老年骨质疏松女性髋部骨密度、骨转换指标与血脂、血清尿酸相关性研究

摘要

目的 研究老年骨质疏松女性髋部骨密度(bone mineral density ,BMD)与血清总胆固醇(total cholesterol,TC)、血清甘油三酯(triglyceride,TG)、血清高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、血清低密度脂蛋白胆固醇(low density lipoprotein cholesterol ,LDL-C)和血清尿酸(uric acid,UA)的相关性.方法 收集2014年1月1日至2015年12月31日就诊的老年女性骨质疏松患者108例.记录患者的年龄、身高、体重、股骨颈BMD、股骨大转子BMD、股骨粗隆间BMD、髋部整体BMD、Ward’s区BMD、TC、TG、HDL-C、LDL-C、UA、血清Ⅰ型胶原交联C末端肽(C-terminal crosslinking telopeptide of type Ⅰ collagen,CTX)、Ⅰ型原胶原N-端前肽(procollagen type Ⅰ N propeptide,PINP)、25羟基维生素D(25-OH-VitD,VitD-T)及基础疾病情况等资料.髋部BMD、体质量指数(body mass index,BMI)、β-CTX、PINP、VitD-T、TC、TG、LDL-C、HDL-C、UA相关性检验采用Pearson相关性检验.结果 股骨颈BMD与年龄、β-CTX呈负相关,与BMI、Vit D-T、TG、UA呈正相关(r＜0,P＜0.05).股骨大转子BMD与年龄、β-CTX呈负相关(r＜0,P＜0.05),与BMI、Vit D-T、TC、TG、LDL-C、UA呈正相关(r＞0,P＜0.05).股骨粗隆间BMD与年龄、β-CTX、PINP呈负相关(r＜0,P＜0.05),与BMI、Vit D-T、TC、TG、UA呈正相关(r＞0,P＜0.05).髋部整体BMD与与年龄、β-CTX呈负相关(r＜0,P＜0.05),与BMI、Vit D-T、TC、TG、LDL-C、UA呈正相关(r＞0,P＜0.05).股骨Ward’s区BMD与年龄、β-CTX呈负相关(r＜0,P＜0.05),与BMI、Vit D-T、TC、LDL-C、UA呈正相关(r＞0,P＜0.05). TC与β-CTX、PINP呈负相关(r＜0,P＜0.05),与Vit D-T、UA呈正相关(r＞0,P＜0.05). TG与UA呈正相关(r＞0,P＜0.05).HDL-C与Vit D-T、UA呈正相关(r＞0,P＜0.05). LDL-C与β-CTX、PINP呈负相关(r＜0,P＜0.05),与Vit D-T、UA呈正相关(r＞0,P＜0.05).结论 骨质疏松患者髋部不同部位骨密度与血脂的相关性不同,适当水平的血清总胆固醇及尿酸有利于维持骨量,预防低骨量及骨质疏松的发生.%Objective To understand the relationships of serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and uric acid (UA) with hip bone mineral density (BMD).Methods The clinical data of 108 elderly female patients with osteoporosis, hospitalized between January 2008 and December 2010, were retrospectively analyzed.Age, height, weight, BMD of hip (Neck, Troch, Inter, Total and Ward), levels of serum β-CTX, PINP, Vit D-T, TC, TG, HDL-C, LDL-C and UA were measured.Pearson correlation analysis was performed to examine the associations between UA, serum lipids and hip bone mineral density.Results Femoral neck BMD negatively correlated with age and β-CTX (r＜0, P＜0.05), and positively correlated with BMI, Vit D-T, TG and UA (r＞0, P＜0.05). Greater trochanter BMD negatively correlated with age and β-CTX (r＜0, P＜0.05), and positively correlated with BMI, Vit D-T, TC, TG, LDL-C and UA (r＞0, P＜0.05).Intertrochanter BMD negatively correlated with age, β-CTX and PINP (r＜0, P＜0.05), and positively correlated with BMI, Vit D-T, TC, TG and UA (r＞0, P＜0.05).Hip BMD negatively correlated with age and β-CTX (r＜0, P＜0.05), and positively correlated with BMI, Vit D-T, TC, TG, LDL-C and UA (r＞0, P＜0.05). Ward’s BMD negatively correlated with age andβ-CTX (r＜0, P＜0.05), and positively correlated with BMI, Vit D-T, TC, LDL-C and UA (r＞0, P＜0.05).TC negatively correlated withβ-CTX and PINP (r＜0, P＜0.05), and positively correlated with Vit D-T and UA (r＞0, P＜0.05).TG positively correlated with UA (r＞0, P＜0.05).HDL-C positively correlated with Vit D-T and UA (r ＞0, P ＜0.05).LDL-C negatively correlated withβ-CTX and PINP (r ＞0, P ＜0.05), and positively correlated with Vit D-T and UA (r＞0, P＜0.05).Conclusion For osteoporotic patients, the correlation of the hip bone mineral density and serum lipid levels were different at different regions of hip.Low vitamin D levels and serum total cholesterol levels may increase the risk of osteoporotic hip fracture occurrence.