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| 中老年2型糖尿病患者血清FGF21、FGF23水平与骨量异常关系的研究 |
| Study on the relationships between serum FGF21, FGF23 and abnormal bone mass in themiddle-aged and elderly patients with type 2 diabetes |
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| DOI：10.3969/j.issn.1006-7108.2022.02.001 |
| 中文关键词: 中老年 2型糖尿病 骨量异常 成纤维细胞生长因子21 成纤维细胞生长因子23 |
| 英文关键词:middle-aged and elderly type 2 diabetes abnormal bone mass fibroblast growth factor 21 fibroblast growth factor 23 |
| 基金项目:国家自然科学基金（81960155）;甘肃省卫生行业科研项目（GSWSKY-2019-07） |
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| 中文摘要: |
| 目的 探讨中老年2型糖尿病（type 2 diabetes mellitus，T2DM）患者血清成纤维细胞生长因子21（FGF21）、23（FGF23）水平与骨量异常的关系。方法 随机纳入中老年T2DM患者250例，根据骨密度结果将研究对象分为骨量正常组和骨量异常组（骨量减少、骨质疏松），收集患者的性别、年龄、糖尿病病程等资料，测定空腹血糖、糖化血红蛋白、血钙、血磷、25羟维生素D、肝肾功、血脂、血清FGF21及FGF23水平，分析T2DM患者血清FGF21、FGF23水平与骨量异常的关系。结果 与骨量正常组相比，骨量异常组患者血清FGF21（P＜0.05）、FGF23水平均降低，但后者比较差异不具有统计学意义（P＞0.05）。排除年龄、收缩期血压（SBP）、体质量指数（body mass index, BMI）、评估的肾小球滤过率（eGFR）及甘油三酯（TG）影响后，协方差分析显示骨量异常组血清FGF21水平（pg/mL）仍低于骨量正常组（P＜0.05）。以T2DM是否合并骨量异常为因变量，年龄、BMI、eGFR、TG、FGF21、FGF23、SBP为自变量，Logistic回归分析显示，年龄、SBP是骨量异常的独立危险因素，BMI、FGF21是骨量异常的保护因素。结论 中老年T2DM合并骨量异常患者血清FGF21、FGF23水平较骨量正常者降低，低血清FGF21水平可能是中老年T2DM患者骨量减少的危险因素。 |
| 英文摘要: |
| Objective To investigate the relationships between serum fibroblast growth 21(FGF21) , 23（FGF23）levels and abnormal bone mass in middle-aged and elderly patients with type 2 diabetes (T2DM). Methods 250 middle-aged and elderly patients with T2DM were randomly enrolled. According to the results of bone mineral density the patients were divided into normal bone mass groups and abnormal bone mass groups (bone reduction, or osteoporosis). Gender, age, diabetes course and other data were collected, fasting blood glucose, glycosylated hemoglobin, blood calcium, blood phosphorus, 25 hydroxyvitamin D levels, liver and kidney function, blood lipid and serum FGF21, FGF23 levels were measured, and the relationships between serum FGF21 and FGF23 levels and abnormal bone mass were analyzed. Results Compared with the normal bone mass group, the serum FGF21 levels(P<0.05), FGF23 level of patients with abnormal bone mass were lower than that of patients with normal bone mass, but the latter did not reach statistical significance (P>0.05). After excluding the effects of age, systolic blood pressure (SBP), body mass index (BMI), estimated?glomerular filtration rate (eGFR) and triglycerides (TG), analysis of covariance showed that the serum FGF21 levels of the abnormal bone mass group were still lower than that of the normal bone mass group (P＜0.05). T2DM with abnormal bone mass as the dependent variable, age, BMI, eGFR, TG, FGF21, FGF23, and SBP as independent variables, logistic regression analysis showed that age and SBP were independent risk factors for abnormal bone mass , while BMI and FGF21 were the protective factors for abnormal bone mass in patients . Conclusion Serum levels of FGF21 and FGF23 in patients with T2DM and abnormal bone mass are lower than those with normal bone mass. Low serum FGF21 levels may be a risk factor for bone loss in middle-aged and elderly patients with T2DM. |
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