ADA2013：同濟大學醫(yī)學院曲伸教授發(fā)現(xiàn)T2DM患者骨鈣蛋白可改善血糖控制

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為了探討在中國2型糖尿病（T2DM）患者中，血清骨鈣蛋白與血糖控制、胰腺功能和胰島素敏感性的關系。來自同濟大學醫(yī)學院的曲伸教授及其團隊進行了一項研究，該研究發(fā)現(xiàn)在T2DM患者中，骨鈣蛋白與血糖呈負相關。

該研究中，招募了1019例T2DM患者（男性：432例，女性：587例，平均年齡：65.96±13.11歲）。測量后確定體重指數(shù)（BMI）、空腹血糖（FPG）、空腹胰島素（FINS）、空腹C肽（F-CP）、餐后血糖（2hPBG）、餐后C肽（2hC-P）、糖化血紅蛋白（HbA1c）、以及骨鈣蛋白。根據(jù)上述參數(shù)計算穩(wěn)態(tài)模型評估的β細胞功能（HOMA-β）和穩(wěn)態(tài)模型評估的胰島素抵抗（HOMA-IR）。

該研究結果表明，男性和女性之間的骨鈣蛋白水平有顯著差異[(13.51±12.37)ng/ml vs （16.22±10.40）ng/ml，P＜0.001]。校正年齡和BMI后，血清骨鈣蛋白與HbA1c、FPG和2hPBG呈負相關（P＜0.05），并與FC-P、2hC-P和HOMA-β呈正相關（P＜0.05）。在男性患者，校正年齡和BMI后，血清骨鈣蛋白與2hPBG呈負相關（P＜0.05），并與FC-P、2hC-P和HOMA-β呈正相關（P＜0.05）。在女性，校正年齡和BMI后，血清骨鈣蛋白與HbA1c、FPG呈負相關（P＜0.05）。多元線性回歸分析顯示，在男性，血清骨鈣蛋白是影響HOMA-β和HOMA-IR的獨立相關因素，并且，在所有受試者中，血清骨鈣蛋白也是影響HOMA-IR的獨立相關因素（P＜0.05）。

該研究發(fā)現(xiàn)，在T2DM患者，骨鈣蛋白與血糖呈負相關，暗示骨鈣蛋白可以降低血糖。并且，骨鈣蛋白與FC-P、2hC-P和HOMA-β呈正相關，支持骨鈣蛋白可以通過促進胰島的胰島素分泌，改善血糖控制的觀點。

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This study is to investigate the association between serum osteocalcin and glucose control pancreatic function and insulin sensitivity in the type 2 diabetes mellitus (T2DM) Chinese patients.

1019 T2DM patients were recruited (Male:432 Female:587 Average age: 65.96 ± 13.11 years). After measured BMI the fasting plasma glucose(FPG) insulin(FINS) C peptide(F-CP) postprandial blood glucose (2hPBG) and C peptide (2hC-P) HbA1C and osteocalcin were determined. Homeostasis model assessment of β cell function (HOMA-β) and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated based on the above parameters.

The difference in osteocalcin levels between male and female are significant [(13.51±12.37)ng/mL vs (16.22±10.40)ng/mL P<0.001]. After adjustment for age and BMI serum osteocalcin was negatively correlated with HbA1C FPG and 2hPBG (P<0.05) and positively correlated with fasting C peptide (FC-P) 2h C peptide (2hC-P) and HOMA-β (P<0.05). In male after adjustment for age and BMI serum osteocalcin was negatively correlated with 2hPBG (P<0.05) and positively correlated with FC-P 2hC-P and HOMA-β (P<0.05). In female after adjustment for age and BMI serum osteocalcin was negatively correlated with HbA1C FPG (P<0.05). Multivariable liner regression analysis showed that serum osteocalcin was the independent related factor in influencing HOMA-β and HOMA-IR in male and it was also the independent related factor in influencing HOMA-IR in all subjects (P<0.05).

In T2DM osteocalcin was negatively associated with glucose implying osteocalcin could lower blood glucose. And osteocalcin was positively associated with FC-P 2hC-P and HOMA-β supporting the idea that osteocalcin might improve glucose control through promoting insulin secretion of pancreatic islet.

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編輯： 葛根    來源：丁香園