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目的分析2型糖尿病(T2DM)患者骨钙素(OC)与胰岛素抵抗、胰岛β细胞功能的相关性。方法测定60例T2DM患者(病例组)及20例正常人(正常对照组)的空腹血糖(FBG)、餐后2 h血糖(P2hBG)、空腹胰岛素(FINS)、空腹C肽(FCP)、糖化血红蛋白(HbA1c)、OC、脂联素(APN),用稳态模式胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗,用稳态模式胰岛素分泌指数(HOMA-B)及FCP评估胰岛β细胞功能状态。根据OC水平将病例患者分为两组,比较低骨钙素(OL)组与高骨钙素(OH)组上述指标的变化。结果病例组FINS、FCP、HOMA-B、OC、APN明显低于正常对照组,HOMA-IR、甘油三脂(TG)高于正常对照组(P<0.05)。OL组FBG、HbA1c、胆固醇(TC)、TG及HOMA-IR均高于OH组,但仅FBG、HbA1c差异有统计学意义(P<0.05);FINS、FCP、OC、APN及HOMA-B低于OH组,仅FCP、OC及APN差异有统计学意义(P<0.05)。相关回归分析显示,OC与FBG、HbA1c、HOMA-IR呈负相关,与FCP、FINS、APN及HO-MA-B呈正相关(P<0.05)。多元线性回归分析显示,OC与FCP呈独立正相关(P<0.05)。结论 T2DM患者血清OC水平的变化与胰岛素抵抗指数及胰岛β细胞功能指数的变化明显相关。
Objective To analyze the correlation between osteocalcin (OC) and insulin resistance and pancreatic β-cell function in type 2 diabetes mellitus (T2DM). Methods Fasting blood glucose (FBG), postprandial 2h blood glucose (P2hBG), fasting insulin (FINS), fasting C-peptide (FCP) HbA1c, OC and APN were measured. Insulin resistance was assessed by homeostasis model insulin resistance index (HOMA-IR). The steady-state insulin secretion index (HOMA-B) . The patients were divided into two groups according to the level of OC, and the changes of these indexes were compared between the low osteocalcin (OL) group and the high osteocalcin (OH) group. Results The FINS, FCP, HOMA-B, OC and APN in the case group were significantly lower than those in the normal control group. HOMA-IR and triglyceride (TG) were higher in the case group than in the normal control group (P <0.05). The levels of FBG, HbA1c, TC, TG and HOMA-IR in OL group were all higher than those in OH group, but there was only difference between FBG and HbA1c group (P <0.05). FINS, FCP, OC, APN and HOMA- In OH group, only FCP, OC and APN difference was statistically significant (P <0.05). Correlation analysis showed that OC was negatively correlated with FBG, HbA1c and HOMA-IR, and positively correlated with FCP, FINS, APN and HO-MA-B (P <0.05). Multivariate linear regression analysis showed that there was a positive correlation between OC and FCP (P <0.05). Conclusion The changes of serum OC levels in patients with T2DM are closely related to the changes of insulin resistance index and β-cell function index.