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초록
Backgroud
Patients with type 2 diabetes are known to have an increased risk for osteoporotic fractures compared with non-dia-betic subjects. We investigated whether the serum endogenous secretory receptor for advanced glycation end products (esRAGE) or pentosidine was associated with prevalent vertebral fractures in patients with type 2 diabetes.
Methods
We enrolled 140 patients with type 2 diabetes mellitus (73 men aged 50 or older and 67 postmenopausal women). Lateral X-ray films of the spine revealed prevalent vertebral fractures. The serum concentration of esRAGE and pentosidine were measured.
Results
The mean age of all patients was 66.2 ± 6.5 years and 22% of patients had prevalent vertebral fractures. Serum pentosidine levels were similar between those with and without vertebral fractures. There were no significant correlations between serum es-RAGE levels and age, body mass index, duration of diabetes, and hemoglobin A1c. However, patients with moderate or severe vertebral fractures have a lower esRAGE level compared to those without after adjusting for age and gender (0.33 ± 0.12 ng/mL vs. 0.24 ± 0.03 ng/mL, P < 0.05). Logistic regression analysis demonstrated that patients in the lowest tertile of esRAGE had a higher risk of moderate or severe vertebral fractures (odds ratio, 16.6; 95% confidence interval, 1.4-198.5) than patients in the highest tertile.
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Fig. 1.
Serum endogenous secretory receptor for advanced glycation end products (esRAGE) concentration in type 2 diabetic patients with or without vertebral fractures after adjusting for age and gender. Patients with moderate or severe vertebral fractures showed significantly lower esRAGE levels compared to those without. ∗Age, gender adjusted P < 0.05.
Table 1.
Baseline characteristics of study patients according to esRAGE tertile
Table 2.
Simple regression analysis between esRAGE level and various param-eters
Table 3.
Association between esRAGE status and the presence of moderate or severe vertebral fractures in type 2 diabetic patients
| esRAGE | Model 1 | Model 2 | Model 3 |
|---|---|---|---|
| 1st tertile (lowest) | 12.0∗ | 11.9∗ | 16.6∗ |
| (1.4-102.0) | (1.3-107.8) | (1.4-198.5) | |
| 2nd tertile (middle) | 5.0 | 6.4 | 6.5 |
| (0.6-45.4) | (0.7-60.5) | (0.5-76.1) | |
| 3rd tertile (highest) | Reference group | Reference group | Reference group |
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