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  • 王琳,张克勤,雷涛.2型糖尿病肾脏病变患者骨代谢变化的研究[J].同济大学学报(医学版),2015,36(3):54-58.    [点击复制]
  • WANG Lin,ZHANG Ke-qin,LEI Tao.Changes of bone metabolism in patients with type 2 diabetic kidney disease[J].同济大学学报(医学版),2015,36(3):54-58.   [点击复制]
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2型糖尿病肾脏病变患者骨代谢变化的研究
王琳,张克勤,雷涛
0
(同济大学附属同济医院内分泌科,上海 200065)
摘要:
目的 探讨2型糖尿病肾脏病变患者骨代谢标志物的变化及与肾功能变化相关性。方法筛选2型糖尿病肾脏病变患者150例,根据肾小球滤过率(glomerular filtration rate,GFR)1~5期分为DN1~5组,每组患者各30例,检测患者血生化及骨代谢标志物指标。结果 25羟维生素D3(25-OH-D3)随着GFR水平下降而逐渐减低,PTH、BGP、P1NP、CTX水平逐渐升高。Spearman相关分析提示,25-OH-D3与GFR呈正相关,相关系数为0.357外,CTX、P1NP、BGP、PTH均与GFR呈负相关,相关系数分别为-0.363、-0.526、-0.568、-0.610。进一步校正性别、年龄等因素后,BGP、25-OH-D3、PTH、P1NP、CTX仍与GFR具有相关性,其中以P1NP相关性最强,其次为PTH。结论糖尿病肾脏病变患者骨代谢呈高转化状态,25羟维生素D与患者肾功能下降程度呈正相关,CTX、P1NP、BGP、PTH均与患者肾功能下降程度呈负相关,P1NP、PTH与患者肾功能下降相关性最强。
关键词:  2型糖尿病  糖尿病肾脏病变  骨代谢标志物
DOI:10.16118/j.1008-0392.2015.03.012
投稿时间:2015-03-22
基金项目:国家自然科学基金(81170802)
Changes of bone metabolism in patients with type 2 diabetic kidney disease
WANG Lin,ZHANG Ke-qin,LEI Tao
(Dept. of Endocrinology, Tongji Hospital, Tongji University, Shanghai 200065, China)
Abstract:
Objective To investigate the changes of bone metabolism in patients with type 2 diabetic kidney disease. Methods One hundred and fifty patients with type 2 diabetic kidney disease were classified as DN 1-5 groups according to glomerular filtration rate stage 1-5, with 30 cases in each group. Blood biochemistry and bone metabolism markers of patients were measured. Results Spearman correlation analysis showed that 25-OH-D3 level was decreased and PTH, BGP, PINP and CTX were increased with the decreasing of GFR. 25-OH-D3 was positively correlated with GFR (r= 0.357, P<0.05); CTX, P1NP, BGP and PTH were negatively correlated with GFR (r=0.363, -0.526, -0.568, -0.610, P<0.05 or P<0.01). BGP, 25-OH-D3, PTH, P1NP, CTX were still correlated with GFR after correcting the impact of sex and age of patients. Conclusion Patients with type 2 diabetic kidney disease present a high conversion state of bone metabolism, the changes of bone metabolic markers are correlated with the decrease of kidney function.
Key words:  type 2 diabetes mellitus  diabetic kidney disease  bone metabolism markers

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