Osteoporos Int：男性血清骨钙蛋白与动粥相关

　　最近的研究显示血清骨钙蛋白（OC）水平不仅仅与骨代谢相关，也与葡萄糖和脂肪代谢相关。然而，血清骨钙蛋白水平与动脉硬化的关系仍有争议。为了检测在2型糖尿病患者中，骨代谢指标包括骨钙蛋白是否与腹主动脉钙化指数相关，来自日本岛根大学医学部的Ogawa–Furuya N教授及其团队进行了一项研究，该研究认为，在男性2型糖尿病患者，血清骨钙蛋白和羧基化骨钙蛋白（ucOC）水平不仅有骨代谢相关，也与动脉粥样硬化相关。该研究结果在线发表在2013年4月6日的《国际骨质疏松症》（Osteoporosis International）杂志上。

　　该研究招募了118例男性和100例绝经后女性2型糖尿病患者。在腰椎侧位片上评估腹主动脉钙化评分（ACS），并检测血清骨钙蛋白或羧基化骨钙蛋白水平与腹主动脉钙化评分之间的关系。

　　该研究结果表明，校正年龄、BMI、血清肌酐和LDL–胆固醇水平、桡骨骨矿密度、吸烟、糖尿病病程、糖化血红蛋白A1c和胰岛素抵抗指数后，Logistic回归分析显示，在男性，对应最高四分位数的3分及以上的腹主动脉钙化评分与血清骨钙蛋白和羧基化骨钙蛋白水平呈显著负相关（OC和ucOC每增加一个标准差，比值比（OR）分别为：OR 0.36，95%CI 0.19–0.70，P＜0.005和OR 0.28，95%CI 0.12–0.69，P＜0.01）。额外校正其他骨代谢指标后，这些观察结果仍然有意义。相反，在女性，血清骨钙蛋白或羧基化骨钙蛋白水平与腹主动脉钙化评分没有明显的关系。

　　该研究发现，在男性2型糖尿病患者，血清骨钙蛋白和羧基化骨钙蛋白水平不仅有骨代谢相关，也与动脉硬化相关，但不是在女性2型糖尿病患者。

与风湿相关的拓展阅读：

• 2013年国内外风湿病学术会议
• Ann Rheum Dis：日光浴或预防类风湿关节炎
• Rheumatology：类风湿关节炎患者整体肿瘤罹患风险高
• Lancet：依那西普维持治疗可控制类风湿关节炎疾病活动
• 加拿大风湿病学会类风关治疗推荐
• Arthritis Rheum：类风湿关节炎患者 THA后易脱臼，TKA后易感染
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Serum osteocalcin levels are inversely associated with abdominal aortic calcification in men with type 2 diabetes mellitus.
Abstract
We found that serum osteocalcin (OC) and undercarboxylated OC (ucOC) levels were negatively associated with abdominal aortic calcification in type 2 diabetes mellitus (T2DM) men. This finding suggests that circulating OC and ucOC are not only related to glucose or fat metabolism but also to arteriosclerosis.
INTRODUCTION
Recent studies revealed that serum osteocalcin levels were associated with not only bone metabolism but also glucose and fat metabolism. However, the relationship between serum OC levels and arteriosclerosis remains controversial. We examined whether or not bone metabolic markers including OC are associated with abdominal aortic calcification in patients with type 2 diabetes mellitus.
METHODS
We recruited 118 men and 100 postmenopausal women with T2DM. We evaluated the abdominal aortic calcification score (ACS) on a lateral lumbar radiograph and examined the association between serum OC or undercarboxylated OC levels and ACS.
RESULTS
The ACS of 3 and greater, which corresponded well to the highest quartile, was significantly and negatively associated with serum OC and ucOC levels in men by logistic regression analyses after adjusting for age, BMI, serum levels of creatinine and LDL cholesterol, radial bone mineral density, smoking, duration of DM, hemoglobin A1c, and the index of insulin resistance [odds ratio (OR) 0.36, 95 % confidence interval (CI) 0.19-0.70, P < 0.005, and OR 0.28, 95 % CI 0.12-0.69, P < 0.01, per standard deviation increase in OC and ucOC, respectively]. These observations were still significant after an additional adjustment for other bone markers. In contrast, there were no significant relationships with serum OC or ucOC levels and ACS in women.
CONCLUSIONS
These findings suggest that serum OC and ucOC levels are associated with not only bone metabolism but also arteriosclerosis in men, but not in women with type 2 diabetes mellitus.