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目的:探讨2型糖尿病(T2DM)患者血清骨保护素(OPG)与患者氧化应激水平的关系。方法:选取2014年1月至2015年12月在邯郸市中心医院诊治的128例T2DM患者进行研究,根据骨密度(BMD)将其分为骨量正常组45例、骨量减少组42例、骨质疏松组41例,另选取年龄、性别基本匹配的50例健康人群作为对照组,检测各组的血清骨保护素(OPG)、超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)、丙二醛(MDA)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)、晚期蛋白质氧化产物(AOPP),并分析相互间关系。结果:骨量正常组、骨量减少组、骨质疏松组的SOD、GSH、GSH-Px测定值显著高于对照组(P<0.05),骨质疏松组的SOD、GSH-Px、CAT显著低于骨量减少组和骨量正常组(P<0.05),骨质疏松组的SOD、GSH显著低于骨量正常组(P<0.05);骨量正常组、骨量减少组、骨质疏松组的MDA、OPG、AOPP测定值显著高于对照组(P<0.05),骨质疏松组的OPG、AOPP显著高于骨量减少组、骨质疏松组(P<0.05);骨质疏松组的MDA显著高于骨量正常组(P<0.05)。多元逐步回归分析法分析结果显示:OPG=-0.481(SOD)-0.322(GSH)+2.755(MDA)-0.319(GSH-Px)+1.672(AOPP);OPG与SOD、GSH、GSH-Px呈负相关关系(P<0.05),与MDA、AOPP呈正相关关系(P<0.05)。结论:T2DM患者OPG水平与氧化应激密切相关,氧化应激可能促进了糖尿病骨质疏松的发生发展。
Objective: To investigate the relationship between serum osteoprotegerin (OPG) and oxidative stress in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 128 T2DM patients diagnosed and treated in Central Hospital of Handan from January 2014 to December 2015 were selected and divided into 45 cases with normal bone mass group, 42 cases with osteopenia group according to bone mineral density (BMD) In the osteoporosis group, 41 cases were selected, and 50 healthy people, whose age and sex matched basically, were selected as the control group. Serum levels of osteoprotegerin (OPG), superoxide dismutase (SOD), reduced glutathione (GSH), malondialdehyde (MDA), catalase (CAT), glutathione peroxidase (GSH-Px) and late oxidation of protein (AOPP) were measured and analyzed. Results: The values of SOD, GSH and GSH-Px in the normal bone mass group, osteopenia group and osteoporosis group were significantly higher than those in the control group (P <0.05). The levels of SOD, GSH-Px and CAT in the osteoporosis group were significantly higher than those in the control group (P <0.05). The levels of SOD and GSH in the osteoporosis group were significantly lower than those in the normal control group (P <0.05). The normal bone mass group, osteopenia group, The values of MDA, OPG and AOPP in osteoporosis group were significantly higher than those in control group (P <0.05). OPG and AOPP in osteoporosis group were significantly higher than those in osteopenia group and osteoporosis group (P <0.05) Group MDA was significantly higher than the normal bone mass group (P <0.05). The results of multivariate stepwise regression analysis showed that OPG was -0.481 (SOD) -0.322 (GSH) +2.755 (MDA) -0.319 (GSH-Px) +1.672 (AOPP), while OPG and SOD, GSH and GSH-Px were negative (P <0.05), but positively correlated with MDA and AOPP (P <0.05). Conclusion: The level of OPG in T2DM patients is closely related to oxidative stress. Oxidative stress may promote the occurrence and development of diabetic osteoporosis.