405例体检健康女性铁蛋白对骨量下降的预测性能评估及绝经后女性骨量下降影响因素研究

发布时间：2018-10-09 18:48

【摘要】：第一部分405例体检健康女性铁蛋白对骨量下降的预测性能评估目的了解正常女性骨量下降的相关危险因素,评估铁蛋白对骨量下降的预测性能。方法收集2011年01月至2012年12月期间,405名苏州大学附属第二医院体检女性资料,年龄22~80岁;空腹抽血测定生化指标和血清铁蛋白;采用双能X线吸收仪测定骨密度。按照骨密度T值分为骨量正常组和骨量减低组。依次运用Pearson相关分析、多元逐步回归分析纳入参数,使用受试者工作特征曲线(ROC),评估各参数对女性骨量下降的预测性能。结果髋部骨密度与年龄、碱性磷酸酶、高密度脂蛋白、铁蛋白呈负相关(p均0.05),与BMI呈正相关(p0.05);腰椎骨密度与年龄、碱性磷酸酶、r谷氨酸转肽酶、尿素、总胆固醇、a羟丁酸脱氢酶、铁蛋白呈负相关(p0.05),与低密度脂蛋白呈正相关(p0.05)。通过多元逐步回归分析,受试者年龄、碱性磷酸酶、血清铁蛋白对髋部及腰椎骨密度有影响(p均0.05)。ROC曲线分析年龄参数的曲线下面积为0.744,95%CI=(0.699,0.786),铁蛋白为0.682,95%CI=(0.634,0.727),碱性磷酸酶为0.652,95%CI=(0.603,0.698)。结论年龄、血清铁蛋白、碱性磷酸酶与骨密度有密切相关性。年龄仍是预测骨量下降的第一因素,血清铁蛋白对骨量下降的预测性能要高于碱性磷酸酶。第二部分绝经后女性骨量下降影响因素研究目的探讨绝经后女性骨量下降的相关影响因素。方法收集2013年06月至2013年08月期间至苏州金庭人民医院体检的240名绝经后女性数据,年龄45~84岁;抽血后电化学发光法检测血清铁蛋白;采用定量超声骨密度仪测定骨密度。按照骨密度T值分为骨量正常组和骨量减低组。使用受试者工作特征曲线(ROC)分类铁蛋白,依次运用卡方检验、二元Logistic回归纳入参数,评估各参数对绝经后女性骨量下降的影响。结果“铁蛋白”的ROC曲线下面积AUC为0.753,95%CI=(0.693,0.806)。约登指数为141.4μg/L。卡方检验显示:年龄、Fer、跌倒史、日常锻炼、喝牛奶、吃钙片、骨折史表现出统计学差异,P0.05。二元Logistic回归显示:年龄、Fer、骨折史的相对危险度(OR)分别为3.185、4.662、9.485,与骨量下降呈正相关;吃钙片的OR值为0.295,与骨量下降呈负相关。结论Fer对绝经后女性骨量下降有一定预测性能,可能存在一个预测界值。年龄、Fer、骨折史是绝经后女性骨量下降的危险因素,服用钙片是绝经后女性骨量下降的保护因素。
[Abstract]:Part one Predictive performance of 405 healthy Women with normal Bone loss objective to investigate the risk factors associated with the decline of bone mass in healthy women and to evaluate the predictive performance of ferritin for the decline of bone mass. Methods from January 2011 to December 2012, 405 women (aged 2280 years) in the second affiliated Hospital of Suzhou University were collected, biochemical indexes and serum ferritin were measured by fasting blood sampling, bone mineral density was measured by dual energy X-ray absorptiometry. According to the T value of bone mineral density, it was divided into two groups: normal bone mass group and low bone mass group. Pearson correlation analysis and multiple stepwise regression analysis were used to evaluate the predictive performance of each parameter on female bone mass decline using (ROC),. Results there was a negative correlation between bone mineral density (BMD) of hip and age, alkaline phosphatase, high density lipoprotein, ferritin (p0. 05), and a positive correlation between BMD and BMI (p0. 05), between bone mineral density of lumbar vertebrae and age, alkaline phosphatase, glutamate transpeptidase, urea, etc. Total cholesterol a hydroxybutyrate dehydrogenase and ferritin were negatively correlated (p0.05) and positively correlated with low density lipoprotein (p0.05). Multiple stepwise regression analysis showed that age, alkaline phosphatase and serum ferritin had influence on bone mineral density of hip and lumbar spine (p 0.05). The area under the curve of ROC curve was 0.74495% CI = (0.6990.786), ferritin was 0.682C 95CI = (0.6340.727), alkaline phosphatase was 0.65295CIr = (0.603mc0.698). Conclusion Age, serum ferritin and alkaline phosphatase are closely related to bone mineral density. Age is still the first factor in predicting the decline of bone mass, and serum ferritin can predict the decline of bone mass better than alkaline phosphatase. The second part is the study on the influencing factors of postmenopausal female bone mass decline objective to explore the related factors of postmenopausal female bone mass decline. Methods 240 postmenopausal women aged 45 to 84 years from June 2013 to August 2013 were collected from Jinting people's Hospital of Suzhou. Serum ferritin was detected by electrochemiluminescence after blood sampling and bone mineral density was measured by quantitative ultrasound absorptiometry. According to the T value of bone mineral density, it was divided into two groups: normal bone mass group and low bone mass group. Using the operating characteristic curve (ROC) of subjects to classify ferritin, Chi-square test and binary Logistic regression were used to evaluate the effect of these parameters on the decline of bone mass in postmenopausal women. Results the area under the ROC curve of ferritin was 0.753C95 CI = (0.693) 0.806. The Jorden index is 141.4 渭 g / L. Chi-square test showed that age, fall history, daily exercise, drinking milk, eating calcium tablets, fracture history showed statistical difference (P 0.05). Binary Logistic regression showed that the relative risk (OR) of fracture history was 3.185 卤4.662n9.485, which was positively correlated with the decrease of bone mass, and the OR value of calcium tablets was 0.295, which was negatively correlated with the decrease of bone mass. Conclusion Fer can predict the decline of bone mass in postmenopausal women. The history of fracture is a risk factor for the decline of bone mass in postmenopausal women, and calcium is the protective factor for the decline of bone mass in postmenopausal women.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R580

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