Serum Osteocalcin/Bone-Specific Alkaline Phosphatase Ratio Is a Predictor for the Presence of Vertebral Fractures in Men with Type 2 Diabetes
Serum Osteocalcin/Bone-Specific Alkaline Phosphatase Ratio Is a Predictor for the Presence of Vertebral Fractures in Men with Type 2 Diabetes
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DOI：
10.1007/s00223-009-9272-4
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发表时间：
2009-09-01
影响因子：
4.2
通讯作者：
Sugimoto, Toshitsugu
中科院分区：
文献类型：
--
作者：
Kanazawa, Ippei;Yamaguchi, Toru;Sugimoto, Toshitsugu
我们检查了248名日本2型糖尿病男性患者的骨密度或骨标记物是否有助于评估椎体骨折的风险。我们分析了骨标记物(骨钙素[OC]、骨特异性碱性磷酸酶[BAP]、尿I型胶原N端交联末端肽)或BMD与HbA(1c)、尿C-肽、胰岛素样生长因子-I(IGF-I)、甲状旁腺激素、1，25(OH)(2)维生素D与椎体骨折的关系。校正年龄、身高、体重、糖尿病病程和血肌酐的多元回归分析显示，血清OC和OC/BAP比值与HBA(1c)呈负相关(P<；0.01)，与IGF-I呈正相关(P<；0.01)。多因素Logistic回归分析显示，血清OC/BAP比值与椎体骨折呈负相关(优势比=0.695，P<0.05)。在对腰椎或股骨颈骨密度进行额外调整后，这种相关性仍然显著。我们的结果表明，糖尿病控制不良和IGF-I水平降低与男性2型糖尿病患者的骨形成受损和OC/BAP比值降低有关。OC/BAP比值可在临床上用于独立于BMD评估糖尿病男性椎体骨折的风险。
We examined whether or not BMD or bone markers were useful for assessing the risk of vertebral fractures in 248 Japanese men with type 2 diabetes. We analyzed the relationships between bone markers (osteocalcin [OC], bone-specific alkaline phosphatase [BAP], urinary N-terminal cross-linked telopeptide of type-I collagen) or BMD and HbA(1c), urinary C-peptide, insulin-like growth factor-I (IGF-I), parathyroid hormone, 1,25(OH)(2) vitamin D, and the presence of prevalent vertebral fractures. Multiple regression analysis adjusted for age, body height, weight, duration of diabetes, and serum creatinine showed that serum OC and OC/BAP ratio were correlated negatively with HbA(1c) (P < 0.01) and positively with IGF-I (P < 0.01). Multivariate logistic regression analysis adjusted for the above parameters showed that serum OC/BAP ratio was inversely associated with the presence of vertebral fractures (odds ratio = 0.695, P < 0.05). This association was still significant after additional adjustment for lumbar or femoral neck BMD. Our results suggest that poor diabetic control and lower IGF-I level are linked to impaired bone formation and resultant reduction in OC/BAP ratio in men with type 2 diabetes. The OC/BAP ratio could be clinically useful for assessing the risk of vertebral fractures independent of BMD in diabetic men.