老年男性骨密度与踝肱指数的相关性探讨

Study of the association between bone mineral density and ankle brachial index in aged men

目的探讨老年男性骨质疏松(OP)与外周动脉疾病(PAD)间的相关性。方法选取我院查体的老年男性222例,年龄53～94岁,平均76.65±9.48岁,采用双能X线吸收法(DXA)测定正位腰椎、股骨颈、粗隆、全股骨的骨密度,测定踝肱指数(ABI)。按ABI<0.9者入选PAD组(87例),ABI≥0.9者为非PAD组(135例)。记录两组患者收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等指标。结果 PAD组与非PAD组除年龄有显著性差异外,血压、血脂、骨密度异常检出率及各部位骨密度二组间无统计学差异,股骨颈,粗隆,全股骨与踝肱指数呈正相关(r=0.258,0.208,0.247,P<0.001)。髋部各部位BMD与身高、年龄、体重、ABI、DBP、LDL-C有显著相关性(P<0.001)。结论 老年男性PAD与非PAD患者间骨密度无显著差异,但髋部BMD指标与ABI密切相关,并同时受增龄等其他因素影响,提示骨质疏松与外周动脉疾病间存在共同病理生理机制。

Objective To explore the association between osteoporosis and peripheral arterial disease in elderly men. Methods Two hundred and twenty-two elder adults were recruited in the study （mean age 76. 65±9.48 years）. DXA was used to measure BMDs of the lumbar spine, the neck troch and the whole shaft of the femur. ABI was measured. The patients were divided into group PAD （ABI 〈 0. 9, 87 cases） and group non-PAD （ABI 〉 0. 9, 135 cases）. Data were collected from the two groups, including SBP, DBP, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, and low density lipoprotein cholesterol （LDL-C）. Results There was no significant difference in blood pressure, serum lipid, and BMD, between the two groups except age. BMD of the neck, troch, and the whole shaft of the femur was positively correlated with ABI （ r = 0. 258,0. 208,0. 247, P 〈 0. 001 ）. BMDs of the hip was significantly correlated with height, age, body weight, ABI, DBP, and LDL-C （P 〈 0. 001 ）. Conclusion There was no significant difference in BMDs between PAD and non-PAD group of the elder men. However, BMD of the hip was closely related to ABI and was influenced by aging and other factors, suggesting potential common pathophysiologic mechanisms between osteoporosis and peripheral arterial disease.