关键词: 晚期糖基化终末产物, 氧化低密度脂蛋白, 相关性, 糖尿病, 骨质疏松症, 老年人

Abstract:

Objective To investigate the relationships of advanced glycation end products（AGE） and oxidized low-density lipoprotein（ox-LDL） in elderly diabetic patients with osteoporosis（OP）. Methods A total of 304 patients with type 2 diabetes mellitus（T2DM）were enrolled,and their ages were ≥60 years. According to the occurrence of OP,they were classified into simple T2DM group（201 cases） and T2DM with OP group（103 cases）. A total of 68 healthy subjects were enrolled as healthy control group. The bone mineral densities of lumbar spine（L1-L4）,spine（except lumbar spine）,left femoral neck（Neck）,left femoral large rotor（Troch） and Ward's triangle area were determined. AGE,ox-LDL,glycated hemoglobin A_1c（HbA_1c）,calcium（Ca）,phosphorus（P）,creatinine（Cr）,urea,fasting plasma glucose（FPG）,2 h postprandial plasma glucose（2 hPG）,uric acid（UA）/ Cr and alkaline phosphatase（ALP） were determined. The data of sex,age,the use of hypoglycemic drugs,the histories of smoking and hypertension,body mass index（BMI） were recorded. Multivariate Logistic regression analysis was used to evaluate the risk factors for T2DM with OP. Spearman correlation analysis was used to analyze the relationship of bone mineral densities with AGE and ox-LDL in T2DM with OP group. Receiver operating characteristic（ROC） curve was used to evaluate the sensitivities and specificities of ox-LDL and AGE for the diagnosis of T2DM with OP.Results HbA_1c,Cr,UA/Cr,FPG,ALP,AGE,ox-LDL and the proportion of hypertension in simple T2DM and T2DM with OP groups were higher than those in healthy control group（P<0.05）. UA/Cr ,AGE and ox-LDL in T2DM with OP group were higher than those in simple T2DM group（P<0.05）,and there was no statistical significance for the other indices（P>0.05）. The bone mineral densities of lumbar spine（L1-L4）,spine,Neck,Troch and Ward's triangle area in T2DM with OP group were lower than those in simple T2DM group（P<0.05）,and the bone mineral densities of lumbar spine（L1-L4）and spine in T2DM with OP group and simple T2DM group were lower than those in healthy control group（P<0.05）. Logistic regression analysis showed that the history of hypertension,UA/Cr,HbA_1c,AGE and ox-LDL were risk factors for T2DM with OP. Spearman correlation analysis showed that AGE and ox-LDL had correlations with the bone mineral densities of Neck,Troch and Wald's triangle area（P<0.05）and no correlation with those of lumbar spine（L1-L4） and spine（P>0.05）. ROC curve showed that the sensitivity,specificity and area under ROC curve of the combined determination of ox-LDL and AGE were higher than those of ox-LDL and AGE single determinations（P<0.05）. Conclusions AGE and ox-LDL have correlations with the incidence of T2DM with OP,and the combined determination of AGE and ox-LDL can improve efficacy for the diagnosis of T2DM with OP.

Key words: Advanced glycation end products, Oxidized low-density lipoprotein, Correlation, Diabetes mellitus, Osteoporosis, Elderly