老年人骨密度、骨代谢相关内分泌激素与冠状动脉钙化的相关性研究

Study on the Relationship of Bone Mineral Density and Bone Metabolic Related Endocrine Hor- mones with Coronary Artery Calcification in Elderly People

【目的】评估老年人腰椎骨密度（BMD）、骨代谢相关内分泌激素与冠状动脉钙化的相关性。【方法】选取有冠心病病史的患者68例，用双能X线骨密度仪检测腰椎BMD，多层螺旋CT检测冠状动脉钙化，分析腰椎BMD和冠脉钙化积分及二者共同的危险因素的关系。【结果】57．1％患者有冠脉钙化，47％的人群有骨质疏松症，26％有低骨量，平均BMD为（161．6士37．2）mg／mL，腰椎BMD与冠状动脉钙化积分显著负相关（OR=1．35；95％CI，1．08—1．70）。校正年龄后二者的相关性降低（OR=1．19；95％CI，0．94—151），但仍呈负相关。进一步校正影响BMD和冠状动脉钙化积分之间共有协变量后，腰椎BMD与冠状动脉钙化积分显著负相关（OR=1．19；95％CI，0．81—1．74）。【结论】腰椎BMD与冠状动脉钙化显著负相关，这种相关性与年龄不相关，独立于影响BMD和冠状动脉钙化之间的共同的危险因素，并没有雌激素的影响。

[Objective] To assess the correlation of lumbar bone mineral density（BMD） and bone metabolic endocrine hormones with coronary artery calcification（CAC） in elderly people. [Methods] A total of 68 pa- tients with the history of coronary heart disease were selected. Dual energy X-ray absorptiometry was used to detect lumbar BMD. CAC was measured by computed tomography. The relationship of lumbar BMD with CAS score and the same risk factors were analyzed. [Results] CAC was detected in 57.1% of patients. Osteo- porosis was found in 47% of patients, and low bone mass was found in 26% of patients. Mean BMD was （161.6!37.2）mg/ml. Lumbar BMD was significantly associated with CAC score（OR：l. 35;95NCI, 1.08- 1.70）. The correlation between lumbar BMD and CAC score after age adjustment decreased（OR= 1.19;95 CI, 0.94-151）, but there was still negative correlation between them. After further adjustment affected the common concomitant variable of BMD and CAC score, lumbar BMD was negatively correlated with CAC score （OR= 1. 19; 95~CI, 0. 81-1. 74）. [Conclusion] Lumbar BMD has significantly negative correlation with CAC. The correlation has no association with age, and is independent of the common risk factors of BMI and CAC, and is not affected by estrogen.