2型糖尿病患者骨合成与内源性慢性应激之间的不平衡

Alla Kovalchuk, Olesia Zinych, Olha Prybyla, Natalia Kushnareva, Volodymyr Kovalchuk, Kateryna Shyshkan-Shyshova
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引用次数: 0

摘要

骨钙素(OC)是表型特征的一个组成部分,与碳水化合物和脂质代谢有关。我们感兴趣的是无肥胖的2型糖尿病(T2DM)的表型,这可能与抗胰岛素激素水平受损有关。本组共87例T2DM患者,年龄40 ~ 78岁,男女比例为41/46。通过生物电阻抗评估人体测量参数和身体成分。测定OC、皮质醇、脱氢表雄酮硫酸酯(DHEA-S)血药浓度及皮质醇/DHEA-S比值作为机体抗逆性指标。根据血清OC水平将患者分为4个四分位数,各四分位数差异显著。 皮质醇/DHEA-S比值在第一(最低OC水平)和第四个四分位数(最高OC水平)之间以及第二、第三和第四个四分位数之间存在显著差异。内脏脂肪水平在第一个OC四分位数中最高,在第四个四分位数中最低。在四分位数之间比较总脂肪的百分比时,没有发现显著差异,这可能表明内脏脂肪在T2DM存在时代谢表型变化形成中的重要性。 慢性内源性应激强度最大的患者血清OC水平最低,表现为糖皮质激素功能根据皮质醇/DHEA-S比值升高。我们假设,局部高皮质是干细胞分化为脂肪细胞的原因,导致糖尿病表型的形成,内脏脂肪积累,而非一般性肥胖,骨合成减慢,OC水平降低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
IMBALANCE BETWEEN OSTEOSYNTHESIS AND ENDOGENOUS CHRONIC STRESS IN PATIENTS WITH TYPE 2 DIABETES
Osteocalcin (OC) is a component of phenotypic characteristics, associated with carbohydrate and lipid metabolism. Of interest is the phenotype of type 2 diabetes mellitus (T2DM) without obesity, which may be associated with impaired levels of counter-insulin hormones. 87 patients with T2DM (age 40-78, females/males – 41/46) were examined. Anthropometric parameters and body composition were assessed by the bioelectrical impedance. OC, cortisol, dehydroepiandrosterone sulfate (DHEA-S) blood levels, and the ratio of cortisol/DHEA-S as indicator of the body stress resistance, were measured. Patients were divided into 4 quartiles, depending on the serum OC level, that were significantly different from each other. Cortisol/DHEA-S ratio was significantly different between the first (lowest OC level) and the fourth quartiles (highest OC level) and between the second, third and fourth quartiles. Visceral fat level was the highest in the first OC quartile, and the lowest in the fourth quartile. When comparing the percentage of total fat between quartiles, no significant difference was found, which may indicate the importance of visceral fat in the formation of metabolic phenotypic changes in the presence of T2DM. The lowest serum OC level was observed in patients with the greatest intensity of chronic endogenous stress, which is manifested by glucocorticoid function increase according to the cortisol/DHEA-S ratio. It is assumed, that local hypercorticism is the cause of stem cell differentiation into adipocytes, which leads to the formation of a diabetes phenotype with the accumulation of visceral fat without general obesity and the slowing of osteosynthesis with a decrease of the OC level.
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Pharmacy World & Science
Pharmacy World & Science 医学-药学
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