原发性骨质疏松症患者维生素D、IGF-1水平与骨密度的关系

Relationship between serum 25(OH) D,IGF-1 levels and bone mineral density in patients with primary osteoporosis

目的探讨血清25-羟基维生素D（25-hydroxyvitaminD，25（OH）D）及胰岛素样生长因子-1（isulin-like growthfactor-1，IGF．1）与骨密度（bone mineral density，BMD）的相关性。方法用双能X线骨密度仪测定88例老年人腰椎（L2-4）及左股骨颈BMD，根据WH01998年的推荐诊断标准分组：正常对照组（A1组）、低骨量组（A2组）、骨质疏松组（A3组），并测定血清25（OH）D、IGF-I浓度及钙（Ca）、磷（P）等，对实验数据进行统计学分析。结果A2、A3组血清25（OH）D、IGF-1水平明显低于A1组（P〈0．05）。A2、A3组受试者腰椎和股骨颈的BMD与血清25（OH）D、IGF-1水平均呈正相关（P〈0．01），与Ca、P无相关性（P〉0．05）。全部受试者中有76．1％血清25（OH）D不足或缺乏。结论血清25（OH）D、IGF-1水平与原发性骨质疏松患者骨量减少有关，而维生素D不足或缺乏较为普遍，骨量减少时维生素D的补充较为重要。

Objective To explore the relationship between serum 25-hydroxyvitamin D （25 （OH） D）, insulin-like growth factor - 1 （ IGF-1 ） and bone mineral density （ BMD）. Methods Serum 25 （OH） D, IGF-I, calcium （Ca） and phosphorus （P） were measured in 88 elder. BMD of lumbar vertebra and left femoral neck were examined by dual energy X-ray absorptiometry. Based on WHO （1998） diagnostic criteria, all the subjects were divided into 3 groups： normal control group （A1 group）, low bone mass group （A2 group）, and osteoporosis group （A3 group）. Results Serum 25 （OH） D and IGF-1 levels in A2 group and A3 group were significantly lower compared to those in A1 group （P 〈 0. 05 ）. Serum 25 （OH） D and IGF-1 levels were significantly and positively correlated with BMD of lumbar spine and femoral neck （P 〈 0. 01 ）, and not correlated with Ca and P （P 〉 0. 05 ）. Among all the subjects, 76. 1% had inadequate （insufficient or deficient） vitamin D status. Conclusion Serum 25 （OH）D and IGF-1 levels are associated with bone loss. Vitamin D insufficiency and deficiency is so common that vitamin D supplement is necessary when bone loss are exist.