血清骨标志物与2 型糖尿病患者 心血管疾病风险的关系

Correlations between bone markers and cardiovascular risk in type 2 diabetes patients

摘要:

目的 评估2 型糖尿病（T2DM）患者中6 种骨标志物（骨钙蛋白、骨桥蛋白、骨粘连蛋白、骨 保护素、碱性磷酸酶和骨硬化蛋白）水平是否与心血管疾病（CVD）风险相关。方法 选取2015 年9 月— 2018 年12 月蚌埠医学院第一附属医院收治的T2DM 患者200 例，其中100 例在2 年的随访过程中出现了 CVD。根据随访期间是否发生CVD 分为CVD 组和无CVD 组，每组100 例。用多重试剂盒法测量血清中 6 种骨标志物，使用多因素Logistic 回归分析评估骨标志物与CVD 风险的关系。结果 CVD 组年龄、糖尿病 病程、骨钙蛋白、骨桥蛋白、骨粘连蛋白、骨保护素、碱性磷酸酶、骨硬化蛋白水平较无CVD 组高（P <0.05）。 多因素Logistic 回归分析结果显示，较高血浆浓度的骨桥蛋白水平[Ol ^ R=5.112（95％ CI ：1.032，22.423）， P =0.000] 是T2DM 患者发生CVD 的危险因素。结论 高骨桥蛋白是T2DM 患者CVD 风险的独立危险因素， 而其他5 种骨标志物和CVD 风险无关。

Abstract:

Objective To assess whether six bone marker levels were associated with CVD risks in type 2 diabetic patients. Methods From September 2015 to December 2018, a total of 200 patients with type 2 diabetes in our hospital were selected, among whom 100 patients developed CVD during 2-year follow-up. According to whether CVD occurred during the follow-up, the patients were divided into two groups: CVD group and non- CVD group. Six bone markers (osteocalcin, osteopontin, osteonectin, osteoprotegerin, alkaline phosphatase and sclerostin) were measured by multiplex assays in baseline plasma samples. Multivariate logistic regression analysis was used to assess the association of bone markers with CVD risk. Results Compared with the patients without CVD, those with CVD had higher levels of age, diabetes duration, osteocalcin, osteopontin, osteonectin, osteoprotegerin, alkaline phosphatase and sclerostin (all P < 0.05). Multivariate logistic regression analysis showed that higher plasma osteopontin was associated with an increased CVD risk [Ol ^ R = 5.112 (95% CI: 1.032, 22.423),P = 0.000]. Conclusions High osteopontin concentration was an independent risk factor of CVD in patients with type 2 diabetes. No significant associations were found among the other five bone markers and risk of CVD.