老年代谢综合征与骨代谢及骨密度的相关性研究

Study on bone metabolism and bone mineral density in elderly patients with metabolic syndrome

目的探讨老年代谢综合征(MS)与骨代谢及骨密度的关系。方法选择老年MS患者157例为MS组,健康体检者192例为对照组,测量腰围、空腹血糖(FBG)、血胆固醇(TC)、甘油三酯(TG)等,ELISA法检测血清骨钙素(OC)、甲状旁腺素(PTH)、骨碱性磷酸酶(B-ALP),双能X线骨密度测量仪检测骨密度。结果 MS组骨密度T值及OC、B-ALP均显著低于对照组,PTH显著高于对照组。各代谢指标正常组与异常组之间骨密度比较发现:血压、TG、腰围异常组患者骨密度显著低于正常组患者,其余代谢组分的正常组与异常组骨密度无统计学差异。结论 MS主要通过肥胖、血脂、血压代谢异常引起体内与骨代谢相关的因子如甲状旁腺素、骨碱性磷酸酶等的改变进而导致骨代谢异常、骨密度下降。

Objective To explore the relationship among bone metabolism, bone mineral density and metabolism syndrome （MS） in elderly patients. Methods One hundred and fifty seven cases of MS in this hospital were allocated in MS group, and 192 healthy persons as control group. Waist circumference, fasting blood glucose （FBG） level, blood levels of cholesterol （TC） and triglyceride （TG） were measured. ELISA method was used to detect serum levels of osteocalcin （OC） , parathyroid hormone （PTH） and bone alkaline phosphatase （B -ALP）. Bone density was detected by Dual - energy X - ray absorptiometry measuring instrument. Results There was significant difference in T, Z values, serum levels of OC, B - ALP and PTH between MS group and control group. T value, Z value and serum levels of OC and B - ALP in MS group were significantly lower than those of control group. The level of PTH was significantly higher in MS group than that of control group. In comparison with various metabolic components of bone mineral density, it had been found that abnormal blood pressure; TG and waist circumference in MS group were significantly lower than those of control group, but there was no statistically significant difference in rest of metabolic components with control group. Conclusion Metabolism syndrome causes abnormal body factors associated with bone metabolism mainly by obesity, blood lipids, blood pressure and metabolism such as change in levels of parathyroid hormone and bone alkaline phosphatase, thus they may lead to abnormal bone metabolism and decreased bone mineral density.