Objective:To investigate the correlation between insulin-like growth factor-1 (IGF-1) and insulin resistance (IR) and the role in type 2 diabetes (T2DM) combined with osteoporosis (OP), by determining IGF-1 level in T2DM combined with OP patients' serum. Methods:115 patients with T2DM combined with OP in our hospital from January 2013 to June 2015 were selected and randomly divided into control group (48 cases, non-OP group) and the experimental group of 67 cases (OP group), according to their bone mineral density (BMD) values and the diagnosis standard of osteoporosis. We detected and compared differences in fasting blood glucose (FBG), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistance index (IRI), IGF-1, and BMD. The correlation analysis between IGF-1 and IR of patients serum in the experimental group was made, and a multifactor related statistical analysis was performed to analyze the related risk factors in T2DM combined with OP. Results:Compared with the control group, the levels of IGF-1[(109.87±22.85)μg·L-1], BMD[(-2.83±0.35)g·cm-2] and ISI(55.94±7.79)in the experimental group were significantly lower, but the levels of FBG[(8.69±0.80)mmol·L-1, FINS[(21.42±1.66)mIU·L-1] and IRI (8.27±1.15) were significantly higher(P<0.0 or P<0.05). The levels of IGF-1 was negatively correlated to FBG, FINS and IRI, but positively correlated to BMD and ISI (P<0.01 or P<0.05). Multiariable logistic regression analysis showed that the level of IGF-1, FBG, FINS and ISI were the related risk factors in T2DM combined with OP (OR=0.958, 4.704, 1.985, 0.812, P<0.01 or P<0.05). Conclusion:The low level of IGF-1, ISI, and the higher level of FBG, FINS are considered as the risk factors of T2DM combined with OP. |
[1] 段宇,刘超.胰岛素样生长因子-1研究进展[J].国外医学:内分泌学分册,2001,21(6):305-307.
[2] OEI L,RIVADENEIRA F,ZILLIKENS M C,et al.Diabetes,diabetic complications,and fracture risk[J].Curr Osteoporos Rep,2015,13(2):106-115.
[3] VESTERGAARD P.Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2diabetes——a meta-analysis[J].Osteoporos Int,2007,18(4):427-444.
[4] 李凝旭,涂艳,刘晓霞,等.糖尿病合并骨质疏松症患者炎症因子、脂肪因子变化的研究[J].海南医学院学报,2016,22(5):438-440.
[5] 张洁,沈默,宇成金罗.2型糖尿病患者骨密度的相关因素[J].中国老年学杂志,2012,32(15):3186-3188.
[6] 朱明明,李宗虎,郑宪玲,等.2型糖尿病患者血清OPG水平及BMD的相关性研究[J].现代医学,2017,45(2):260-263.
[7] STARUP-LINDE J,VESTERGAARD P.Management of endocrine disease:diabetes and osteoporosis:cause for concern[J].Eur J Endocrinol,2015,173(3):R93-99.
[8] 韦少玲,肖燕爽,李巧云.2型糖尿病胰岛素抵抗现代医学研究进展[J].实用糖尿病杂志,2011,7(1):9-11.
[9] 王晓丽,常向云,孙侃.不同程度糖尿病足溃疡风险患者血浆胰岛素样生长因子1水平的变化及意义[J].中国全科医学,2011,14(15):1632-1634.
[10] 刘润萍,孙丽莎,陈秋.胰岛素样生长因子-1与糖尿病并发骨质疏松的关系研究进展[J].中国全科医学,2013,16(3):237-239.
[11] WONGDEE K,CHAROENPHANDHU N,BOUXSEIN M L.Update on type 2 diabetes-related osteoporosis[J].World J Diabetes,2015,6(5):673-678.
[12] 荣太梓,胡淑芳,程奎.2型糖尿病与骨质疏松症的相关因素分析[J].河北医药,2017,39(1):102-104.
[13] 薛云,胡继红.2型糖尿病患者并发骨质疏松症的相关危险因素分析[J].实用临床医药杂志,2013,17(21):155-156.
[14] 唐辰义.胰岛素受体底物家族成员的结构和组织特异性与功能的关系[J].临床与病理杂志,2016,36(3):295-302
[15] 吴淑会.胰岛素样生长因子Ⅰ(IGF-Ⅰ)与各疾病的相关性研究进展[J].中国实验诊断学,2014,18(7):1214-1216.
[16] 胡晓琳,娄宁,董振华,等.胰岛素对骨骼肌微血管的调节作用[J].国际内分泌代谢杂志,2012,32(2):107-110.
[17] DOMINGUEZ L J,MURATORE M,QURATA E,et a1.Osteoporosis and diabetes[J].Reumatismo,2011,56(4):235-241.
[18] KURRA S,FINK D A,SIRIS E S.Osteoporosis-associated fracture and diabetes[J].Endocrinol Metab Clin North Am,2014,43(1):233-243. |
