库欣综合征病人与正常妇女骨密度比较研究

Bone loss is more severe in younger Cushing's syndrome women than in older ones:comparison of bone mineral density between Cushing's syndrome and healthy women

目的探讨年龄对库欣综合征(CS)病人骨密度改变的影响。方法将不同年龄段 CS病人与正常妇女的骨密度进行比较。收集1996年6月至2004年2月期间因 CS 住院且做过骨密度检查的女性病例,共57例,选取同期健康查体的正常女性49例作为正常对照组。根据不同年龄段将两组进行分层分析,20～29岁 CS 组14例,对照组14例;30～39岁 CS 组27例,对照组15例;40～49岁 CS 组16例,对照组20例。对骨密度进行比较。结果正常对照组腰椎的骨峰值出现在30～39岁,髋部的骨峰值出现在20～29岁。CS 组的骨密度低于正常对照组,以20～29岁层最显著;腰椎和 Wards 三角的骨密度降低最为明显。CS 病人年龄越轻,其骨量丢失越显著。CS 病人骨质疏松者占29.8%(17/57),骨量减少者占50.9%(29/57),骨折发生率为26.3%(15/57)。发生骨折的 CS 病人腰椎骨密度 Z 值明显低于未发生骨折者(P=0.003)。结论 CS 病人的骨密度较正常妇女明显降低,以腰椎和 Wards 三角下降更为显著,年轻 CS 病人骨量丢失较年长者明显,腰椎骨密度低者更易发生骨折。

Objective To investigate the influence of age on bone mass in Cushing＇s syndrome patients. Methods Measurement of bone mineral density （BMD） was conducted among 57 women with Cushing＇s syndrome （CS） and 49 healthy women. There were 14 CS women and ld healthy women in the group aged 20-29; 27 CS women and 15 healthy women in the group aged 30-39; and 16 CS women and 20 healthy women in the group aged 40-49. Results Among the healthy women the peak bone mass of lumbar spine was in the group aged 30-39, while the peak bone mass of hip was in the group aged 20-29. The BMD values of the CS women were lower than those of the healthy women, especially those in lumbar spine and in Ward＇s triangle. The younger the CS women, the lower the BMD Z-score （for the BMD Z-score of lumbar spine P = 0. 021, for the BMD Z-score of femoral neck P = 0. 020, and for the BMD Z-score of Ward＇ s triangle P =0.026） . Seventeen of the 57 （29.8%） CS women had osteoporosis, 29 （50.9%） of the 57 had osteopenia, and 15 （26.3%） had fractures. The CS women with bone fractures had lower BMD Z-score than those without fractures （for lumbar fracture P = 0.003）. Conclusion The BMD of CS women is lower than that of the healthy women. Bone loss is more severe in younger CS women than in older ones. CS women with low BMD are prone to have bone fracture.