| Objective To investigate the expression of tumor markers and bone metabolism in patients with type 2 diabetes mellitus(T2DM),to explore the relationship between serum tumor markers and bone metabolism in T2 DM,and to provide basis for the diagnosis and treatment of bone metabolism abnormality in serum tumor markers of T2DMMethods1.From February 2014 to December 2016,240 cases of T2 DM patients admitted to the endocrinology department of the first affiliated hospital of shihezi university medical school and hospitalized as subjects,and their bone mineral density was examined by dual energy X-ray.According to the results of the examination,they were divided into three groups: normal bone mass group,osteopenia group and osteoporosis group.To record general clinical baseline data,such as age,sex,height,weight,waist circumference,hip circumference,diabetes course and so on,to calculate the body mass index(BMI)and waist-to-hipratio according to the formula.2.After heparin anticoagulation,fasting venous blood samples from subjects were measured by automatic biochemical analyzer to determine the biochemical indexes of fasting blood glucose(FPG),glycerin trilaurate(TG),cholesterol total(TC),blood calcium(Ca),serium inorganic phosphorus(P),alkaline phosphatase(ALP),and so on,determination of 25-dihydroxy vitamin d3,parathyroid hormone(PTH),and fasting Insulin(FINS)by chemiluminescence,determination of glycosylated hemoglobin(Hb A1c)by high pressure liquid phase method,determination of alpha-fetoprotein and other tumor markers by chemiluminescence immunoassay.3.Using dual-energy X-ray DEXA method to measure the BMD of femoral neck,greater trochanter,and L1-4 of lumbar vertebra.4.Data were processed by SPSS 19.0 software.The measured data were expressed as mean±standard deviation((?)±s).When the baseline data were identical,the analysis of variance was used to compare the measurement data among groups.When the baseline data were not available,covariance analysis was used for comparison of measurement data among groups,and correlation between multivariate was analyzed by SNK method.Perason correlation analysis of correlation between variables.The influencing factors of multivariate linear regression analysis variables,P<0.05 was statistically significant.Results1.Comparison of baseline: compared with normal bone mass group,the age of osteopenia group and osteoporosis group was higher than that of bone mass group(p<0.05),and compared with osteopenia group,the age of osteoporosis group was higher than that of osteopenia group(p<0.05),there were statistical differences in age and sex ratio among the three groups,the baseline data were not available,in order to exclude the influence of age and sex,covariance analysis was used to process the data.2.After covariance analysis,the general data were compared: There was no significant difference in BMI,WHR and course of disease among the three groups.3.After covariance analysis,the comparison of glucose and lipid metabolism indexes among three groups showed that: compared with the normal bone mass group,the FPG of osteopenia group and OP group were higher than that of bone mass group(8.52±4.14,9.45±4.94,10.19±7.41)(p<0.05).Compared with the normal bone mass group,Hb A1 c in OP was higher than that of bone mass group(8.61±3.07,9.55±5.48)(p<0.05).Compared with the normal bone mass group,the FINS in the osteopenia group and OP group were lower than that of normal bone mass group(124.96±144.97,63.46±173.32,30.13±259.29)(p<0.05).Compared with the normal bone mass group,the HOMA-IR in the osteopenia group and OP group were lower than that of normal bone mass group(6.78±9.48,3.81±11.34,2.17±16.95)(p<0.05).Compared with the normal bone mass group,the HOMA-IS in the osteopenia group and OP group were lower than that of normal bone mass group(101.74±159.45,45.87±59.09,21.79±24.56)(p<0.05).Compared with the osteopenia group,the HOMA-IS in the OP group was lower than that in the osteopenia group(45.87±59.09,21.79±24.56)(p<0.05).Compared with the normal bone mass group,the TC in OP group was higher than that in normal bone mass group(4.43±1.25,5.03±1.11)(p<0.05).There was no significant difference in triglyceride among the three groups.4.After covariance analysis,the comparison of bone metabolism indexes among the three groups showed that:compared with normal bone mass group,the ALP in the osteopenia group was higher than that of normal bone mass group(72.48±23.86,82.19±40.97)(p<0.05).Compared with normal bone mass group,the PTH in OP group was higher than that of normal bone mass group(50.27±37.27,78.63±114.65)(p<0.05).Compared with the osteopenia group,the PTH in the OP group was higher than that of the osteopenia group(45.83±21.32,78.63±114.65)(p<0.05).There was no significant difference in blood calcium,serium inorganic phosphorus and 25-(OH)D3 among the three groups.5.After covariance analysis,the comparison of tumor markers among the three groups showed that: Compared with normal bone mass group,the CA199 in OP group was higher than that of normal bone mass group(11.28±29.93,27.40±53.52)(p<0.05).There was no significant difference in AFP,CEA,CA153 and CA724 among the three groups.6.Correlation analysis display that: There was a negative correlation between BMD(collum femoris,L1-4,all)and CA199(r=-0.192,-0.173,-0.242,p<0.05).Positive correlation between PTH and CA153(r=0.127,p<0.05).7.Regression analysis showed that: CA199 as an dependent variable,and Ca,P,ALP,25-(OH)D3,PTH,BMD(collum femoris),BMD(L1-4),BMD(all)as independent variables were in progress multivariate linear regression analysis,the BMD(all)enter regression equation,Y=53.535-35.340 X,result display: BMD(all)is the influential factor of CA199(P=0.037,t=-2.093),that is,the decrease of BMD is a risk factor for the increase of CA199.Conclusion The expression of serum CA199 was the highest in the T2 DM with OP group,and the decrease of BMD was a risk factor for the increase of CA199.Therefore,in the T2 DM population,CA199,as a tumor marker,may be a predictor in this group combined reduction of bone mineral density. |
PDF Full Text Request