Relationship between metabolic risk factors and serum markers of bone metabolism in patients with metabolic and bariatric surgery

doi:10.16139/j.1007-9610.2020.06.010

Abstract

Abstract:

Objective To investigate the influence of metabolic risk factors on serum markers of bone metabolism and their relationship. Methods The data of patients with metabolic and bariatric surgery including blood glucose, triglyceride (TG), high density lipoprotein (HDL), bone specific alkaline phosphatase (B-ALP) and carboxy terminal peptide of type I collagen (CTX) were collected from department of gastrointestinal surgery in our hospital from January 2015 to April 2020. The patients were divided into two groups according to the median of B-ALP (≤14.24 μg/L, >14.24 μg/L) and CTX (≤0.36 μg/L, >0.36 μg/L). The clinical data and metabolic risk factors were compared between two groups and the clinical and metabolic factors correlated with parameters including B-ALP and CTX were analyzed. Results A total of 205 patients were included in this study with 81 males and 124 females There were significant differences in the parameters including systolic blood pressure, diastolic blood pressure, TG, HDL and the cases with lower HDL between B-ALP≤14.24 μg/L group and B-ALP>14.24 μg/L group (P<0.05). Between CTX ≤0.36 μg/L group and CTX >0.36 μg/L group, there were significant differences in gender, subcutaneous fat area and fasting blood glucose (P<0.05). B-ALP correlated with age and HDL negatively, and with systolic blood pressure, diastolic blood pressure and TG positively. CTX correlated with age and fasting blood glucose negatively. Logistic regression analysis showed that the risk of abnormal B-ALP increased significantly in patients with higher HDL (OR=2.931, 95% CI:1.585-5.421, P=0.001). Patients with larger area of subcutaneous fat decreased risk of abnormal CTX significantly (OR=0.381, 95% CI:0.194-0.748, P=0.005), while those with higher HDL had higher risk of abnormal CTX significantly (OR=2.067, 95% CI:1.118-3.824, P=0.021). Conclusions It was shown that lower HDL, higher fasting hyperglycemia and hypertension have influence on bone metabolism indexes of patients with metabolic and bariatric surgery.

Key words: Metabolic and bariatric surgery, Metabolic risk factors, Bone metabolism, Metabolic syndrome

CLC Number:

R589

ZHANG Guixiang, CHEN Gang, LI Zhengzheng, CHEN Yi, DU Xiao, CHENG Zhong. Relationship between metabolic risk factors and serum markers of bone metabolism in patients with metabolic and bariatric surgery[J]. Journal of Surgery Concepts & Practice, 2020, 25(06): 493-497.

Figures/Tables 3

References 16

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变量	B-ALP（μg/L）		P值	CTX（μg/L）		P值
变量	≤14.24（n=103）	>14.24（n=102）	P值	≤0.36（n=104）	>0.36（n=101）	P值
男/女	37/66	44/58	0.291	29/75	52/49	0.001^b)
年龄（岁）	33.88±10.43	32.40±9.89	0.298	34.00±10.15	32.27±10.15	0.223
BMI	35.58±5.80	36.23±6.64	0.457	35.28±5.49	36.54±6.87	1.145
皮下脂肪面积（cm²）	401.91±147.83	430.69±152.79	0.172	393.02±144.38	440.12±153.91	0.025^b)
内脏脂肪面积（cm²）	215.63±130.28	227.48±158.79	0.560	216.50±125.68	226.70±162.88	0.616
高血压（有/无）	46/57	55/47	0.185	45/59	56/45	0.081
收缩压（mmHg）	128.83±14.05	132.94±15.29	0.046^a)	129.55±14.18	132.24±15.34	0.194
舒张压（mmHg）	82.10±11.13	86.23±13.02	0.015^a)	82.98±12.91	85.36±11.47	0.166
糖尿病（有/无）	63/40	64/38	0.816	66/38	61/40	0.651
空腹血糖（mmol/L）	6.67±2.64	6.95±3.08	0.476	7.03±3.20	6.29±2.38	0.011^b)
高TG血症（有/无）	50/53	57/45	0.293	51/53	56/45	0.359
TG（mmol/L）	1.99±1.45	2.74±2.10	0.003^a)	2.21±1.74	2.52±1.92	0.225
低HDL血症（有/无）	56/47	77/25	0.002^a)	63/41	70/31	0.190
HDL（mmol/L）	1.63±1.33	1.09±0.60	<0.001^a)	1.44±1.14	1.29±0.98	0.305
LDL（mmol/L）	2.57±0.96	2.73±1.01	0.266	2.67±0.96	2.63±1.02	0.777

变量	B-ALP		CTX
变量	r值	P值	r值	P值
年龄	-0.191	0.006	-0.143	0.040
BMI	0.122	0.082	0.128	0.067
皮下脂肪面积	0.088	0.210	0.125	0.074
内脏脂肪面积	0.073	0.301	0.086	0.218
收缩压	0.163	0.019^a)	0.062	0.380
舒张压	0.184	0.008^a)	0.052	0.462
空腹血糖	0.009	0.903	-0.155	0.026^a)
TG	0.245	<0.001^a)	0.049	0.483
HDL	-0.201	0.004^a)	-0.127	0.069
LDL	0.033	0.637	0.002	0.976

项目	B-ALP		CTX
项目	OR（95%CI）	P值	OR（95%CI）	P值
BMI
≤35.51	1.00		1.00
>35.51	0.846（0.451~1.585）	0.601	1.025（0.545~1.929）	0.938
内脏脂肪面积（cm²）
≤184.30	1.00		1.00
>184.30	1.390（0.741~2.608）	0.305	1.542（0.816~2.913）	0.182
皮下脂肪面积（cm²）
≤423.20	1.00		1.00
>423.20	0.693（0.357~1.347）	0.280	0.381（0.194~0.748）	0.005^a)
IFG或糖尿病
有	1.00		1.00
无	0.929（0.497~1.738）	0.818	1.027（0.548~1.923）	0.935
高血压
有	1.00		1.00
无	0.791（0.437~1.431）	0.438	0.625（0.344~1.133）	0.121
高TG血症
有	1.00		1.00
无	1.049（0.571~1.927）	0.877	0.967（0.525~1.779）	0.913
HDL（mmol/L）
≤1.06	1.00		1.00
>1.06	2.931（1.585~5.421）	0.001^a)	2.067（1.118~3.824）	0.021^a)
LDL（mmol/L）
≤2.63	1.00		1.00
>2.63	0.830（0.464~1.486）	0.531	1.103（0.615~1.979）	0.742