达格列净对2型糖尿病病人骨代谢指标的影响

    Effect of dapagliflozin on bone metabolism indexes in type 2 diabetic patients

    • 摘要:
      目的 观测达格列净对2型糖尿病(T2DM)病人骨代谢指标的影响, 为临床动态监测达格列净使用安全性提供指导。
      方法 选择38例服用达格列净的T2DM病人为达格列净组, 42例使用其他降糖方案的T2DM病人为非达格列净组, 测定2组病人的糖脂代谢指标、骨代谢指标, 比较2组差异性, 利用相关分析及多元线性回归分析预测影响病人骨代谢指标的相关因素。
      结果 达格列净组三酰甘油(TG)、1, 25二羟基维生素D(1, 25(OH)2D)、1-ɑ羟化酶(CYP27B1)显著低于非达格列净组(P < 0.01);达格列净组甲状旁腺激素(PTH)、Ⅰ型胶原交联C-末端肽(S-CTX)显著高于非达格列净组(P < 0.05);相关性分析显示S-CTX与TG(r=-0.318)和钠(r=-0.455)呈负相关, 与PTH(r=0.319)呈正相关; P1NP与其他指标无相关性; 多元线性回归分析显示, 低钠、低TG、高PTH、服用达格列净是S-CTX的主要危险因素。
      结论 达格列净可以增强T2DM病人骨吸收, 可能是通过导致TG、1, 25(OH)2D降低, PTH增加来实现的。>

       

      Abstract:
      Objective To observe the effects of dapagliflozin on bone metabolism in patients with type 2 diabetes mellitus(T2DM) and provide guidance for the clinical dynamic monitoring of drug use safety.
      Methods A total of 38 T2DM patients taking dagaglizin were selected as dagaglizin group, and 42 T2DM patients using other hypoglycemic programs were selected as non-daglizin group.The glucose and lipid metabolism indexes and bone metabolism indexes in two groups were measured, and the differences between wo groups were compared.Correlation analysis and multiple linear regression analysis were used to predict the related factors affecting bone metabolism indexes of the patients.
      Results The levels of triglyceride(TG), 1, 25-dihydroxyvitamin D(1, 25(OH)2D) and 1-hydroxylase(CYP27B1) in the dapagliflozin group were significantly lower than those in non-dapagliflozin group(P < 0.01).The parathyroid hormone(PTH) and type Ⅰ collagen cross-linked C-terminal peptide(S-CTX) in the dapagliflozin group were significantly higher than those in non-dapagliflozin group(P < 0.05).The results of correlation analysis showed that the S-CTX was negatively correlated with TG(r=-0.318) and sodium(r=-0.455), and positively correlated with PTH(r=0.319).There was no correlation between P1NP and other indexes.The results of multiple linear regression analysis showed that the low sodium, low TG, high PTH and taking dapagliflozin were the main risk factors of S-CTX.
      Conclusions Daglipzin enhances bone resorption in T2DM patients, possibly by reducing TG, 1, 25(OH)2D and increasing PTH.

       

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