左卡尼汀对肥胖骨质疏松椎体压缩骨折患者术后恢复及脂代谢影响

Effect of L-carnitine on postoperative recovery and lipid metabolism in obese patients with osteoporotic vertebral compression fractures

目的研究左卡尼汀对肥胖骨质疏松椎体压缩骨折患者术后恢复及脂代谢影响。方法选择肥胖合并骨质疏松椎体压缩骨折椎体后凸成形术后病人84例,随机分为A组与B组。A组采取钙尔奇D+阿仑膦酸钠治疗,B组在此基础上加用左卡尼汀治疗。治疗前及经治疗后分别检查两组患者的骨密度、生化指标、血脂及脂肪因子。结果 A组治疗后L1-L4骨密度及全髋关节骨密度较治疗前显著改善(P<0.05),B组L1-L4骨密度及股骨颈骨密度、全髋关节骨密度治疗后较治疗前均有显著性改善(P<0.05)。治疗后B组股骨颈骨密度、全髋关节骨密度较A组有显著性差异(P<0.05)。A组治疗后CTX-1、BGP较治疗前显著改善(P<0.05)。B组治疗后较治疗前CTX-1、BGP均有显著性改善(P<0.05)。治疗后B组CTX-1、BGP较A组具有显著性差异(P<0.05)。B组治疗后较治疗前TG、HDL、LDL均有显著性改善(P<0.05)。治疗后B组TG、HDL、LDL较A组具有显著性差异(P<0.05)。A组治疗后Chemerin较治疗前有显著下降(P<0.05)。B组治疗后较治疗前Chemerin、Visfatin、Vaspin均有显著性改善(P<0.05)。治疗后B组Chemerin、Visfatin、Vaspin较A组具有显著性差异(P<0.05)。CTX-1、BGP与Chemerin、Visfatin、Vaspin呈显著负相关(P<0.05)。ALP与Chemerin、Visfatin、Vaspin未见显著相关性(P>0.05)。结论肥胖所致脂肪因子代谢紊乱可影响骨质疏松恢复,左卡尼汀可纠正改善脂肪因子水平,有助于骨质疏松性椎体骨折骨密度恢复。

Objective To investigate the effect of L-carnitine on postoperative recovery and lipid metabolism in obese patients with osteoporotic vertebral compression fractures.Methods Eighty-four obese patients with osteoporosis vertebral compression fractures after kyphoplasty were selected.All the patients were randomly divided into group A and group B.Patients in group A were treated with Caltrate D ＋alendronate, and on this basis, patients in group B were treated with L-carnitine therapy additionally.Bone mineral density （BMD）, biochemical markers, and lipids and adipokines in both groups were detected before and after the treatment.Results After the treatment, BMD of L1-L4 and the total hip in Group A improved significantly compared with that before the treatment （P〈0.05）.BMD of L1-L4, the femoral neck, and the total hip in group B all improved significantly than that before the treatment （P〈0.05）.After the treatment, BMD of the femoral neck and the total hip in Group B was significantly different with that in group A （ P 〈0.05 ） .The CTX-1 and BGP level in group A and group B improved significantly after the treatment （P〈0.05）, and the difference between the two groups was significant （P〈0.05）.The levels of TG, HDL, and LDL in group B improved significantly after the treatment （P〈0.05）, and the difference of TG, HDL, and LDL between group A and group B was significant （P〈0.05）.The Chemerin level in group A after the treatment decreased significantly （P〈0.05）, while the levels of Chemerin, Visfatin, and Vaspin in group B improved significantly after the treatment （P〈0.05）. And the difference of Chemerin, Visfatin, and Vaspin between group B and group A was significant （ P〈0.05 ） .The levels of＆amp;nbsp;CTX-1 and BGP were significantly negatively correlated with the level of Chemerin, Visfatin, and Vaspin （ P 〈0.05 ） .No significant correlation between ALP and Chemerin, Visfatin, and Vaspin was observed （ P〉0.05 ） .Conclusion Adipokine metabolic disorder caused by obesity can affect the recovery in osteoporosis patients .L-carnitine can improve adipokine levels and help restore BMD in patients with osteoporotic vertebral compression fractures .