Interrelationship between Glucose Metabolism and Undercarboxylated Osteocalcin: A Cross-Sectional Study in a Community-Dwelling Population

葡萄糖代謝與未羧化骨鈣素之相關：一個社區族群的橫斷性研究

Shozo Yano ； Toru Nabika ； Atsushi Nagai ； Tsuyoshi Hamano ； Masayuki Yamasaki ； Minoru Isomura ； Kuninori Shiwaku ； Shuhei Yamaguchi ； Toru Yamaguchi ； Toshitsugu Sugimoto

《Asia Pacific Journal of Clinical Nutrition》 24卷3期 (2015/09) Pp. 489-495

https://doi.org/10.6133/apjcn.2015.24.4.02

摘要

目的：近期，骨頭生成的未羧化骨鈣素（ucOC）被發現扮演胰島素及脂聯素分泌的調節角色。我們執行一個橫斷性研究以探討ucOC與糖尿病的相關性。方法：此研究納入1870名大於50歲來自健康檢查的參與者。根據目前藥物治療及過去病史，605名研究對象有高血壓（HT）、316名有血脂異常（DL）及182名有第2型糖尿病。收集禁食血液樣本以ELSA測量ucOC及骨轉換標記、抗酒石酸磷酸酶5b（TRACP5b）濃度。結果：男女性糖尿病患者比起非糖尿病患者都有顯著較低的血清ucOC濃度。以羅吉斯迴歸分析，校正年齡、BMI、血清肌酸酐、三酸甘油酯及TRACP5b後，發現男女性低濃度的ucOC與糖尿病有顯著相關。複迴歸分析顯示ucOC與HbA1c、禁食血糖為負相關，與胰島素濃度則為正相關。反之，並未發現與TRACP5b以及上述指標的相關性，意指ucOC對胰島素分泌及血糖狀態的影響是獨立於骨轉換。結論：此橫斷性研究顯示在社區的男女性，校正骨轉換後，ucOC及葡萄糖代謝的顯著相關性，這顯示ucOC可能透過獨立於骨代謝的途徑扮演糖尿病致病重要的角色。

關鍵字

未羧化骨鈣素 ； 葡萄糖代謝 ； 糖尿病 ； 骨代謝 ； TRACP5

並列摘要

Objective: Undercarboxylated osteocalcin (ucOC) produced from the bone was recently found to play a regulatory role in the insulin and adiponectin secretion. We performed a cross-sectional study to investigate the relationship between ucOC and diabetes mellitus (DM). Methods: We included 1,870 subjects aged over 50 from participants of a health examination. According to the current medication and past history, 605 subjects had hypertension (HT), 316 had dyslipidemia (DL), and 182 had type 2 DM. Fasting blood samples were collected to measure concentrations of ucOC and the bone turnover marker, tartrate-resistant acid phosphatase 5b (TRACP5b) by ELISA. Results: The serum ucOC level was significantly lower in DM (+) than DM (-) in both men and women. In a logistic regression analysis, a low level of ucOC was significantly associated with the presence of DM in both men and women after adjusting for age, BMI, serum creatinine, triglyceride, and TRACP5b. Multiple regression analysis showed a negative association of ucOC with HbA1c and fasting plasma glucose, and a positive association with the insulin level. In contrast, no association was found between TRACP5b and the indices above, suggesting that the effect of ucOC on the insulin secretion and the glycemic status was independent of bone turnover. Conclusions: The present cross-sectional study showed a significant association between ucOC and glucose metabolism after correction with bone turnover in a community-dwelling population both in men and women, indicating that ucOC may play an important role in the pathogenesis of DM through the pathways independent of bone metabolism.

並列關鍵字

undercarboxylated osteocalcin ； glucose metabolism ； diabetes mellitus ； bone metabolism ； TRACP5