中国骨质疏松杂志

2型糖尿病性骨质疏松患者骨小梁分数与骨代谢标志物的相关性分析

A correlational analysis between trabecular bone score and bone metabolic markers in patients with type 2 diabetic osteoporosis

DOI：10.3969/j.issn.1006-7108.2021.11.008

中文关键词: 2型糖尿病骨质疏松骨小梁分数骨密度骨代谢标志物

英文关键词:type 2 diabetes mellitus osteoporosis trabecular bone score bone mass density bone metabolic markers

基金项目:南通市市级科技计划项目（MSZ19145）

作者	单位
范晓琳1 杨小华1 刘月军2 苏如婷1 许梦培1 刘华3*	1.南通大学附属海安医院内分泌科，江苏海安 226600 2.南通大学附属海安医院放射科，江苏海安 226600 3.海安市中医院骨伤科，江苏海安 226000

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中文摘要:

目的分析研究2型糖尿病性骨质疏松患者骨小梁分数(trabecular bone score，TBS)与骨代谢标志物的相关性。方法选取115例2型糖尿病患者，根据测定的TBS值水平将这些患者分为骨质疏松组（62例）和非骨质疏松组（53例），比较两组间骨密度(bone mass density，BMD)、TBS值及骨代谢标志物，并对骨质疏松组骨代谢标志物与TBS值进行相关性分析。结果两组间腰椎总BMD及各腰椎（L1-L4）BMD比较差异均无统计学意义（P＞0.05）；TBS值在骨质疏松组明显高于非骨质疏松组，差异有统计学意义（P＜0.05）；骨质疏松组骨钙素(bone gla protein，BGP)、1型胶原羧基端肽β特殊序列(β-Carboxyl terminal peptide，β-CTX)及抗酒石酸酸性磷酸酶5b(tartra-resistant acid phosphatase 5b，TRAP-5b)明显高于非骨质疏松组，比较差异均有统计学意义（P＜0.05）；两组间骨源性碱性磷酸酶(bone alkaline phosphatase，NBAP)、1型前胶原氨基末端前肽(type 1 procollagen N-terminal propeptide，P1NP）及25羟维生素D[25-hydroxyvitamin D，25-(OH)VD]比较差异均无统计学意义（P＞0.05）。经Pearson分析，骨质疏松组的BGP、β-CTX 及TRAP-5b与TBS值呈负相关（r值分别为-0.213、-0.247、-0.235，P＜0.05）。结论 2型糖尿病性骨质疏松患者的骨代谢标志物与TBS值之间具有一定的相关性，TBS联合BGP、β-CTX 及TRAP-5b可能有助于2型糖尿病性骨质疏松的早期诊断和治疗监测。

英文摘要:

Objective To analyze the correlation between trabecular bone score (TBS) and bone metabolic markers in patients with type 2 diabetic osteoporosis. Methods A retrospective analysis was conducted in 115 cases of type 2 diabetic osteoporosis. According to the TBS, the patients were divided into osteoporosis group (62 cases) and non osteoporosis group (53 cases). Bone mineral density (BMD), TBS, and bone metabolic markers were compared between the two groups. The correlation between bone metabolic markers and TBS in osteoporosis group was analyzed. Results There was no statistical difference in BMD of the total lumbar and lumbar (L1-L4) between the two groups (P>0.05). TBS was significantly higher in osteoporosis group than in non osteoporosis group, with statistically significant difference (P<0.05). BGP, β-CTX, and TRAP-5b in osteoporosis group were significantly higher than in non osteoporosis group, with the statistically significant difference (P<0.05). There was no statistical difference in the levels of NBAP, P1NP, and 25-(OH)VD between the two groups (P>0.05). Pearson correlation analysis showed that BGP, β-CTX, and TRAP-5b were negatively correlated with TBS in osteoporosis group (r=-0.213, -0.247, -0.235, P<0.05). Conclusion Bone metabolic markers and TBS are correlated in patients with type 2 diabetic osteoporosis. TBS combined with BGP, β-CTX, and TRAP-5b is considered useful in early diagnosis and therapeutic monitoring in patients with type 2 diabetic osteoporosis probably.

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