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目的:探讨2型糖尿病(T2DM)合并骨折患者血清脂联素(adiponectin)水平的变化、骨密度及相关指标的关系。方法:采用酶联免疫法测定了T2DM合并骨折患者和单纯骨折患者及正常人血清adiponectin水平,采用美国NORLAND双能X线BMD仪测定L2～L4腰椎骨密度(BMD),分析了血清adiponectin水平BMD及相关指标等的关系。结果:T2DM合并骨折患者血清adiponectin水平明显低于单纯骨折和正常对照(P<0.05)。单纯骨折血清adiponectin水平明显低于正常对照(P<0.05)。T2DM合并骨折患者血清adiponectin水平与高密度脂蛋白胆固醇(HDL-C)、BMD和护骨素(OPG)呈正相关,与体重指数(BMI)、腰臀比(WHR)和HOMA-胰岛素抵抗指数(HOMA-IR)呈负相关(P<0.05)。ad-iponectin和OPG是影响T2DM合并骨折组BMD的独立相关因素。结论:血清adiponectin水平与糖脂代谢及骨代谢有关,并可能在T2DM合并骨折患者发生和发展中具有一定的作用。
Objective: To investigate the changes of serum adiponectin level, bone mineral density (BMD) and related indexes in patients with type 2 diabetes mellitus (T2DM) complicated with fracture. Methods: Serum levels of adiponectin in patients with T2DM complicated with fracture and those with simple fracture and normal persons were determined by enzyme-linked immunosorbent assay (ELISA). BMD of L2 ~ L4 vertebrae were measured by NORLAND dual-energy X-ray BMD. The serum levels of adiponectin And related indicators such as the relationship. Results: The level of adiponectin in patients with T2DM complicated fracture was significantly lower than that in simple fractures and normal controls (P <0.05). Simple fracture serum adiponectin levels were significantly lower than the normal control (P <0.05). Serum adiponectin levels were positively correlated with HDL-C, BMD and osteoprotegerin (OPG) in patients with T2DM complicated with fracture, and were positively correlated with body mass index (BMI), WHR and HOMA-insulin resistance index HOMA-IR) (P <0.05). Ad-iponectin and OPG were independent factors that affected BMD in T2DM combined fracture group. Conclusion: The level of adiponectin in serum is related to glucose and lipid metabolism and bone metabolism, and may play a role in the occurrence and development of patients with T2DM complicated with fracture.