Positive Association Between Serum Levels of Bone Resorption Marker CTX and HbA1c in Women With Normal Glucose Tolerance
Positive Association Between Serum Levels of Bone Resorption Marker CTX and HbA1c in Women With Normal Glucose Tolerance
复制标题
糖耐量正常女性的骨吸收标志物 CTX 和 HbA1c 血清水平呈正相关
DOI：
10.1210/jc.2014-2583
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发表时间：
2015-01-01
影响因子：
5.8
通讯作者：
Ning, Guang
中科院分区：
文献类型：
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作者：
Xuan, Yan;Sun, Li-Hao;Ning, Guang
背景：骨形成标志物骨钙素（OCN）对葡萄糖代谢有有益作用。在小鼠中，OCN生物活性通过骨吸收诱导。目的：本研究旨在探讨人类骨吸收与葡萄糖稳态之间的关系，设计和设置：本研究在一所大学教学医院进行，研究对象：共195名正常葡萄糖耐量（NGT）的女性，主要结果指标：血清OCN、I型胶原交联C端肽（CTX）、空腹血糖、口服葡萄糖耐量试验期间激发后2小时血糖水平、空腹胰岛素、糖化血红蛋白A1 c（HbA 1c）、肝肾功能、电解质、腰椎和股骨近端骨密度（BMD），结果：在校正多种混杂因素后，CTX与HbA 1c呈正相关（r = 0.269，P = 0.006）。OCN（β = 0.015，P = 0.000）、腰椎2-4（L2-4）BMD（β =-0.128，P = 0.003）和HbA 1c（β = 0.051，P = 0.01）是基于多变量回归分析的CTX变化的主要决定因素（模型校正R-2 = 0.608，P = 0.01）。与HbA 1c最低三分位数的患者相比，最高三分位数的患者具有显著更高的CTX浓度（0.37 +/- 0.15 ng/ml vs 0.26 +/- 0.11 ng/ml，P = 0.000），即使调整了多个混杂因素（趋势P = 0.015）。NGT受试者中CTX水平升高是否是预测葡萄糖稳态轻微受损和糖尿病发生风险的早期标志物，需要进一步研究。
Context: The bone formation marker osteocalcin (OCN) has a beneficial effect on glucose metabolism. In mice, the OCN bioactivity is induced by bone resorption. But in humans, the role of bone resorption in modulating glucose homeostasis is not clear.Objective: Our study aimed to examine the relationship between bone resorption and glucose homeostasis in humans.Design and Setting: This was a cross-sectional study conducted in a university teaching hospital.Subjects: A total of 195 women with normal glucose tolerance (NGT) were analyzed.Main Outcome Measures: Serum OCN, cross-linked C-telopeptide of type I collagen (CTX), fasting plasma glucose, and 2h post-challenge glucose levels during oral glucose tolerance test, fasting insulin, glycated hemoglobin A1c (HbA1c), hepatic and renal functions, electrolytes, and bone mineral densities (BMDs) at lumbar-spine and proximal femur, and anthropometric parameters were measured.Results: CTX was positively associated with HbA1c after adjustments for multiple confounding factors (r = 0.269, P = .006). OCN (beta = 0.015, P = .000), lumbar-spine 2-4 (L2-4) BMD (beta = -0.128, P = .003) and HbA1c (beta = 0.051, P = .01) were the major determinants of the variations of CTX (adjusted R-2 for the model = 0.608, P = .01) based on multivariate regression analysis. Compared with those in the lowest HbA1c tertile, individuals in the highest tertile had significantly higher CTX concentrations (0.37 +/- 0.15 ng/ml vs 0.26 +/- 0.11 ng/ml, P = .000), even when multiple confounders were adjusted (P for trend = .015).Conclusions: Bone resorption marker serum CTX was independently associated HbA1c in NGT women. Whether the increased CTX level in NGT subjects is an early marker predicting the subtle impairment of glucose homeostasis and the risk of occurrence of diabetes requires additional study.