25(OH)D、HDL-C、PINP、BGP明显降低，差异有统计学意义（P＜0.05）。结论绝经后T2DM合并骨质疏松患者血清中MMP-2、β-CTX、BGP水平明显升高，而25(OH)D、PINP水平明显减低，提示高水平的MMP-2及低水平的25(OH)D 可能共同参与了绝经后T2DM合并OP的发生发展。

英文摘要:

Objective By detecting the levels of 25-hydroxyvitamin D [25(OH)D], matrix metalloproteinases-2 (MMP-2), beta collagenous degradation products (β-CTX), type I-collagen amino end lengthening peptide (PINP), and osteocalcin (BGP) in the serum of postmenopausal T2DM patients in different bone metabolic status, to preliminarily study their role and significance in the occurrence and development of osteoporosis complicated with T2DM. Methods One hundred and thirty postmenopausal T2DM women in the Department of Endocrinology of our hospital from October 2016 to October 2017 were selected. They were divided into 3 groups according to their bone mineral density: T2DM with normal bone mass group (group A, 45 cases), T2DM with osteopenia group (group B, 40 cases), and T2DM with osteoporosis group (group C, 45 cases). In the same period, age and gender-matched healthy people in physical examination center of our hospital were selected in normal control group (NC group, 50 cases). Serum MMP-2 was measured in all subjects with ELISA method. Pearson correlation analysis was used to analyzed the correlation between serum MMP-2 and clinical indicators in patients with T2DM postmenopausal women with osteoporosis. Logistic regression analysis was used to analyze the factors affecting bone mineral density in postmenopausal women with T2DM. Results 1) The levels of 25 (OH) D, HDL-C, and PINP in group A were significantly higher than those in group B, while the levels of MMP-2, β-CTX, BGP, HbA1c, and HOMA-IR significantly decreased, and the difference was statistically significant (P<0.05). FBG, LDL-C, TC, TG, FINS, course of disease were not different statistically (P>0.05). 2) The levels of MMP-2, FBG, HbA1c, HOMA-IR, LDL-C, TG, TC, and β-CTX in group C were significantly higher than those in group NC, while the levels of 25(OH)D, HDL-C, PINP, and BGP significantly decreased, and the difference was statistically significant (P<0.05). Conclusion The levels of MMP-2, β-CTX, and BGP in serum of postmenopausal patients with T2DM combined with osteoporosis increase significantly, while the levels of 25(OH)D and PINP decrease significantly, suggesting that high level of MMP-2 and low level of 25(OH)D may be involved in the development of postmenopausal T2DM combined with osteoporosis.

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