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中华老年骨科与康复电子杂志

中华老年骨科与康复电子杂志 ›› 2018, Vol. 04 ›› Issue (01) : 9 -13. doi: 10.3877/cma.j.issn.2096-0263.2018.01.003

所属专题： 文献；

骨质疏松

血清OPG、TGF-β和IL-6水平对绝经后骨量减少合并2型糖尿病患者骨折风险的预测
鲍晓雪1, 王娜1, 李玉坤1, 王燕1, 薛鹏1,†()   
  1. 1. 050051　石家庄，河北医科大学第三医院内分泌二科
  • 收稿日期:2017-06-12 出版日期:2018-02-05
  • 通信作者: 薛鹏
  • 基金资助:
    河北省自然科学基金(H2016206243); 河北省高等学校自然科学青年拔尖人才项目(BJ2016037)

Prediction of fracture risk in postmenopausal type 2 diabetes mellitus with osteopenia by serum OPG, TGF-β and IL-6 levels

Xiaoxue Bao1, Na Wang1, Yukun Li1, Yan Wang1, Peng Xue1,†()   

  1. 1. Department of Endocrinology, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
  • Received:2017-06-12 Published:2018-02-05
  • Corresponding author: Peng Xue
  • About author:
    Corresponding author: Xue Peng, Email:
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鲍晓雪, 王娜, 李玉坤, 王燕, 薛鹏. 血清OPG、TGF-β和IL-6水平对绝经后骨量减少合并2型糖尿病患者骨折风险的预测[J]. 中华老年骨科与康复电子杂志, 2018, 04(01): 9-13.

Xiaoxue Bao, Na Wang, Yukun Li, Yan Wang, Peng Xue. Prediction of fracture risk in postmenopausal type 2 diabetes mellitus with osteopenia by serum OPG, TGF-β and IL-6 levels[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2018, 04(01): 9-13.

目的

研究绝经后骨量减少合并2型糖尿病（T2DM）患者血清骨保护素（OPG）、转化生长因子-β（TGF-β）和白细胞介素-6（IL-6）水平的变化；评估血清OPG、TGF-β和IL-6水平对绝经后骨量减少合并T2DM患者10年骨折风险的影响；分析上述因子在绝经后T2DM患者骨折进展中的作用。

方法

该回顾性研究共纳入128名绝经后骨量减少患者，其中64名合并T2DM患者（-2.5<T值<-1.0）为实验组，并将64名单纯骨量减少患者（糖代谢正常）设置为对照组；比较两组骨密度（BMD）、血清OPG、TGF-β和IL-6水平；应用骨折风险评估工具对上述研究对象的10年骨折风险进行预测，评估不同血清因子与10年骨折风险的相关性。

结果

绝经后骨量减少合并T2DM患者的BMD与单纯骨量减少患者的BMD之间没有统计学差异（Z=0.841，P>0.05）；绝经后骨量减少合并T2DM患者血清OPG（Z=2.264，P=0.024）、TGF-β（Z=2.836，P=0.005）和IL-6（Z=2.431，P=0.015）水平高于单纯骨量减少患者；两组患者的血清OPG、TGF-β、IL-6水平与10年骨折风险均存在相关性。

结论

绝经后骨量减少合并T2DM患者的促炎细胞因子和OPG水平高于单纯骨量减少患者，促炎因子TGF-β和IL-6水平的升高对于预测绝经后骨量减少合并T2DM患者的骨折风险具有重要意义。

关键词: 糖尿病，2型, 骨质疏松症, 血清反应因子, 骨折风险
Objective

To evaluate the variations of serum OPG, TGF-β and IL-6 levels with bone loss in postmenopausal women with or without type 2 diabetes mellitus (T2DM), to elucidate the role of serum OPG, TGF-β and IL-6 levels in prediction for 10-year probability of fracture risk, and to explore the impact of serum OPG, TGF-β and IL-6 levels on the progression of type 2 diabetic fracture.

Methods

This study included 128 postmenopausal women who were diagnosed as osteopenia (areal bone mineral density at spine and hip of all subjects were measured by DXA, patients with T score more than -2.5 and less than -1.0 were diagnosed as osteopenea). They were divided into two groups, T2DM group and non-T2DM group. Besides of BMD, all subjects were measured the serum levels of OPG, TGF-β and IL-6. Furthermore, we predicted the 10-year probability of fracture risk in all cohorts by FRAX? and analyzed the correlations of the risk with serum levels of OPG, TGF-β and IL-6 in all subjects.

Results

There were no significant differences of BMD between the two groups (Z=0.841, P>0.05). However, the serum levels of OPG (Z=2.264, P=0.024), TGF-β (Z=2.836, P=0.005) and IL-6 (Z=2.431, P=0.015) in T2DM group were higher than that in non-T2DM group. Furthermore, the serum levels of OPG, TGF-β and IL-6 were correlated with the 10-year probability of fracture risk in T2DM group.

Conclusion

The serum levels of OPG, TGF-β and IL-6 increased in osteopenia patients with T2DM, suggesting that the increased inflammatory factors could be used as predictors for the 10-year probability of fracture risk in osteopenia patients with T2DM.

Key words: Diabetes mellitus, Type 2, Osteoporosis, Serum response factor, Fracture risk
表1 两组2型糖尿病患者年龄、左股骨颈及腰椎BMD比较
组别 例数 年龄（岁） 左股骨颈BMD 腰椎BMD
糖尿病组 64 65（52，89） 0.73（0.58，0.95） 0.74（0.61，0.95）
非糖尿病组 64 65（44，82） 0.71（0.56，0.94） 0.76（0.56，0.94）
Z值 ? 0.322 0.841 0.779
P值 ? 0.748 0.400 0.436
表2 两组2型糖尿病患者血清OPG、TGF-β、IL-6水平比较
组别 例数 OPG（pg/ml） TGF-β（ug/l） IL-6（pg/ml）
糖尿病组 64 357.16（159.98，543.25） 40.35（23.51，66.25） 11.91（7.14，17.48）
非糖尿病组 64 337.33（168.42，537.51） 36.75（10.34，64.58） 10.00（5.26，18.34）
Z值 ? 2.264 2.836 2.431
P值 ? 0.024 0.005 0.015
表3 两组2型糖尿病患者血清OPG、TGF-β和IL-6水平与骨折风险相关性分析
? OPG TGF-β IL-6
? 相关系数 P值 相关系数 P值 相关系数 P值
FRAX主要骨质疏松性骨折 0.329 <0.001 0.427 <0.001 0.369 <0.001
FRAX髋部骨折 0.260 0.003 0.328 <0.001 0.394 <0.001
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