Diabetes during Oral Glucose and Isoglycemic iv Glucose JCEM:非酒精性脂肪性肝病和2型糖尿病对骨转

2018-03-03 MedSci MedSci原创

众所周知非酒精性脂肪性肝病(NAFLD)与2型糖尿病(T2D)相关,反之亦然,而且这两种情况都与骨折风险增加和骨转换改变相关。虽然NAFLD患者通常发生骨密(BMD)下降,而T2D患者则表现为正常至高BMD水平。其相关病理生理学机制尚未明确,但可能涉及肠骨轴。

众所周知非酒精性脂肪性肝病(NAFLD)与2型糖尿病(T2D)相关,反之亦然,而且这两种情况都与骨折风险增加和骨转换改变相关。虽然NAFLD患者通常发生骨密(BMD)下降,而T2D患者则表现为正常至高BMD水平。其相关病理生理学机制尚未明确,但可能涉及肠骨轴。

近日在JCEM上发表的一篇文章则旨在研究健康对照和患有T2D和/或活检验证的NAFLD的患者肠道对葡萄糖诱导的血浆骨转换标志物变化的影响。研究人员纳入了糖耐量正常的NAFLD患者、T2D的NAFLD患者、无肝病的T2D患者和健康对照者。对其进行4小时50g口服葡萄糖耐量试验(OGTT)和等血糖静脉内葡萄糖输注(IIGI)。主要测量结果胶原蛋白1型C-端肽(CTX),骨钙蛋白,前胶原蛋白1型N-端前肽(P1NP)和甲状旁腺激素(PTH)的水平。

研究结果表明OGTT试验中血糖上升的程度与相应IIGI天数的结果相一致。NAFLD+T2D的患者在两个葡萄糖试验中表现出相似的CTX抑制(P = 0.46),而与OGTT试验相比,在IIGI中明显抑制P1NP。相反的,其余的组在OGTT试验中抑制CTX(p<0.05),在IIGI和OGTT中抑制骨形成标记的效果类似。

上述研究结果表明OGTT导致的CTX抑制可能在NAFLD+T2D患者中受损,但在患有T2D或者NAFLD的患者中仍有保留,提示T2D和NAFLD同时存在可能会影响肠骨轴。

原始出处:

Henrik Maagensen.et al. Bone Turnover Markers in Patients with Non-Alcoholic Fatty Liver Disease and/or Type 2 Diabetes during Oral Glucose and Isoglycemic iv Glucose. J Clin Endocrinol Metab. 2018.

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    2019-01-30 仁者大医
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attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Sun Oct 07 21:39:00 CST 2018, time=2018-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810072, encodeId=c0bc18100e277, content=<a href='/topic/show?id=70f484349b5' target=_blank style='color:#2F92EE;'>#脂肪性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84349, encryptionId=70f484349b5, topicName=脂肪性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c49e75, createdName=qjddjq, createdTime=Sun Jun 17 02:39:00 CST 2018, time=2018-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1673375, encodeId=a20d16e337538, content=<a href='/topic/show?id=757b954e922' target=_blank style='color:#2F92EE;'>#酒精性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95479, encryptionId=757b954e922, topicName=酒精性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=398f26933958, createdName=huiwelcome, createdTime=Mon Dec 31 11:39:00 CST 2018, time=2018-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902004, encodeId=dd80190200450, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Thu May 03 17:39:00 CST 2018, time=2018-05-03, status=1, ipAttribution=)]
  5. 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createdName=ms9608593228839890, createdTime=Wed Mar 07 09:39:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784859, encodeId=d8b51e8485955, content=<a href='/topic/show?id=07c56336c5' target=_blank style='color:#2F92EE;'>#during#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6336, encryptionId=07c56336c5, topicName=during)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK17mLkWpia3T92NlEWTkEhrhZa7XPNic2JqQumEicZXGYFG6Ww5SCIl0Uq62bhhPnibAqIZDHtRva92A/132, createdBy=e0752500025, createdName=江川靖瑶, createdTime=Thu Sep 06 04:39:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1654002, encodeId=072a165400259, content=<a href='/topic/show?id=1e1584351b2' target=_blank style='color:#2F92EE;'>#脂肪性肝病#</a>, beContent=null, 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attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Sun Oct 07 21:39:00 CST 2018, time=2018-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810072, encodeId=c0bc18100e277, content=<a href='/topic/show?id=70f484349b5' target=_blank style='color:#2F92EE;'>#脂肪性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84349, encryptionId=70f484349b5, topicName=脂肪性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c49e75, createdName=qjddjq, createdTime=Sun Jun 17 02:39:00 CST 2018, time=2018-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1673375, encodeId=a20d16e337538, content=<a href='/topic/show?id=757b954e922' target=_blank style='color:#2F92EE;'>#酒精性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95479, encryptionId=757b954e922, topicName=酒精性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=398f26933958, createdName=huiwelcome, createdTime=Mon Dec 31 11:39:00 CST 2018, time=2018-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902004, encodeId=dd80190200450, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Thu May 03 17:39:00 CST 2018, time=2018-05-03, status=1, ipAttribution=)]
  6. 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attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Sun Oct 07 21:39:00 CST 2018, time=2018-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810072, encodeId=c0bc18100e277, content=<a href='/topic/show?id=70f484349b5' target=_blank style='color:#2F92EE;'>#脂肪性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84349, encryptionId=70f484349b5, topicName=脂肪性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c49e75, createdName=qjddjq, createdTime=Sun Jun 17 02:39:00 CST 2018, time=2018-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1673375, encodeId=a20d16e337538, content=<a href='/topic/show?id=757b954e922' target=_blank style='color:#2F92EE;'>#酒精性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95479, encryptionId=757b954e922, topicName=酒精性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=398f26933958, createdName=huiwelcome, createdTime=Mon Dec 31 11:39:00 CST 2018, time=2018-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902004, encodeId=dd80190200450, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Thu May 03 17:39:00 CST 2018, time=2018-05-03, status=1, ipAttribution=)]
    2018-07-06 小几洁
  7. 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attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Sun Oct 07 21:39:00 CST 2018, time=2018-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810072, encodeId=c0bc18100e277, content=<a href='/topic/show?id=70f484349b5' target=_blank style='color:#2F92EE;'>#脂肪性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84349, encryptionId=70f484349b5, topicName=脂肪性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c49e75, createdName=qjddjq, createdTime=Sun Jun 17 02:39:00 CST 2018, time=2018-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1673375, encodeId=a20d16e337538, content=<a href='/topic/show?id=757b954e922' target=_blank style='color:#2F92EE;'>#酒精性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95479, encryptionId=757b954e922, topicName=酒精性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=398f26933958, createdName=huiwelcome, createdTime=Mon Dec 31 11:39:00 CST 2018, time=2018-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902004, encodeId=dd80190200450, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Thu May 03 17:39:00 CST 2018, time=2018-05-03, status=1, ipAttribution=)]
    2018-10-07 achengzhao
  8. 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topicName=null, topicId=null, topicList=[TopicDto(id=95479, encryptionId=757b954e922, topicName=酒精性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=398f26933958, createdName=huiwelcome, createdTime=Mon Dec 31 11:39:00 CST 2018, time=2018-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902004, encodeId=dd80190200450, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Thu May 03 17:39:00 CST 2018, time=2018-05-03, status=1, ipAttribution=)]
    2018-06-17 qjddjq
  9. 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  10. 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