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目的:探讨氟骨症患者血清中骨钙素(Osteocalcin,OCN)与糖代谢之间的关系。方法:在新疆阿克苏地区饮水型氟中毒病区沙雅县等,通过WS192-2008《地方性氟骨症诊断标准》确诊的患者60例作为氟骨症组;选取该地区经相同诊断方法诊断为无氟中毒骨病变的,且经X线拍片排除佝偻病等相关骨骼疾病的健康60例作为对照组。采集血清酶联免疫吸附实验(Enzyme-linked immunosorbent assay,ELISA)法与化学法等检测总骨钙素(Total osteocalcin t OCN)、未羧化骨钙素(Uncarboxylated osteocalcin,uc OCN)、空腹胰岛素(Fasting insulin,FINS)、空腹血糖(Fasting blood glucose,GLU)及糖化血清蛋(Glycated serum protein,GSP)水平,计算胰岛素抵抗指数(Insulin resistance index,HOMA-IR)。SPSS16.0软件进行数据统计,Pearson法分析氟骨症OCN与糖代谢指标之间的相关性。结果:与对照组比较,氟骨症组uc OC、FINS、GSP水平显著升高(P<0.05)。氟骨症组OCN、HOMA-IR较对照升高但无统计学差异(P>0.05)。氟骨症组GLU水平与对照组相比降低但无统计学差异(P>0.05)。相关回归分析显示氟骨症组uc OC与FINS呈正相关(r=0.543,P<0.05),与GLU、HOMA-IR呈负相关性(r=-0.902,r=-0.530,P<0.05),与OCN、GSP无相关性(P>0.05)。结论:氟骨症患者血清未羧化骨钙素显著升高,影响胰岛素分泌与抵抗,与糖代谢紊乱有一定相关性。
Objective: To investigate the relationship between serum osteocalcin (OCN) and glucose metabolism in skeletal fluorosis patients. Methods: Sixty patients diagnosed by the diagnostic criteria of endemic fluorosis in WS192-2008 in Shaya County, Aksu Prefecture, Xinjiang Autonomous Region were selected as the skeletal fluorosis group. The patients diagnosed by the same method in this area were diagnosed as CFC-free bone lesions, and by X-ray film to exclude rickets and other related bone disease health 60 cases as a control group. Serum levels of total osteocalcin t OCN, uc OCN, fasting insulin (P <0.05) were detected by enzyme-linked immunosorbent assay (ELISA) Fasting insulin, FINS, Fasting blood glucose (GLU) and Glycated serum protein (GSP) levels were calculated. Insulin resistance index (HOMA-IR) was calculated. SPSS16.0 software for data statistics, Pearson analysis of skeletal fluorosis OCN and glucose metabolism between the correlation. Results: Compared with the control group, the levels of uc OC, FINS and GSP in skeletal fluorosis group were significantly increased (P <0.05). OCN and HOMA-IR in skeletal fluorosis group were higher than those in control group, but there was no significant difference (P> 0.05). Compared with the control group, the GLU level in skeletal fluorosis group was lower but not statistically significant (P> 0.05). Correlation analysis showed that there was a positive correlation between uc OC and FINS in fluorosis group (r = 0.543, P <0.05) and negative correlation with GLU and HOMA-IR (r = -0.902, r = -0.530, No correlation with OCN, GSP (P> 0.05). Conclusion: Serum non-carboxylated osteocalcin in patients with skeletal fluorosis is significantly increased, affecting insulin secretion and resistance, and has some correlation with disorders of glucose metabolism.