2型糖尿病,身体组成和胰岛素抵抗与骨参数的关联:杜博骨质疏松流行病学研究
Angela Sheu1,2,3, Robert D Blank1, Thach Tran1,2
1Skeletal Diseases Program Garvan Institute of Medical Research Sydney NSW Australia.
JBMR plus
|September 13, 2023
概括
2型糖尿病与较低的骨循环标志物有关,这表明尽管骨密度正常,骨可能脆弱. 肥胖和胰岛素抵抗也会影响骨健康,这表明需要进行全面的骨折风险评估.
科学领域:
- 内分泌学 在内分泌学.
- 骨生物学 骨生物学 骨生物学
- 代谢疾病 代谢疾病
背景情况:
- 2型糖尿病 (T2D) 与骨折风险增加有关,即使有正常的骨矿物质密度 (BMD).
- 肥胖和胰岛素抵抗 (IR) 可能独立地影响骨的循环和强度,导致骨脆弱.
- 了解这些关系对于评估T2D患者骨折风险至关重要.
研究的目的:
- 描述和评估肥胖,身体组成,IR和T2D与骨周转标记 (BTMs),BMD和高级部分析 (AHA) 的关联.
- 确定这些因素在队列研究中对骨脆弱性的相对贡献.
主要方法:
- 杜博骨质疏松流行病学研究的横截面分析 (n=525).
- 参与者按T2D,IR (HOMA-IR ≥2.5) 和BMI (≥25 kg/m2) 分类.
- 通过贝叶斯模型平均和主要成分分析评估BMD,AHA,身体组成 (包括内脏脂肪组织 (VAT)) 和禁食BTM.
主要成果:
- 在男性和女性中,T2D独立地与明显较低的BTM相关,在增值税调整后仍然存在.
- 在T2D,IR和胰岛素敏感的超重/肥胖群体中,BMD和AHA成分相似,但在胰岛素敏感的瘦个体中较低.
- 内脏脂肪组织 (VAT) 与女性的部几何参数 (截面模量,截面面积,惯性瞬间) 和男性的部轴长度相反相关.
结论:
- 低骨周转率是T2D的特征,在男性中,IR,表明骨重塑受损.
- 骨密度和部强度主要受到身体大小的影响,而增值税影响骨质几何.
- 将BTM和AHA整合到骨折风险评估中可以提高T2D患者的骨评估.
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