绝经后妇女桡骨远端骨质疏松性骨折相关因素的研究

Study on relative factors for distal radius osteoporosis fracture in postmenopausal women

目的探讨绝经后妇女桡骨远端骨质疏松性骨折的危险因素,雌激素受体-α(ER-α)基因多态性与骨密度的关系。方法以哈尔滨地区自然绝经后妇女108名为研究对象,采用问卷调查的方式,测量腰椎(L2-4)、股骨近端和桡骨远端的骨密度,分为桡骨远端骨质疏松性骨折组、骨质疏松症组和正常对照组。利用PCR-限制性片段长度多态技术检测ER-α基因的PvuⅡ和XbaⅠ的酶切多态性,分析基因多态性与骨密度之间的关系。结果骨折组各部位骨密度均低于正常对照组各部位骨密度,差异有显著统计学意义(P<0.01),骨折组与骨质疏松症组各部位骨密度差异无统计学意义(P>0.05)。Ca、P、AKP在不同组间无统计学意义(P>0.05)。文化程度高、身高较高、月经初潮较早、钙制剂、牛奶饮用量、VD、体重指数大是桡骨远端骨质疏松性骨折的保护性因素,有统计学意义(P<0.05),绝经年龄早、绝经年限长、妊娠次数多、多产次、身高缩短为桡骨远端骨质疏松性骨折的危险因素,有统计学意义(P<0.05)。ER-α基因PvuⅡ多态性与股骨颈、大转子及桡骨远端骨密度有统计学意义(P<0.05),PP基因型较Pp及pp型具有更低的骨密度值,差异有统计学意义(P<0.05),XbaⅠ多态性与骨密度无相关性(P>0.05)。结论文化程度高、身高较高、月经初潮较早、钙制剂、牛奶饮用量、VD、体重指数大是桡骨远端骨质疏松性骨折的保护性因素,绝经年龄早、绝经年限长、妊娠次数多、多产次、身高缩短为桡骨远端骨质疏松性骨折的危险因素。ER-α基因PvuⅡ多态性与股骨颈、大转子及桡骨远端骨密度具有相关性。

Objective To examine the risk factors of distal radius osteoporosis fracture in postmenopausal women and the relationship of estrogen receptor-α（ER-α） gene polymorphisms and bone mineral density. Methods 108 healthy postmenopausal women living in Harbin district were selected and asked to complete a questionnaire to obtain information. They were divided into fracture, osteoporosis and control groups. Bone mineral density （BMD） was measured by duel energy X-ray absorptiometry, ER-a gene Pvu Ⅱ , Xba Ⅰpolymorphisms were determined by PCR-restriction fragment length polymorphism （RFLP）. Results There was significant difference between fracture and control groups （ P 〈 0.01 ）, BMD at any sites in fracture and osteoporosis groups were not different （ P 〉 0.05）, Ca, P, AKP were not significantly different in three groups （ P 〉 0.05 ） either. Culture, calcium, milk, body mass index were protective factors for women in distal radius osteoporosis facture （ P 〈 0.05） and menarche, menopause and height shortening were risk factors for factures （ P 〈 0.05）. Pvu Ⅱ and Xba 1 genotypes were in Hardy-Weinberg equilibrium. No significant differences were found between three groups in frequencies of alleles and genotypes in ER-a.There were significant relationships in bone mineral density between the Pvu Ⅱ genotypes at the femoral neck, troch and distal radius （ P 〈 0.05）. Xba genotypes have no relationship with BMD at all sites （ P 〉 0.05）. Conclusions Body mass index, culture, calcium, milk, et al were protective factors for women in distal radius osteoporosis facture, and menarche, menopause, height shortening, et al were risk factors for factures. There was a significant relationship in BMD at the femoral neck, troch and distal radius with the Pvu Ⅱ genotypes.