大连地区中老年人25-羟维生素D和同型半胱氨酸与骨质疏松症相关性研究

发布时间：2018-06-18 09:14

本文选题：骨质疏松症 + -羟维生素D　；参考：《中国骨质疏松杂志》2017年10期

【摘要】：目的探讨大连地区中老年人25-羟维生素D[25-hydroxyvitamin D,25(OH)D]、血清同型半胱氨酸(Homocysteine,Hcy)水平与骨密度(Bone mineral density,BMD)及骨质疏松性骨折(Osteoportic fracture,OPF)的相关性。方法本研究为横断面研究。210例(男85例,女125例)研究对象均来自我院门诊及体检中心,年龄46-90岁。所有研究对象均检测腰椎1-4(Total)(BMD-L)、髋部(Total)(BMD-H)、股骨颈(BMD-N)骨密度和血清25(OH)D、Hcy、钙、磷、镁、碱性磷酸酶。210例分为骨质疏松组,骨量减少组和骨量正常组。应用方差分析和回归分析分别对男性和女性血清25(OH)D、Hcy与BMD及OPF的相关性进行分析。结果男性和女性骨质疏松组25(OH)D均低于骨量减少组和骨量正常组,差异有统计学意义(P0.05)。多元线性回归分析校正年龄等潜在混杂因素后,25(OH)D与男性BMD-L(P=0.064)、BMD-H(P=0.073)和女性BMD-H(P=0.072)近似正相关;25(OH)D20 ng/m L时,男性25(OH)D与BMD-N呈显著正相关;25(OH)D15 ng/m L时,女性25(OH)D与BMD-L和BMD-N呈显著正相关。Logistic回归分析显示,女性骨质疏松症患者血清中25(OH)D每增加1 ng/m L骨折风险降低12.8%。女性Ln Hcy在骨质疏松组与骨量正常组和骨量减少组比较差异有统计学意义(P=0.040和P=0.020)。女性Ln Hcy与BMD-N呈负相关,校正年龄后不相关。男性和女性Ln Hcy和25(OH)D均不相关。结论 25(OH)D在不同范围时,大连地区中老年男性和女性25(OH)D与各部位BMD不同程度正相关。维生素D缺乏可能是中老年女性OPF发生的独立危险因素。Hcy不是女性发生OPF的危险因素(女性Hcy和OPF不相关),女性高Hcy与低BMD有一定相关关系,这种相关可能与增龄有关。男性Hcy与BMD不相关。
[Abstract]:Objective to investigate the correlation between serum homocysteine (HcyH) and bone mineral density (BMD) and osteoporosis fracture (Osteoportic fracture) in middle-aged and elderly people in Dalian. Methods in this study, 210 cases (85 males and 125 females) were studied from outpatient clinic and physical examination center of our hospital, aged 46 to 90 years. Bone mineral density (BMD-HN) and serum 25 OHH (DHCH), calcium, phosphorus, magnesium, alkaline phosphatase (ALP) in the lumbar vertebrae (1-4) were measured. The patients were divided into three groups: osteoporosis group, osteopenia group and normal bone mass group. Variance analysis and regression analysis were used to analyze the correlation between serum 25 OHH Hcy and BMD and OPF in male and female. Results 25 OHH D in male and female osteoporosis group was lower than that in bone loss group and normal bone mass group, the difference was statistically significant (P 0.05). After correction of potential confounding factors such as age by multivariate linear regression analysis, there was a significant positive correlation between 25 OHH D and BMD-L, BMD-HP0. 073 (male) and BMD-HP0. 072 (0. 072) in females. The logistic regression analysis showed that there was a significant positive correlation between BMD-L and BMD-N in males and BMD-N at 25OHHHHU D, BMD-L and BMD-N by logistic regression analysis, and the correlation between BMD-L and BMD-N was significantly higher than that of BMD-L, BMD-N, BMD-L, BMD-N, BMD-L, BMD-N, BMD-L, BMD-N, BMD-L and BMD-N, respectively. In female patients with osteoporosis, the risk of fracture decreased by 12.8 per 1 ng/m / L increase of 25 OHH D. The difference of Ln Hcy between osteoporosis group and normal bone mass group and osteopenia group was statistically significant (P = 0.040) and P < 0.020 (P < 0.05). There was a negative correlation between Ln Hcy and BMD-N in women, but not after correction. There was no correlation between Ln Hcy and 25 OHH D in male and female. Conclusion there is a positive correlation between 25 OHH D and BMD in the middle and old aged men and women in Dalian. Vitamin D deficiency may be an independent risk factor for OPF in middle-aged and elderly women. Hcy is not a risk factor for OPF in women (Hcy and OPF in women are not associated with OPF, but high Hcy in women is associated with low BMD, which may be related to age. Male Hcy was not associated with BMD.
【作者单位】：大连医科大学附属第一医院检验科;大连医科大学附属第一医院核医学科;
【基金】：国家863计划课题资助(2014AA022304)
【分类号】：R446.1;R580

【相似文献】