老年人血清骨保护素与骨量异常的相关性研究

发布时间：2018-04-24 04:29

  本文选题：老年 + 骨保护素　； 参考：《新疆医科大学》2015年硕士论文

【摘要】：目的：明确老年人血清骨保护素(OPG)在骨量异常组与对照组、维吾尔族与汉族、不同性别、不同年龄间是否存在差异性,探讨其与骨量异常的相关性。方法选择2011年10月至2013年12月在新疆医科大学第一附属医院干部病房住院的患者312例(年龄≥60岁),采用双能X线吸收法(DEXA)测量腰椎、左股骨近端骨密度(BMD),按WHO标准将入选患者分为骨量异常组(骨量减少+骨质疏松)199例,对照组(骨量正常)113例。采用酶联免疫吸附法(ELISA)检测血清OPG浓度。结果(1)骨量异常组血清OPG浓度1.588(1.559)ng/ml较对照组2.062(1.606)ng/ml减低(Z=1.531,P=0.018)；按民族分层：两组间的比较无论在维吾尔族还是在汉族,未发现统计学差异(P0.05)；按性别分层：骨量异常的男性血清OPG浓度1.481(1.410) ng/ml较对照组男性2.062(1.606)ng/mI (Z=1.732,P=0.005)减低,而在女性两组间未发现此差异(P0.05)。(2)维吾尔族血清OPG浓度1.503 (1.033) ng/ml较汉族1.971 (1.805) ng/ml明显偏低(Z=1.834,P=0.002)；按性别分层：维吾尔族男性血清OPG浓度1.474(0.729)ng/ml较汉族男性2.062(1.712)ng/ml低(Z=2.215,P=0.000),两民族在女性间的比较未发现统计学差异(P0.05)；按病例-对照分层：骨量异常的维吾尔族与汉族间血清OPG浓度的比较,未发现统计学差异(P0.05),骨量正常者中维吾尔族血清OPG浓度1.772(1.044)ng/ml较汉族2.303(2.031)ng/ml低(Z=1.404,P=0.039)。(3)血清OPG浓度在60-70岁与70岁组间整体比较及按民族、性别、骨量分层后比较,均未发现统计学差异(P0.05)；(4) Spearman相关性分析显示：汉族女性血清OPG浓度与腰2-腰4、腰总、股骨颈、大粗隆、粗隆间、髋关节部位骨密度呈负相关(r=-0.235～-0.333,P=0.02～0.032),经控制BMI、年龄后相关性仍有统计学意义(r=-0.126～-0.277,P=0.012～0.028)；汉族男性血清OPG浓度与G.T部位骨密度呈正相关(r=0.174,P=0.026),经控制BMI、年龄后未发现统计学意义(P0.05)；维吾尔族无论男性还是女性血清OPG浓度与各骨骼部位的骨密度均未发现相关性有统计学意义(P0.05)。(5)线性回归分析结果提示：汉族女性血清OPG浓度对L1、L2、L3、L总、InterTro部位骨密度是负性决定因素,可以解释骨密度变异的0.8%-10%。(6)拟合汉族女性血清OPG浓度与骨密度变化的最优曲线提示：血清OPG浓度与L1、L2、L3、L总、InterTro部位骨密度以线性拟合最优,与G.T、Hip部位骨密度以二次多项式拟合最优,与L4、Neck部位骨密度未发现最优拟合曲线。(7) Logistic回归分析显示：血清OPG浓度为影响骨量异常的保护因素(OR=0.761,95%CI:0.591～0.979,P=0.034),而女性(OR=14.934,95%CI:6.971～31.991,P=0.000)、年龄(OR=2.131,95%CI:1.366～ 3.323,P=0.001)、饮酒(OR=2.891,95%CI:1.849～4.521,P=0.000)为骨量异常的危险因素,可能增加骨质疏松的患病风险。结论维吾尔族老年人血清OPG浓度较汉族老年人低,尤其维吾尔族男性低于汉族男性；女性、高龄、饮酒可能增加老年人骨量异常的危险性；血清OPG可能与老年人骨量异常相关,是老年人骨量异常的保护性因素。
[Abstract]:Objective : To investigate the correlation between bone mineral density ( OPG ) and bone mass abnormalities in elderly patients with abnormal bone volume ( BMD ) of lumbar spine and left femur by using double - energy X - ray absorpting ( DEXA ) .
There was no statistical difference between the two groups ( P0.05 ) .
The serum OPG concentrations were 1.481 ( 1.410 ) ng / ml and 2.062 ( 1.606 ) ng / ml ( Z = 1.732 , P = 0.005 ) in the control group .
The serum OPG concentration of Uygur male was 1.474 ( 0.729 ) ng / ml and 2.062 ( 1.712 ) ng / ml ( Z = 2.215 , P = 0.000 ) , but no statistical difference was found between the two groups ( P0.05 ) .
There was no statistical difference between the serum OPG concentrations in the Uygur and Han nationalities ( P0.05 ) . The serum OPG concentrations in the normal subjects were 1.772 ( 1.044 ) ng / ml and 2.303 ( 2.031 ) ng / ml in the Han population ( Z = 1.404 , P = 0.039 ) .
( 4 ) The correlation analysis showed that the serum OPG concentration in Han women was negatively correlated with waist 2 - waist 4 , waist total , femoral neck , big bolone , trochanter , and hip part bone density ( r = - 0.235 - 0.333 , P = 0.02 - 0.032 ) . After control of BMI , the correlation of age - related remained statistically significant ( r = - 0.126 ~ - 0.277 , P = 0.012 ~ 0.028 ) ;
The serum OPG concentrations were positively correlated with bone mineral density ( r = 0.174 , P = 0.026 ) in Han men ( r = 0.174 , P = 0.026 ) .
( 7 ) Logistic regression analysis showed that the concentration of OPG in serum of Han women was the best factor affecting bone mineral density ( OR = 0.761 , 95 % CI : 6.971 锝，

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