男性吸烟与骨密度及骨生化指标关系

The relationship between smoking, bone turnover and bone mineral density in healthy Chinese men

目的探讨男性吸烟与骨密度及骨生化指标关系。方法用DXA仪测定腰椎及髋部骨密（BMD），用ELISA测定389例20～80岁健康男性血清骨特异性碱性磷酸酶（sBAP）和I型胶原氨基末端肽（sNTX）。结果（1）各部位BMD均在20岁～年龄组最高，30岁之后随年龄增加而缓慢下降；40—60岁各年龄组之间的BMD差异无统计学意义。（2）除腰椎侧位BMD外，吸烟组其它各部位BMD显著低于非吸烟组；吸烟组的BAP显著高于非吸烟组，2组之间的sNTX差异无统计学意义。（3）校正年龄与BMI后，烟龄与腰椎正位，髋部总体，股骨颈及ward＇s区BMD均呈负相关（P〈0．05）。每日吸烟量与腰椎正位及Ward＇s区BMD呈负相关（P〈0．05）。结论男性随年龄增长骨量丢失。男性吸烟者骨生化指标与骨转换水平增高，骨量丢失加速。吸烟等生活方式增高骨转换水平，影响骨转换的增龄性变化并加速骨量的丢失。吸烟是骨质疏松的一个危险因素。预防骨质疏松症（OP）应提倡戒烟。

Objective To study the relationships of smoking and bone alkaline phosphatase （BAP） , cross-linked N-telopeptides of type 1 collegen （sNTX） and bone mineral density in healthy men aged 20 - 80. Methods BAP, sNTX were measured using ELISA, BMD at lumbar spine and hip was,measured by dual energy x-ray densitometer, correlation of bone biochemical marker with age and BMD were fitted by ten kinds of regression models. Result All subjects were categorized into two groups according to smoking or not, there was a lower BMD mean of all sites and a higher BAP values in those smoking men （ all P 〈 0. 05）. After adjusted age and BMI, smoking years was negatively correlated with BMD values at all sites. Smoking amount per day was negatively correlated with BMD values at anteroposterior lumbar spine and Ward＇s region while positively with other values （all P 〈 0. 05）. Conclusion Smoking raises bone turnover rate and accelerates bone lose. In order to prevent osteoporosis, smoking should be inhibited.