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  • 赵智伟,张晓亚,黄润之,等.2型糖尿病患者血脂水平与骨代谢的相关性研究[J].同济大学学报(医学版),2019,40(4):489-495,500.    [点击复制]
  • ZHAO Zhi-wei,ZHANG Xiao-ya,HUANG Run-zhi,et al.Association of serum lipid profiles with bone metabolism in patients with type 2 diabetes[J].同济大学学报(医学版),2019,40(4):489-495,500.   [点击复制]
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2型糖尿病患者血脂水平与骨代谢的相关性研究
赵智伟,张晓亚,黄润之,李慧娟,温宇华,宋利格
0
(同济大学附属同济医院内分泌代谢科,上海 200065; 河南科技大学第一附属医院康复医学科,河南 洛阳 471000;同济大学附属同济医院内分泌代谢科,上海 200065; 同济大学医学院骨质疏松和代谢性骨病研究所,上海 200065;同济大学附属同济医院脊柱外科,上海 200065)
摘要:
目的 探讨2型糖尿病患者脂代谢与骨代谢的关系。方法 选择2016年6月—2018年6月的1182例2型糖尿病患者,其中包括74例初发2型糖尿病患者,分为骨量正常(323例)、骨量减少(572例)和骨质疏松(287例)3组,比较各组间血脂谱指标、骨代谢标志物和骨密度的差异,并分析血脂谱中各项指标与骨代谢标志物和骨密度的关系。结果 2型糖尿病患者中总胆固醇、三酰甘油、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇与骨代谢各指标和骨密度均无相关性,但血清磷与游离脂肪酸呈负相关(r=-0.148),该负相关关系在初发2型糖尿病患者中更显著(r=-0.564)。应用多元Logistic回归分析发现,校正甲状旁腺激素和25羟基维生素D这2个磷调节激素后,血清磷与游离脂肪酸仍呈负相关关系。结论 2型糖尿病患者中血脂谱与骨代谢指标无相关,但游离脂肪酸与血清磷存在负相关。
关键词:  脂代谢  血脂  骨代谢  骨质疏松  2型糖尿病
DOI:10.16118/j.1008-0392.2019.04.017
投稿时间:2019-05-11
基金项目:上海市卫生和计划生育委员会临床研究专项(201840217);上海申康医院发展中心临床科技创新项目(SHDC12018X10);同济大学附属同济医院临床培育项目(ITJ(ZD)1904)
Association of serum lipid profiles with bone metabolism in patients with type 2 diabetes
ZHAO Zhi-wei,ZHANG Xiao-ya,HUANG Run-zhi,LI Hui-juan,WEN Yu-hua,SONG Li-ge
(Dept. of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China; Dept. of Rehabilitation Medicine, The First Affiliated Hospital of Henan University of Science & Technology, Luoyang 471000, Henan Province, China;Dept. of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China; Institute of Osteoporosis and Metabolic Bone Diseases, Tongji University School of Medicine, Shanghai 200065, China;Dept. of Spinal Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China)
Abstract:
Objective To investigate the relationship between serum lipid profiles and bone metabolism in patients with type 2 diabetes (T2DM). Methods A total of 1182 patients with T2DM were enrolled from June of 2016 to June of 2018, including 74 patients with newly diagnosed T2DM. They were divided into normal bone mass group (n=323), osteopenia roup (n=572) and osteoporosis group (n=287). The levels of serum lipid profiles bone remodeling markers and its related hormones were determined. The correlations between lipid profiles with the markers of bone metabolism and bone mineral density were analyzed. Results There was no correlation between lipid profiles and the markers of bone metabolism or bone mineral density in T2DM patients. Serum phosphorus was inversely correlated with free fatty acids (r=-0.148), and this negative correlation was more significantly in patients with newly diagnosed T2DM (r=-0.564). Moreover, Logistic regression analysis indicated that serum phosphorus was negatively correlated with free fatty acids after adjusting for potential confounders including parathyroid hormone and 25(OH)D. Conclusion Serum phosphorus is negatively correlated with free fatty acids in patients with type 2 diabetes, indicating its potential role in the lipids metabolism.
Key words:  lipid metabolism  lipid profiles  bone metabolism  osteoporosis  type 2 diabetes

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