为了探讨在中国2型糖尿病（T2DM）患者中，血清骨钙蛋白与血糖控制、胰腺功能和胰岛素敏感性的关系。来自同济大学医学院的曲伸教授及其团队进行了一项研究，该研究发现在T2DM患者中，骨钙蛋白与血糖呈负相关。
该研究中，招募了1019例T2DM患者（男性：432例，女性：587例，平均年龄：65.96±13.11岁）。测量后确定体重指数（BMI）、空腹血糖（FPG）、空腹胰岛素（FINS）、空腹C肽（F-CP）、餐后血糖（2hPBG）、餐后C肽（2hC-P）、糖化血红蛋白（HbA1c）、以及骨钙蛋白。根据上述参数计算稳态模型评估的β细胞功能（HOMA-β）和稳态模型评估的胰岛素抵抗（HOMA-IR）。
该研究结果表明，男性和女性之间的骨钙蛋白水平有显著差异[(13.51±12.37)ng/ml vs （16.22±10.40）ng/ml，P＜0.001]。校正年龄和BMI后，血清骨钙蛋白与HbA1c、FPG和2hPBG呈负相关（P＜0.05），并与FC-P、2hC-P和HOMA-β呈正相关（P＜0.05）。在男性患者，校正年龄和BMI后，血清骨钙蛋白与2hPBG呈负相关（P＜0.05），并与FC-P、2hC-P和HOMA-β呈正相关（P＜0.05）。在女性，校正年龄和BMI后，血清骨钙蛋白与HbA1c、FPG呈负相关（P＜0.05）。多元线性回归分析显示，在男性，血清骨钙蛋白是影响HOMA-β和HOMA-IR的独立相关因素，并且，在所有受试者中，血清骨钙蛋白也是影响HOMA-IR的独立相关因素（P＜0.05）。
该研究发现，在T2DM患者，骨钙蛋白与血糖呈负相关，暗示骨钙蛋白可以降低血糖。并且，骨钙蛋白与FC-P、2hC-P和HOMA-β呈正相关，支持骨钙蛋白可以通过促进胰岛的胰岛素分泌，改善血糖控制的观点。
This study is to investigate the association between serum osteocalcin and glucose control pancreatic function and insulin sensitivity in the type 2 diabetes mellitus (T2DM) Chinese patients.
1019 T2DM patients were recruited (Male:432 Female:587 Average age: 65.96 ± 13.11 years). After measured BMI the fasting plasma glucose(FPG) insulin(FINS) C peptide(F-CP) postprandial blood glucose (2hPBG) and C peptide (2hC-P) HbA1C and osteocalcin were determined. Homeostasis model assessment of β cell function (HOMA-β) and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated based on the above parameters.
The difference in osteocalcin levels between male and female are significant [(13.51±12.37)ng/mL vs (16.22±10.40)ng/mL P<0.001]. After adjustment for age and BMI serum osteocalcin was negatively correlated with HbA1C FPG and 2hPBG (P<0.05) and positively correlated with fasting C peptide (FC-P) 2h C peptide (2hC-P) and HOMA-β (P<0.05). In male after adjustment for age and BMI serum osteocalcin was negatively correlated with 2hPBG (P<0.05) and positively correlated with FC-P 2hC-P and HOMA-β (P<0.05). In female after adjustment for age and BMI serum osteocalcin was negatively correlated with HbA1C FPG (P<0.05). Multivariable liner regression analysis showed that serum osteocalcin was the independent related factor in influencing HOMA-β and HOMA-IR in male and it was also the independent related factor in influencing HOMA-IR in all subjects (P<0.05).
In T2DM osteocalcin was negatively associated with glucose implying osteocalcin could lower blood glucose. And osteocalcin was positively associated with FC-P 2hC-P and HOMA-β supporting the idea that osteocalcin might improve glucose control through promoting insulin secretion of pancreatic islet.
