2型糖尿病患者骨代谢标志物的临床意义

Pub Date : 2022-02-15 DOI:10.31901/24566330.2022/22.02.799
Yujie Wu
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引用次数: 0

摘要

本文比较了2型糖尿病(T2DM)合并或不合并糖尿病肾病(DKD)患者骨代谢标志物(BTM)的变化。根据尿白蛋白、白蛋白/肌酐比值(ACR)及血清肌酐(SCR)水平,将204例T2DM患者分为无蛋白尿组1、微量蛋白尿组2、大量蛋白尿组3、DKD组4。DKD患者的ACR、SCR、尿酸(UA)、骨钙素(OC)、I型前胶原n端前肽(PINP)、I型胶原c端末端肽(CTX)和腰椎1-4骨密度(BMDLV)均显著高于非DKD患者(P<0.05)。当糖尿病患者没有DKD时,ACR检测是最敏感和特异的。对于DKD, SCR最敏感,PINP特异性大于CTX,但敏感性较低。DKD是骨质疏松症风险的主要因素。
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Clinical Implications of Bone Metabolic Markers in Patients with Type 2 Diabetes Mellitus
This paper compared the changes of bone metabolic markers (BTM) in patients with Type 2 Diabetes Mellitus (T2DM) with or without diabetic kidney disease (DKD). 204 T2DM patients were divided into 4 groups, such that group 1 had no albuminuria, group 2 had microalbuminuria, group 3 with macroalbuminuria, and group 4 with DKD according to urine albumin and albumin to creatinine ratio (ACR) and levels of serum creatinine (SCR). The ACR, SCR, uric acid (UA), osteocalcin (OC), procollagen type I N-terminal propeptide (PINP), C-terminal telopeptide of type I collagen (CTX) and bone mineral density of the lumbar vertebrae 1-4 (BMDLV) in DKD were considerably higher than those who were non-DKD (P<0.05). When there is no DKD in diabetes, ACR detection is the most sensitive and specific. When it comes to DKD, the SCR is the most sensitive, and PINP specificity is greater than CTX, but the sensitivity is lower. DKD is a major contributor to osteoporosis risk.
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