老年人骨质疏松与冠状动脉硬化关系的初步探讨

Relationship between osteoporosis and coronary atherosclerosis in aged population

目的探讨老年人骨质疏松与冠状动脉粥样硬化的关系。方法对64例老年患者进行腰椎骨密度(BMD)的定量CT(QCT)测定判断有无骨质疏松症,运用多排螺旋CT(MSCT)检测冠脉钙化积分和总积分,并通过填写调查表了解患者的一般情况、生活习惯及其他影响冠脉钙化的因素。将所有患者按冠脉钙化总积分值分为TCS>50组和TCS≤50组,并比较两组的临床数据和骨密度,用Logistic回归方法和偏相关法分析有关因素与冠脉钙化之间的关系。结果年龄、腰椎BMD、血Ca、TC、TG、HDL两组比较有显著性差异(P<0.05),而体重指数、血清LDL、P、ApoA、ApoB等指标,两组间比较,差异无显著性(P>0.05)。Logistic回归显示:年龄、高密度脂蛋白、吸烟及骨质疏松对冠脉钙化有影响,其中年龄、吸烟及骨质疏松是其独立危险因素,高密度脂蛋白是保护因素,偏相关分析得出骨质疏松与冠脉钙化之间存在正相关,腰椎BMD与冠脉TCS存在负相关关系。结论老年人骨质疏松与冠状动脉粥样硬化存在一定的相关关系,MSCT检测的TCS可作为反映冠状动脉硬化和骨质疏松关系的参考指标。

Objective To investigate the correlation between osteoporosis and coronary atheroselerosis in the aged population and its possible mechanism. Methods Totally,64 patients underwent quantitative CT （QCT） of lumbar vertebrae for bone mineral density （BMD） and muliti-sliee spiral CT （MSCT） of coronary artery for calcification seore and total ealeification seore （TCS）. A questionairre was flled out for general eondition, lifestyle and other faetors. All subjects were divided into two groups aeeording to the TCS：group A （TCS 〉 50） and group B （TCS≤ 50）. The elinieal data and BMD were eompared between the two groups. Logistie regression analysis was performed. Results Signifieant differenee was defeeted in the age, BMD of lumbar spine, levels of Ca, TC, TG and HDL between the two groups （ P 〈 0.05） , but not in the serum level of BMI, LDL, phosphorus, ApoA and ApoB （P 〉 0.05）. Logistic regression analysis showed that the factors for TCS were age, smoking,high density lipoprotein （HDL） and osteoporosis, while age, smoking and osteoporosis were independent risk factors and HDL was a protective factor. There was positive correlation between the coronary artery calcification and osteoporosis and negative correlation with BMD. Conclusions Osteoporosis is associated with coronary atheroselerosis, and TCS could be eonsidered as an index for judging the relationship between osteoporosis and eoronary atheroselerosis.