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目的探讨男性2型糖尿病(T2DM)患者的糖化血红蛋白水平与骨转换指标1型前胶原氨基端前肽(PINP)的关系,进一步明确不同血糖水平对PINP的影响。方法选取2014年3月至2016年10月合肥市第一人民医院内分泌科收治的94例住院男性T2DM患者为研究对象。测定患者的糖化血红蛋白(Hb A1C)、血脂、胱抑素C(Cys-C)、PINP、血清1型胶原交联C-末端肽(CTX)等指标。按照Hb A1C水平分为A组(Hb A1C<9.0%)44例和B组(Hb A1C≥9.0%)50例。用SPSS19.0软件进行t检验,指标间的相关性分析采用Pearson相关分析,以PINP和CTX为因变量,进行多元逐步回归分析。结果 A组PINP水平为(14.81±6.67)nmol/L,B组PINP水平为(11.82±6.74)nmol/L,A组高于B组,差异有统计学意义(P<0.05)。两组患者CTX水平分别为(4.34±2.64)和(4.27±2.36)nmol/L,差异无统计学意义(P>0.05)。Pearson相关分析结果显示,PINP与Hb A1C呈负相关(r=-0.248,P<0.05),与Cys-C呈正相关(r=0.269,P<0.01);CTX与各项指标的相关性均无统计学意义(P>0.05)。多元线性回归分析结果显示,男性T2DM患者中,对PINP有影响的指标是Hb A1C(β’=-0.306,P<0.01),Hb A1C水平越高,PINP水平越低;未发现对CTX水平产生影响的指标(P>0.05)。结论男性T2DM患者血糖控制水平越差,骨形成指标PINP越低,高血糖可抑制成骨细胞的活动,积极控制血糖可有助于减少骨折的风险。
Objective To investigate the relationship between glycosylated hemoglobin (HbA1c) and PINP in type 2 diabetes mellitus (T2DM) patients and to determine the effect of different blood glucose levels on PINP. Methods From March 2014 to October 2016, 94 inpatients with T2DM admitted to Department of Endocrinology, First People’s Hospital of Hefei City were selected as study subjects. Hb A1C, lipids, cystatin C (Cys-C), PINP and CTX of serum type 1 collagen in patients were measured. According to the Hb A1C level, there were 44 cases in group A (Hb A1C <9.0%) and 50 cases in group B (Hb A1C≥9.0%). SPSS19.0 software t test, correlation analysis of indicators using Pearson correlation analysis, PINP and CTX as dependent variables, multiple stepwise regression analysis. Results The PINP level in group A was (14.81 ± 6.67) nmol / L, that in group B was (11.82 ± 6.74) nmol / L, and that in group A was higher than that in group B (P <0.05). CTX levels in the two groups were (4.34 ± 2.64) and (4.27 ± 2.36) nmol / L, respectively, with no significant difference (P> 0.05). Pearson correlation analysis showed that there was a negative correlation between PINP and Hb A1C (r = -0.248, P <0.05), positive correlation with Cys-C (r = 0.269, P <0.01) Statistical significance (P> 0.05). Multivariate linear regression analysis showed that in patients with T2DM, the index of influence on PINP was Hb A1C (β ’= - 0.306, P <0.01). The higher the level of Hb A1C, the lower the level of PINP. No effect was found on the level of CTX Impact indicators (P> 0.05). Conclusion The lower the level of blood glucose control in male patients with T2DM, the lower the PINP, the marker of bone formation, and the high blood glucose can inhibit the activity of osteoblasts. Positive control of blood glucose can help reduce the risk of fractures.