上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

初诊2型糖尿病患者餐后骨转换标志物的动态变化

华飞1,项守奎1,吕欣1,万静波1,蒋晓红1,贾伟平2   

  1. 1.苏州大学附属第三医院内分泌科， 常州 213003； 2.上海交通大学附属第六人民医院内分泌代谢科， 上海 200233
  • 出版日期:2016-05-28 发布日期:2016-05-26
  • 作者简介:华飞(1970—)， 男， 主任医师， 博士生; 电子信箱: czhuafei@vip.sina.com。
  • 基金资助:

    常州市科技局项目（CJ20159019）

Dynamic changes in bone turnover markers after intake of food in newly diagnosed type 2 diabetic patients

HUA Fei1, XIANG Shou-kui1, LÜ Xin1, WAN Jing-bo1, JIANG Xiao-hong1, JIA Wei-ping2   

  1. 1.Department of Endocrinology, Third Affiliated Hospital of Soochow University， Changzhou 213003, China; 2.Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
  • Online:2016-05-28 Published:2016-05-26
  • Supported by:

    Science and Technology Project of Changzhou, CJ20159019

PDF (PC)

869

摘要：

目的 探讨初诊2型糖尿病（T2DM）男性患者馒头餐后血清骨转换标志物的动态变化。方法 随机选取46例男性初诊T2DM患者（T2DM组）及40例年龄相匹配的体检健康男性（对照组）作为研究对象，所有受试者空腹采静脉血后进食100 g馒头，分别测定空腹及餐后30、60、120及180 min血清1型原胶原N-端前肽（P1NP）及1型胶原交联Ｃ-末端肽（β-CTX）等指标，并进行统计学分析。结果 空腹状态下，T2DM组的血清P1NP及β-CTX水平均显著低于对照组[P1NP: (40.6±12.9) ng/mL vs (54.2±14.8) ng/mL。β-CTX: (318.6±89.4) pg/mL vs (396.3±105.7) pg/mL。均P<0.05]。与空腹状态下相比，2组餐后各时间点的血清P1NP水平均无显著变化，而血清β-CTX水平随着时间延长显著降低，且均在120 min降至最低，随后略有升高。餐后120 min，T2DM组的血清β-CTX降低率显著低于对照组（34.6% vs 45.2%，P=0.006）。结论 初诊T2DM患者的血清骨转换标志物水平显著低于健康人群，并且进食抑制骨吸收的能力也显著降低，这可能是T2DM患者骨折风险增加的原因之一。

关键词: 2型糖尿病, 馒头餐试验, 骨转换标志物

Abstract:

Objective To investigate the dynamic changes in serum bone turnover markers after intake of steamed bread in newly diagnosed male type 2 diabetic patients. Methods Forty-six male patients with newly diagnosed type 2 diabetes (T2DM group) and forty healthy male individuals with matched ages (control group) were enrolled. All participants took 100 g steamed bread after fasting venous blood was drawn. Fasting procollagen type Ⅰ N-terminal propeptide (P1NP) and resorption marker C-terminal telopeptide of type Ⅰ collagen (β-CTX) levels and levels of P1NP and β-CTX 30, 60, 120, and 180 min after intake of steamed bread were measured and statistically analyzed. Results The T2DM group had remarkably lower fasting serum P1NP and β-CTX levels as compared with the control group [P1NP: (40.6±12.9) vs (54.2±14.8) ng/mL; β-CTX: (318.6±89.4) pg/mL vs (396.3±105.7) pg/mL. P<0.05]. Serum P1NP levels at time points after intake of steamed bread in two groups had no significant change as compared with fasting serum P1NP levels. However, serum β-CTX levels significantly decreased with time, reached troughs at 120 min, and then increased slightly. The decrease in serum β-CTX in the T2DM group 120 min after intake of steamed bread was significantly less than that in the control group (34.6% vs45.2%, P=0.006).  Conclusion The levels of serum bone turnover markers in newly diagnosed T2DM patients are significantly lower as compared with healthy individuals. The ability of patients to inhibit the bone resorption via intake of food is significantly reduced, which may be one of reasons for the elevated risk of fractures in T2DM patients.

Key words: diabetes mellitus type 2, steamed bread meal test, bone turnover markers