2019 年第 9 期 第 14 卷

糖耐量正常健康青年男性空腹血糖与骨钙素的关系

Relation between fasting blood glucose and osteocalcin in healthy young men with normal glucose tolerance

作者：范冬梅吴广飞刘俊茹王星刘博伟尹福在

英文作者：

单位：066000河北省秦皇岛市第一医院内分泌科

英文单位：

关键词：正常糖耐量；空腹血糖；骨钙素；骨密度

英文关键词：

• 摘要：

• 【摘要】目的    探讨糖耐量正常健康青年男性空腹血糖水平与骨钙素的关系。方法    选取2015年1—12月于秦皇岛市第一医院体检中心糖耐量正常的健康青年男性138名，测体重指数、空腹血糖、空腹胰岛素、胰岛素抵抗指数（HOMA-IR）、血清骨代谢指标［骨钙素、Ⅰ型前胶原氨基端前肽（PINP）、Ⅰ型前胶原羧基端肽（CTX）］，应用双能X线骨密度测量仪测定腰椎L1～L4、股骨颈、全身骨密度值。根据空腹血糖四分位数分为4组：A组（31例，空腹血糖＜5.1 mmol/L），B组（29例，5.1 mmol/l≤空腹血糖＜5.3 mmol/L），C组（39例，5.3 mmol/L≤空腹血糖＜5.6 mmol/L），D组（39例，空腹血糖≥5.6 mmol/L）。分析空腹血糖水平与各指标的相关性。结果    4组受试者的体重指数、HOMA-IR、骨钙素、CTX水平总体比较差异均有统计学意义（均P＜0.05），且D组骨钙素水平明显低于C组［（35±4）μg/L比（37±3）μg/L，P＝0.004］，D组 CTX水平明显高于C组［（1.4±0.7）μg/L比（1.1±0.4）μg/L，P＝0.042］。矫正年龄和体重指数后，空腹血糖与骨钙素水平呈负相关（r′＝－0.202，P＝0.018）。以空腹血糖损害标准分组进行Logistic回归分析显示，空腹血糖≥5.6 mmol/L人群骨钙素降低的风险是空腹血糖＜5.6 mmol/L人群的10.117倍（95%置信区间为2.300～44.503，P＝0.002）。结论    糖耐量正常青年健康男性随空腹血糖在正常范围内的升高，骨钙素水平明显降低，CTX水平明显升高，提示空腹血糖可作为青年男性早期预测骨代谢变化的指标。

• 【Abstract】Objective    To investigate the relation between fasting blood glucose and osteocalcin in healthy young men with normal glucose tolerance. Methods    Totally 138 healthy young men with normal glucose tolerance were enrolled in First Hospital of Qinhuangdao from January to December 2015. Body mass index, fasting blood glucose (FBG), fasting insulin, homeostasis model assessment insulin resistance index（HOMA-IR） and serum bone metabolism indexes［osteocalcin（OC）, procollagen typeⅠ N-terminal propeptide（PINP）, procollagen typeⅠ C-terminal peptide（CTX）］ were tested. Bone mineral densities of lumbar vertebra 1-4, femoral neck and whole body were detected by dual energy X-ray absorptiometry. According to the quartiles of FBG, the patients were divided into 4 groups: group A（31 cases, FBG＜5.1 mmol/L）, group B（29 cases, 5.1 mmol/l≤FBG＜5.3 mmol/L）, group C（39 cases, 5.3 mmol/L≤FBG＜5.6 mmol/L）, group D（39 cases, FBG≥5.6 mmol/L）. Relation between FBG and the other indicators was analyzed. Results    There were significant differences of body mass index, HOMA-IR, OC and CTX among the 4 groups（P＜0.05）; OC in group D was significantly lower than that in group C［（35±4）μg/L vs （37±3）μg/L， P＝0.004］; CTX in group D was significantly higher than that in group C［（1.4±0.7）μg/L vs （1.1±0.4）μg/L， P＝0.042］. With adjustments of age and body mass index, FBG was negatively correlated with OC（r′＝－0.202， P＝0.018）. Logistic regression showed that men with FBG≥5.6 mmol/L had a significant higher risk of OC reduction than men with FBG＜5.6 mmol/L(odds ratio＝10.117， 95% confidence interval: 2.300-44.503， P＝0.002). Conclusion    In healthy young men with normal glucose tolerance, OC decreased and CTX rose with the increase of FBG within normal range, suggesting that FBG may be an early indicator of bone metabolism.