ABCB1基因C3435T多态性与ICS治疗COPD合并OP的相关性研究
发布时间：2018-09-03 08:10
【摘要】：目的：探讨长期(≥6个月)吸入糖皮质激素治疗的老年男性COPD患者的骨密度及临床指标的相关性。 方法：选择109名COPD患者,其中51名有骨质疏松(0P组),58名非骨质疏松(NOP组),50名健康对照者(NC组)。测定COPD患者的肺功能,测定实验组和对照组的骨密度、血清白蛋白(ALB)、血清总蛋白(STP)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血尿素氮(BUN)、血肌(?)(CREA)、血尿酸(SUA)、总胆固醇(TC)、甘油三酯(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、体重指数(BMI)、收缩压(SBP)、舒张压(DBP)。 结果：(1)在NC组：体重与L1、L2、L3、L4、L1-L4、股骨颈、股骨大粗降的BMD值呈正相关,BMI与L]、L3、L4、L1-L4的BMD值正相关,且有统计学意义(P0.05)。(2)在COPD组：年龄与股骨颈、股骨大粗隆的BMD值呈负相关,体重、BMI与L1、L2、L3、L4、L1-L4、股骨颈、股骨大粗隆的BMD值呈正相关，有统计学意义(P0.05)。(3)骨密度测定值比较NC组NOP组OP组(P0.05),有统计学意义。(4)吸入糖皮质激素累积用量(mg)和吸入糖皮质激素应用时间(月)与L4及L1-L4的13MD值呈负相关,有统计学意义(P0.05),L4的BMD更具有显著性(P0.01)。(5)Logistic回归分析结果：昆明地区老年男性COPD患者并发骨质疏松的危险因素与年龄、日照时间2小时/天、COPD病程(年)、糖皮质激素应用时间均相关,其保护因素为体重、BMI、减少糖皮质激素累计使用量。 结论：1、(1)昆明地区老年男性COPD患者并发骨质疏松的危险因素与年龄、日照时间2小时/天、COPD病程(年)、糖皮质激素应用时间均相关,糖皮质激素作为药物因素增加了骨质疏松的风险。(2)维持适当的体重、BMI,减少糖皮质激素累计用量对老年男性COPD患者预防骨质疏松的发生有保护性作用。 2、吸入糖皮质激素累积用量(mg)和吸入糖皮质激素应用时间(月)与L4及L1-L4的BMD值呈负相关,其中在L4的BMD呈负相关作用更具有显著性意义。 3、昆明地区汉族老年男性COPD患者吸入常规剂量的糖皮质激素,可显著减少患者BMD以及增加骨质疏松风险的发生。建议该群体应定期行骨密度检查,并预防性用药,避免骨质疏松的发生。 目的：探讨ARCB1基因C3435T多态性与吸入糖皮质激素治疗对老年男性COPD患者的骨量影响是否存在相关性。 方法：选择109名长期吸入糖皮质激素治疗的老年COPD患者,其中：51名为骨质疏松(OP组),58名为非骨质疏松(NOP组),50名健康对照者(NC组)。采用PCR一RFI提取基因组DNA检验ABCB1C3435T多态性。 结果：1、ABCBl基因C3435T多态性与糖皮质激素剂量比较结果：CC基因型吸入糖皮质激素累积用量最大及吸入糖皮质激素应用时间最长(p0.05),差别有统计学意义。2、(1)昆明地区老年男性COPD患行并发骨质疏松的危险因索与年龄、日照时间2小时、糖皮质激素应用时间均相关(2)昆明地区老年男性COPD患者并发骨质疏松的保护因索为：体重、BM1.ABCB1基因C3435T、的CC基因型和CT基因型。3、ABCB1基因C3435T的CC基因型在NOP组分布频率最高,C等位基因分布频率为63.8%。 结论1、ABCB1基因C3435T的基因型(CC)和基因型(CT)均保护性因素,即C等位基因为吸入糖皮质激素治疗老年男性COPD患者合并骨质疏松的保护因素。2.ABCB1基因C3435T的分布频率存在种族上的差异。
[Abstract]:AIM: To investigate the correlation between bone mineral density (BMD) and clinical parameters in elderly male patients with COPD after long-term (> 6 months) inhalation of corticosteroids.
Methods: 109 COPD patients, 51 osteoporosis (0 P group), 58 non-osteoporosis (NOP group) and 50 healthy controls (NC group) were selected. The lung function, bone mineral density (BMD), serum albumin (ALB), total serum protein (STP), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and bone mineral density (BMD) were measured. Blood urea nitrogen (BUN), blood muscle (?) (CREA), blood uric acid (SUA), total cholesterol (TC), triglyceride (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP).
Results: (1) In NC group, body weight was positively correlated with L1, L2, L3, L4, L1-L4, femoral neck, femoral trochanter, BMI was positively correlated with L], L3, L4, L1-L4, BMD was positively correlated with L], L3, L4, L1-L4, and had statistical significance (P 0.05). (2) In COPD group, BMD was negatively correlated with age, femoral neck and trochanter, body weight, BMI was negatively correlated with L1, L2, L3, L4, L1-L4, femoral neck and trochanter. (4) The cumulative dose of inhaled glucocorticoids (mg) and the duration of inhaled glucocorticoids (month) were negatively correlated with the 13MD values of L4 and L1-L4, and the BMD of L4 was more significant (P 0.01). (5) Logisti C regression analysis showed that the risk factors of osteoporosis in elderly male patients with COPD in Kunming were related to age, sunshine duration 2 hours/day, COPD duration (year) and glucocorticoid use time. The protective factors were weight, BMI and reducing the cumulative use of glucocorticoid.
Conclusion: (1) The risk factors of osteoporosis in elderly male patients with COPD in Kunming are related to age, duration of sunshine (2 hours per day), duration of COPD (year) and duration of glucocorticoid use. Glucocorticoid as a drug increases the risk of osteoporosis. (2) Maintaining appropriate body weight, BMI, and reducing the cumulative dose of glucocorticoid are important factors for osteoporosis. Elderly men with COPD have protective effects on preventing osteoporosis.
2. The cumulative dose of inhaled glucocorticoids (mg) and the duration of inhaled glucocorticoids (month) were negatively correlated with the BMD values of L4 and L1-L4, and the BMD values of L4 were negatively correlated.
3. Inhaling conventional doses of glucocorticoids can significantly reduce BMD and increase the risk of osteoporosis in elderly male patients with COPD in Kunming.
Objective: To investigate whether the C3435T polymorphism of ARCB1 gene is associated with the effect of inhaled corticosteroids on bone mass in elderly male patients with COPD.
Methods: 109 elderly COPD patients with long-term inhalation of corticosteroids were selected, 51 of them were osteoporosis (OP group), 58 were non-osteoporosis (NOP group) and 50 were healthy controls (NC group). The ABCB1C3435T polymorphism was detected by PCR-RFI genomic DNA extraction.
Results: 1, ABCBl gene C3435T polymorphism and glucocorticoid dosage comparison results: CC genotype inhaled glucocorticoid maximum cumulative dose and inhaled glucocorticoid use the longest time (p0.05), the difference was statistically significant. 2, (1) Kunming area elderly male COPD risk factors and age of osteoporosis, sunshine time 2 small The protective factors of osteoporosis in elderly male patients with COPD were weight, BM1. ABCB1 gene C3435T, C C genotype and CT genotype.
Conclusion 1. Both genotype (CC) and genotype (CT) of ABCB1 gene C3435T are protective factors, i.e. C allele is a protective factor in elderly male COPD patients with osteoporosis treated with inhaled corticosteroids. 2. The distribution frequency of ABCB1 gene C3435T is racially different.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R563.9
本文编号：2219402
[Abstract]:AIM: To investigate the correlation between bone mineral density (BMD) and clinical parameters in elderly male patients with COPD after long-term (> 6 months) inhalation of corticosteroids.
Methods: 109 COPD patients, 51 osteoporosis (0 P group), 58 non-osteoporosis (NOP group) and 50 healthy controls (NC group) were selected. The lung function, bone mineral density (BMD), serum albumin (ALB), total serum protein (STP), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and bone mineral density (BMD) were measured. Blood urea nitrogen (BUN), blood muscle (?) (CREA), blood uric acid (SUA), total cholesterol (TC), triglyceride (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP).
Results: (1) In NC group, body weight was positively correlated with L1, L2, L3, L4, L1-L4, femoral neck, femoral trochanter, BMI was positively correlated with L], L3, L4, L1-L4, BMD was positively correlated with L], L3, L4, L1-L4, and had statistical significance (P 0.05). (2) In COPD group, BMD was negatively correlated with age, femoral neck and trochanter, body weight, BMI was negatively correlated with L1, L2, L3, L4, L1-L4, femoral neck and trochanter. (4) The cumulative dose of inhaled glucocorticoids (mg) and the duration of inhaled glucocorticoids (month) were negatively correlated with the 13MD values of L4 and L1-L4, and the BMD of L4 was more significant (P 0.01). (5) Logisti C regression analysis showed that the risk factors of osteoporosis in elderly male patients with COPD in Kunming were related to age, sunshine duration 2 hours/day, COPD duration (year) and glucocorticoid use time. The protective factors were weight, BMI and reducing the cumulative use of glucocorticoid.
Conclusion: (1) The risk factors of osteoporosis in elderly male patients with COPD in Kunming are related to age, duration of sunshine (2 hours per day), duration of COPD (year) and duration of glucocorticoid use. Glucocorticoid as a drug increases the risk of osteoporosis. (2) Maintaining appropriate body weight, BMI, and reducing the cumulative dose of glucocorticoid are important factors for osteoporosis. Elderly men with COPD have protective effects on preventing osteoporosis.
2. The cumulative dose of inhaled glucocorticoids (mg) and the duration of inhaled glucocorticoids (month) were negatively correlated with the BMD values of L4 and L1-L4, and the BMD values of L4 were negatively correlated.
3. Inhaling conventional doses of glucocorticoids can significantly reduce BMD and increase the risk of osteoporosis in elderly male patients with COPD in Kunming.
Objective: To investigate whether the C3435T polymorphism of ARCB1 gene is associated with the effect of inhaled corticosteroids on bone mass in elderly male patients with COPD.
Methods: 109 elderly COPD patients with long-term inhalation of corticosteroids were selected, 51 of them were osteoporosis (OP group), 58 were non-osteoporosis (NOP group) and 50 were healthy controls (NC group). The ABCB1C3435T polymorphism was detected by PCR-RFI genomic DNA extraction.
Results: 1, ABCBl gene C3435T polymorphism and glucocorticoid dosage comparison results: CC genotype inhaled glucocorticoid maximum cumulative dose and inhaled glucocorticoid use the longest time (p0.05), the difference was statistically significant. 2, (1) Kunming area elderly male COPD risk factors and age of osteoporosis, sunshine time 2 small The protective factors of osteoporosis in elderly male patients with COPD were weight, BM1. ABCB1 gene C3435T, C C genotype and CT genotype.
Conclusion 1. Both genotype (CC) and genotype (CT) of ABCB1 gene C3435T are protective factors, i.e. C allele is a protective factor in elderly male COPD patients with osteoporosis treated with inhaled corticosteroids. 2. The distribution frequency of ABCB1 gene C3435T is racially different.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R563.9
【参考文献】
相关期刊论文 前3条
1 李学军;司良毅;王璋;袁侨英;;沙美特罗氟替卡松对慢性阻塞性肺疾病患者骨代谢与骨密度影响的回顾性研究[J];重庆医学;2010年11期
2 刘素彩,李恩;糖皮质激素诱导骨质疏松的细胞及分子学机制[J];国外医学(内分泌学分册);2000年01期
3 黄公怡;骨质疏松性骨折及治疗原则[J];国外医学(内分泌学分册);2003年02期
，本文编号：2219402
本文链接：https://www.wllwen.com/yixuelunwen/huxijib/2219402.html
最近更新
教材专著
