老年2型糖尿病性肾病患者骨代谢指标与肾小球滤过率的相关性分析

doi:10.3969/j.issn.1671-7171.2021.12.006

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摘要【目的】探讨老年2型糖尿病性肾病(DN)患者骨代谢指标与肾小球滤过率(eGFR)的相关性。【方法】选取2019年5月至2020年10月在西安医学院第三附属医院诊治的129例老年DN患者(观察组)和125例单纯2型糖尿病(T2DM)患者(对照组)。对比两组患者一般资料、骨代谢指标｛血钙(Ca)、血磷(P)、骨钙素(OCN)、25羟维生素D₃[25(OH)D₃]及eGFR,并分析骨代谢指标、甲状旁腺素(PTH)及总Ⅰ型原胶原氨基端前肽(T-PINP)｝与eGFR的相关性。【结果】两组患者性别、年龄、体重指数(BMI)、合并高血压、合并高脂血症比例相比较差异无统计学意义(P>0.05)。与对照组比较,观察组患者糖尿病病程更长,空腹血糖(FPG)、餐后2 h血糖(2hPG)、尿白蛋白、血P、OCN、PTH、T-PINP及eGFR水平升高(P<0.05),血Ca、25(OH)D₃水平降低(均P<0.05)。与肾功能Ⅰ~Ⅱ期患者比较,Ⅲ~Ⅴ期患者血Ca、血P、OCN、PTH及T-PINP水平升高(均P<0.05),25(OH)D₃和eGFR降低(均P<0.05)。观察组患者OCN、PTH、T-PIN与eGFR均呈负相关(r=-0.863,P=0.002;r=-0.754,P=0.013;r=-0.728,P=0.018);25(OH)D₃与eGFR呈正相关(r=0.802,P=0.005)。【结论】老年DN患者骨代谢指标和eGFR均存在异常,且OCN、PTH、T-PINP、25(OH)D₃与eGFR均存在相关性。

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	陈玉昌
	王重阳

关键词 ：糖尿病,2型/并发症, 糖尿病肾病, 骨和骨组织/代谢, 肾小球滤过率, 老年人

Abstract：【Objective】To investigate the correlation between bone metabolism indexes and estimated glomerular filtration rate (eGFR) in elderly patients with type 2 diabetic nephropathy. 【Methods】A total of 129 elderly patients with type 2 diabetic nephropathy admitted from May 2019 to October 2020 were selected as the observation group, and 125 patients with simple type 2 diabetes (T2DM) were selected as the control group. The general information, bone metabolism indexes and eGFR of the two groups of patients were recorded. Bone metabolism index ｛blood calcium (Ca), blood phosphorus (P), osteocalcin (OCN), 25 hydroxy vitamin D₃[25(OH)D₃], parathyroid hormone (PTH) and total type Ⅰ｝ procollagen amino terminal were compared between the two groups. The correlation of eGFR with bone metabolism index, parathyroid hormone (PTH) and propeptide (T-PINP) was analyzed. 【Results】There were no statistically significant differences in gender, age, body mass index (BMI), combined with hypertension, and combined with hyperlipidemia between the two groups (P>0.05). Compared with the control group, the observation group had a longer course of diabetes with higher level of fasting blood glucose (FPG), 2 h postprandial blood glucose (2hPG), urine albumin, blood P, OCN, PTH, T-PINP and eGFR increased (P<0.05), while the blood Ca and 25(OH)D₃ levels decreased in the observation group (all P<0.05). Compared to patients with renal function stage Ⅰ~Ⅱ, OCN, PTH and T-PINP in patients with stage Ⅲ~Ⅴ increased (all P<0.001), while their 25(OH)D₃ and eGFR decreased (all P<0.05). OCN (r=-0.863, P=0.002), PTH (r=-0.754, P=0.013) and T-PINP (r= -0.728, P=0.018) were negatively correlated with eGFR(r=-0.863,P=0.002;r=-0.754,P=0.013;r=-0.728,P=0.018), while 25(OH)D₃ was positively correlated with eGFR (r=0.802, P=0.005). 【Conclusion】There are abnormalities in bone metabolism and eGFR in elderly patients with type 2 diabetic nephropathy, and there is a correlation of eGFR with OCN, PTH, T-PINP and 25(OH)D₃.

Key words： Diabetes Mellitus, Type 2/CO Diabetic Nephropathies Bone and Bones/ME Glomerular Filtration Rate Aged

收稿日期: 2021-11-03

中图分类号:

R587.1

通讯作者: *E-mail:july99love@sina.com

引用本文:

陈玉昌, 王重阳. 老年2型糖尿病性肾病患者骨代谢指标与肾小球滤过率的相关性分析[J]. 医学临床研究, 2021, 38(12): 1777-1779.
CHEN Yu-chang, WANG Chong-yang. Relationship between Bone Metabolism Indexes and Glomerular Filtration Rate in Elderly Patients with Type 2 Diabetic Nephropathy. JOURNAL OF CLINICAL RESEARCH, 2021, 38(12): 1777-1779.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.12.006 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I12/1777

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