대한임상검사과학회지 (Korean Journal of Clinical Laboratory Science)

  • 제50권3호
  • /
  • Pages.313-319
  • /
  • 2018
  • /
  • 1738-3544(pISSN)
  • /
  • 2288-1662(eISSN)
대한임상검사과학회 (Korean Society for Clinical Laboratory Science)
권호 표지
DOI QR코드

DOI QR Code

광주 소재 한 종합병원을 방문한 성인에서 혈중 Osteocalcin과 HbA1c의 상관관계

Correlation between Serum Osteocalcin and Hemoglobin A1c in Gwangju General Hospital Patients

  • 서요한 (광주보훈병원 진단검사의학과) ;
  • 신희영 (전남대학교 의과대학 의생명과학교실)
  • Seo, Yo-Han (Department of Laboratory Medicine, Gwangju Veterans Hospital) ;
  • Shin, Hee-Young (Department of Biomedical Science, Chonnam National University Medical School)
  • 투고 : 2018.05.19
  • 심사 : 2018.08.13
  • 발행 : 2018.09.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

최근 골대사와 당뇨병 발생 기전의 관계에 대해 많은 연구가 진행되고 있으며, osteocalcin이 제 2형 당뇨병을 위한 치료법에 관련될 수 있다는 것이 밝혀지고 있다. 따라서 본 연구는 osteocalcin과 HbA1c의 상관관계를 알아보고자 한다. 2015년 1월 1일부터 2016년 12월 31일까지 광주 소재 한 종합병원 수진자 중 osteocalcin과 HbA1c를 비롯하여 칼슘, 카르복시말단펩티드, 총 콜레스테롤, 중성지방, 고밀도 지질단백 콜레스테롤, 저밀도 지질단백 콜레스테롤, 25-수산화비타민D, 키, 몸무게를 측정한 40세 이상의 성인 총 714명($70.8{\pm}10.4$세)을 연구대상자로 최종 선정하였다. 성별은 남자(452명, 63.3%)가 여자(262명, 36.7%)보다 많았다. 당뇨환자군에서 osteocalcin과 HbA1c는 약한 음의 상관관계(r=-0.183, P<0.001)가 있었고, 다른 요인들을 모두 보정했을 때에도 여전히 음의 상관관계(r=-0.251, P<0.001)가 있었다. 본 연구는 당뇨환자에서의 osteocalcin과 HbA1c가 음의 상관관계가 있음을 보여주었다. 골대사와 당대사의 생물학적 기전 및 관련요인들이 미치는 영향을 바탕으로 골대사와 당뇨병 발생의 상호관계에 대한 연구가 지속되어야 한다.

Recently, there have been many studies on the relationship between the bone metabolism and the mechanism of diabetes. In those studies, it was shown that osteocalcin can be involved in the treatment of type 2 diabetes. Therefore, this study examined the correlation between osteocalcin and HbA1c. From January 1, 2015 to December 31, 2016, a total of 714 adults aged 40 years or older ($70.8{\pm}10.4years$, 452 males), in whom both osteocalcin and HbA1c checked in a general hospital in Gwangju, were enrolled in the study. The serum calcium, total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, and 25-(OH) vitamin D were measured and basic information, such as the height and weight, were recorded. There was a weak negative correlation (r=-0.183, P<0.001) between the osteocalcin and HbA1c levels in diabetic patients but a negative correlation (r=-0.251, P<0.001) when adjusted by all other study variables. The present study showed that there was a negative correlation between the osteocalcin and HbA1c levels in diabetic patients. The relationship between the bone metabolism and the incidence of diabetes mellitus should be studied based on the influence of biological mechanisms and associated factors of bone and glucose metabolism.

키워드

참고문헌

  1. Oh KW. Diabetes and osteoporosis. Korean Diabetes J. 2009;33:169-177. https://doi.org/10.4093/kdj.2009.33.3.169.
  2. Han AL, Shin SR, Park SH, Lee JM. Association of hemoglobin A1c with visceral fat measured by computed tomography in nondiabetic adults. J Agric Med Community Health. 2012; 37:215-222. https://doi.org/10.5393/jamch.2012.37.4.215.
  3. Lee YS, Moon SS. The use of HbA1c for diagnosis of Type 2 diabetes in Korea. Korean J Med. 2011;80:291-297.
  4. Ferron M, Wei J, Yoshizawa T, Del Fattore A, DePinho RA, Teti A, et al. Insulin signaling in osteoblasts integrates bone remodeling and energy metabolism. Cell. 2010;142:296-308. https://doi.org/10.1016/j.cell.2010.06.003.
  5. Wang Q, Zhang B, Xu Y, Xu H, Zhang N. The relationship between serum osteocalcin concentration and glucose metabolism in patients with Type 2 diabetes mellitus. Int J Endocrinol. 2013;7. https://doi.org/10.1016/j.cell.2010.06.003.10.1155/2013/842598.
  6. Kim KJ, Kim KK, Hwang IC, Lee KS, Suh HS. The relation of plasma osteocalcin and BMI in subjects who visited a health promotion center of a general hospital. Korean J Obes. 2011; 20:51-58. https://doi.org/10.7570/kjo.2011.20.2.51
  7. Chen Y, Zhao Q, Du G, Xu Y. Association between serum osteocalcin and glucose/lipid metabolism in Chinese Han and Uygur populations with Type 2 diabetes mellitus in Xinjiang: two cross-sectional studies. Lipids Health Dis. 2017;16:139. https://doi.org/10.1186/s12944-017-0512-8.
  8. Korean Diabetes Association. Korean diabetes fact sheet 2015 [Internet] Seoul: Korean Diabetes Association; 2015 [cited 2018 Aug 8]. Available from: http://www.diabetes.or.kr/bbs/index. html?sub_menu=&code=e_resource&category=1&gubun=&page= 1&number=215&mode=view&order=&sort=&keyfield=&key=.
  9. Bao YQ, Zhou M, Zhou J, Lu W, Gao YC, Pan XP, et al. Relationship between serum osteocalcin and glycaemic variability in Type 2 diabetes. Clin Exp Pharmacol Physiol. 2011; 38:50-54. https://doi.org/10.1111/j.1440-1681.2010.05463.x.
  10. Lipscombe LL, Jamal SA, Booth GL, Hawker GA. The risk of hip fractures in older individuals with diabetes: a population-based study. Diabetes Care. 2007;30:835-841. https://doi.org/10.2337/dc06-1851.
  11. Zhou M, Ma X, Li H, Pan X, Tang J, Gao Y, et al. Serum osteocalcin concentrations in relation to glucose and lipid metabolism in Chinese individuals. Eur J Endocrinol. 2009;161: 723-729. https://doi.org/10.1530/eje-09-0585.
  12. Xuan Y, Sun LH, Liu DM, Zhao L, Tao B, Wang WQ, et al. Positive association between serum levels of bone resorption marker CTX and HbA1c in women with normal glucose tolerance. J Clin Endocrinol Metab. 2015;100:274-281. https://doi.org/10.1210/jc.2014-2583.
  13. Urano T, Shiraki M, Kuroda T, Tanaka S, Urano F, Uenishi K, et al. Low serum osteocalcin concentration is associated with incident type 2 diabetes mellitus in Japanese women. J Bone Miner Metab. 2017;36:470-477. https://doi.org/10.1007/s00774-017-0857-0.
  14. Parfitt AM, Gallagher J, Heaney RP, Johnston C, Neer R, Whedon GD. Vitamin D and bone health in the elderly. Am J Clin Nutr. 1982;36:1014-1031. https://doi.org/10.1093/ajcn/36.5.1014.
  15. Auwerx J, Bouillon R, Kesteloot H. Relation between 25-hydroxyvitamin D3, apolipoprotein A-1 and high density lipoprotein cholesterol. Arterioscler Thromb. 1992;12:671-674. https://doi.org/10.1161/01.ATV.12.6.671
  16. Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfuntion. Am J Clin Nutr. 2004;79:820-825. https://doi.org/10.1093/ajcn/80.6.1666.
  17. Kim MY, Kim MJ, Ly SY. Vitamin D intake, serum 25OHD, and bone mineral density of Korean adults: based on the Korea National Health and Nutrition Examination Survey (KNHANES, 2011). J Nutr Health. 2016;49:437-446. https://doi.org/10.4163/jnh.2016.49.6.437.
  18. Starup-Linde J. Diabetes, biochemical markers of bone turnover, diabetes control, and bone. Front Endocrinol (Lausanne). 2013;4:21. https://doi.org/10.3389/fendo.2013.00021.
  19. Treatment Guidelines Commission of The Korean Society for The Study of Obesity. Obesity treatment guidelines 2018 [Internet]. Seoul: The Korean Society for The Study of Obesity; 2018 [cited 2018 Aug 8]. Available from: http://general.kosso. or.kr/html/user/core/view/reaction/main/kosso/inc/data/type02.pdf.
  20. Tentolouris N, Andrianakos A, Karanikolas G, Karamitsos D, Trontzas P, Krachtis P, et al. Type 2 diabetes mellitus is associated with obesity, smoking and low socioeconomic status in large and representative samples of rural, urban, and suburban adult Greek populations. Hormones (Athens). 2012;11:458-467. https://doi.org/10.14310/horm.2002.1378.
  21. Kwon SY, Na YA. The cutoff value of HbA1c in predicting diabetes and impaired fasting glucose. Korean J Clin Lab Sci. 2017;49:114-120. https://doi.org/10.15324/kjcls.2017.49.2.114.
  22. Chubb SA. Measurement of C-terminal telopeptide of type I collagen (CTX) in serum. Clin Biochem. 2012;45:928-935. https://doi.org/10.1016/j.clinbiochem.2012.03.035.
  23. Chung YS, Yoo BW, Oh JE, Lee DC, Lee HS, Cho CY. The relationship between vitamin D levels and chronic diseases. Korean J Clin Geriatr. 2010;11:154-169.
  24. Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 2004;79:362-371. https://doi.org/10.1093/ajcn/79.3.362.
  25. Ducy P. The role of osteocalcin in the endocrine cross-talk between bone remodelling and energy metabolism. Diabetologia. 2011;54:1291-1297. https://doi.org/10.1007/s00125-011-2155-z.
  26. Ferron M, McKee MD, Levine RL, Ducy P, Karsenty G. Intermittent injections of osteocalcin improve glucose metabolism and prevent type 2 diabetes in mice. Bone. 2012;50: 568-575. https://doi.org/10.1016/j.bone.2011.04.017.
  27. Kim DW, Kim DH. Hemoglobin Alc levels according to duration and complications of diabetes mellitus. The DongGuk Journal of Medicine. 1999;6:424-435.
  28. Qvist P, Christgau S, Pedersen BJ, Schlemmer A, Christiansen C. Circadian variation in the serum concentration of C-terminal telopeptide of type I collagen (serum CTx): effects of gender, age, menopausal status, posture, daylight, serum cortisol, and fasting. Bone. 2002;31:57-61. https://doi.org/10.1016/S8756-3282(02)00791-3.
  29. Maddaloni E, D'Onofrio L, Lauria A, Maurizi AR, Strollo R, Palermo A, et al. Osteocalcin levels are inversely associated with Hba1c and BMI in adult subjects with long-standing type 1 diabetes. J Endocrinol Invest. 2014;37:661-666. https://doi.org/10.1007/s40618-014-0092-7.