| Objective By studying the expression of type I procollagen amino-terminal peptide(PINP),type I collagen cross-linked carboxy-terminal peptide(β-CTX)and homocysteine(HCY)in serum of patients with type 2 diabetic nephropathy at different stages,To analyze the significance of the changes of type I procollagen amino-terminal peptide(PINP),type I collagen crosslinked carboxyl terminal peptide(β-CTX),homocysteine(HCY)levels,and their correlation with the occurrence and development of osteoporosis in DN.Methods From December 2020 to December 2021,90 patients with type 2 diabetic nephropathy who were hospitalized in the Department of Nephrology of the First Affiliated Hospital of Jiamusi University were selected.According to the clinical stage of diabetic nephropathy,it was divided into three groups,namely microalbuminuria group,clinical albuminuria group and renal insufficiency group,with 30 cases in each group.All subjects collected 5 ML of elbow venous blood on an empty stomach in the morning.The levels of PINP,β-CTX and HCY in patients’ serum were measured by enzyme-linked immunosorbent assay and circulating enzyme method,and the bone mineral density was measured by dual-energy X-ray absorptiometry.Statistical analysis was made by SPSS20.0,and the correlations between PINP,β-CTX,HCY levels and bone mineral density were compared among the three groups.Results 1.The level of serum PINP decreased gradually in the three groups,including microalbuminuria group(30.03 ± 4.64)ng / ml,clinical proteinuria group(27.34 ± 2.11)ng/ ml and renal insufficiency group(24.26 ± 4.32)ng / ml(P < 0.05);The level of serum β-CTXincreased successively in the three groups: Microalbuminuria group(405.89 ± 39.90)pg/ ml,clinical proteinuria group(443.95 ± 58.24)pg / ml and renal insufficiency group(494.82± 43.44)pg / ml(P < 0.05);The level of serum HCY increased successively in the three groups: Microalbuminuria group(12.44 ± 1.87)umol / L,clinical proteinuria group(14.75± 2.36)umol / L,renal insufficiency group(16.59 ± 1.57)umol / L,(P < 0.05)2.Pearson correlation analysis:(1)Serum PINP was significantly positively correlated with BMD of lumbar spine and femur(r = 0.401,P < 0.01 and R = 0.338,P < 0.01)(2)β-CTX was significantly negatively correlated with BMD of lumbar spine and femur(r=-0.392,P < 0.01 and R =-0.443,P < 0.01)(3)HCY was negatively correlated with BMD of lumbar spine and femur(r =-0.424,P < 0.01 and R =-0.457,P < 0.01)Conclusions 1.With the progress of diabetes nephropathy,the level of PINP decreased gradually,β-The levels of CTX and HCY increased gradually.Prompt PINP β-The levels of CTX and HCY can reflect the severity of diabetes nephropathy to some extent.2.With the development of diabetic nephropathy,BMD of lumbar vertebrae and femur in three groups showed a decreasing trend.There was a positive correlation between bone metabolism marker PINP and bone mineral density,β-CTX and HCY were negatively correlated with bone mineral density,suggesting PINP β-CTX and HCY can be used as early predictors of diabetic nephropathy and osteoporosis,and provide new ideas for clinical diagnosis and treatment of patients with diabetic nephropathy and osteoporosis. |
