中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (2): 351-354.doi: 10.3969/j.issn.1673-8225.2010.02.038

• 组织构建临床实践 clinical practice in tissue construction • 上一篇    下一篇

在糖尿病肾病过程中血清骨保护素及骨密度的变化

黄德芳1，陈高翔2，张  松1，张  峰3，曹  宏1   

  1. 江苏省无锡市第三人民医院，1内分泌科，2肾内科，3检验科，江苏省无锡市  214041
  • 出版日期:2010-01-08 发布日期:2010-01-08
  • 作者简介:黄德芳★，女， 1963年生，四川省自贡市人，汉族， 1986年苏州医学院毕业，硕士，主任医师，硕士生导师，主要从事糖尿病慢性并发症研究。 huangdefang@medmail.com.cn

Changes of serum osteoprotegerin and bone mineral density in diabetic nephropathy patients

Huang De-fang1, Chen Gao-xiang2, Zhang Song1, Zhang Feng3, Cao Hong1   

  1. 1 Department of Endocrinology, 2 Department of Nephrology, 3 Department of Laboratory Medicine, Third People’s Hospital of Wuxi, Wuxi  214041, Jiangsu Province, China
  • Online:2010-01-08 Published:2010-01-08
  • About author:Huang De-fang★, Master, Chief physician, Master’s supervisor, Department of Endocrinology, Third People’s Hospital of Wuxi, Wuxi 214041, Jiangsu Province, China huangdefang@medmail.com.cn

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363

被引次数

28

摘要：

背景：目前人们对糖尿病肾病过程中所致肾性骨病骨保护素的关系仍不清楚。
目的：探索2型糖尿病肾病过程中患者骨密度、血清骨保护素水平的变化及其间的相关性。
方法：选择2型糖尿病患者104例，根据肾小球滤过率将患者分为5组：单纯糖尿病组、肾脏轻，中，重度损伤组、肾衰竭组。选择健康体检者20名为对照组。采用双抗体夹心酶联免疫吸附法(ELISA)测定受试者血清骨保护素水平。采用全自动生化分析仪检测血清钙、磷、碱性磷酸酶、肌酐、尿素氮及糖化血红蛋白。采用双能X射线骨密度仪测定正位L 2~4的骨密度。观察受试者骨密度、骨保护素水平及其与各指标的多元回归相关分析。
结果与结论：糖尿病肾病患者血清骨保护素水平明显高于健康对照人群(P < 0.05)，肾脏轻，中，重度损伤组、肾衰竭组患者骨密度明显低于健康对照人群(P < 0.05，P < 0.01，P < 0.001)。总体来说，肾功能越差，骨保护素水平越高，骨密度越低。糖尿病肾病患者骨保护素水平与骨密度呈负相关(r=-0.497，P < 0.01)，与糖尿病病程(r=0.566，P < 0.01)、血清肌酐水平(r=0.772，P < 0.01)、尿素氮水平(r=0.708，P < 0.01)、磷水平(r=0.329，P < 0.01)、全段甲状旁腺激素水平(r=0.702，P < 0.01)呈正相关，与血清钙水平呈负相关(r=-0.505，P < 0.01)。提示糖尿病肾病过程中随肾脏功能的恶化，骨保护素水平升高，骨密度降低，骨保护素水平与骨密度呈负相关，与糖尿病病程、血清肌酐水平、尿素氮水平、磷水平、全段甲状旁腺激素水平呈正相关，与血清钙水平呈负相关。

关键词: 骨保护素, 骨密度, 糖尿病, 肾病, 肾性骨病, 骨组织工程

Abstract:

BACKGROUND: At present, the relationship between diabetic nephropathy and osteoprotegerin remains poorly understood.
OBJECTIVE: To investigate the correlation between bone mineral density (BMD) and serum osteoprotegerin changes in patients with 2 type diabetic nephropathy.
METHODS: Totally 104 patients with 2 type diabetes were divided following 5 groups according to glomerular filtration rate: simple diabetes, mild renal injury, moderate renal injury, severe renal injury, and renal failure groups. Additional 20 healthy people were selected as the control group. The level of serum osteoprotegerin was measured by ELISA. Meantime, levels of serum calcium, phosphonium, alkaline phosphatase, creatinine, urea nitrogen, and glycosylated hemoglobin were measured by the automatic biochemistry analyzer. The bone mineral density of entopic L 2-4 was determined by dual X-ray bone density equipment. The whole data was analyzed by multiple regression correlation analysis.
RESULTS AND CONCLUSION: The level of serum osteoprotegerin in patients with diabetic nephropathy was obviously greater than that of the healthy people (P < 0.05), but BMD of the mild renal injury, moderate renal injury, severe renal injury, and renal failure groups was obviously lower than that of the healthy people (P < 0.05). Generally, the worse renal function accompanied by higher osteoprotegerin level, and lower BMD. There was a negative correlation between osteoprotegerin level and BMD in patients with diabetic nephropathy (r=-0.497, P < 0.01). However, the relationships between osteoprotegerin level and diabetic duration (r=0.566, P < 0.01), serum creatinine level (r=0.772, P < 0.01), serum urea nitrogen level (r=0.708, P < 0.01), serum phosphonium level (r=0.329, P < 0.01), or serum intact parathyroid hormone level (r=0.702, P < 0.01) were positive. Meantime, the serum phosphonium level had negative correlation to serum calcium level (r=-0.505, P < 0.01). It demonstrated that when the renal function got worse in diabetic nephropathy patients, the serum osteoprotegerin level was increasing accompanied by BMD decreasing. The osteoprotegerin level presents a negative correlation to BMD and serum calcium level, but positive to diabetic duration, serum creatinine, serum urea nitrogen, serum phosphonium and serum intact parathyroid hormone levels. 

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