低骨密度与老年冠心病关系的研究

The relation between low bone mineral density and coronary heart disease in the elderly

目的探讨老年人群低骨密度(包括骨质疏松和骨量减少)与冠心病的相关性。方法回顾性分析130例我院经冠脉造影确诊为冠心病的老年患者,根据检查结果,分为冠心病组及非冠心病组;根据双能X线骨密度仪检查结果分为骨质疏松组、骨量减少组和骨量正常组,比较三组间冠心病发病率的差异,进一步分析低骨密度与冠心病的关系。结果 (1)冠心病组与非冠心病组在年龄、高血压病、吸烟、糖尿病、服用他汀类药物、血清肌酐、血高密度脂蛋白胆固醇<40 mg/dL两组间比较均有显著性差异(P<0.01);在体质指数(BMI)、性别、冠心病家族史、服用影响骨密度的药物(钙剂、类固醇激素及双膦酸盐类)、血低密度脂蛋白胆固醇>130 mg/dL、血清钙离子水平两组间比较均无统计学差异。(2)骨量减少组及骨质疏松组冠心病的发病率明显高于骨量正常组,3组间比较有统计学差异(P<0.01)。(3)与冠心病的危险因素比较,低骨密度、糖尿病、高血压的相对危险度分别为20.1、3.12、4.85。结论低骨密度组的冠心病发病率高于骨量正常组,低骨密度与冠心病的发病存在一定的相关性。

Objective To investigate the relation between coronary heart disease（CHD） and low bone mineral density（BMD,including osteoporosis and osteopenia） in the elderly.Methods A retrospective analysis of 130 elderly CHD patients diagnosed by coronary angiography was conducted in our hospital.According to the results,the patients were divided into CHD group and nonCHD group.In addition,the patients were divided into osteoporosis group,osteopenia group and the normal group based on BMD results by dual-energy X-ray absorptiometry.Difference of the incidence of CHD among the 3 groups was compared.The relationship between low BMD and CHD was further analyzed.Results 1） There were significant differences in age,hypertension,smoking,diabetes,statins,serum creatinine,and high-density lipoprotein cholesterol 40 mg /dl between CHD and non-CHD group（P 0.01）.There were no statistically significance between the two groups in the body mass index（BMI）,gender,family history of CHD,drugs affected BMD（calcium,steroids and bisphosphonates）,low-density lipoprotein cholesterol 130 mg /dl,and levels of serum calcium.2） The incidence of CHD in the osteopenia group and osteoporosis group was significantly higher than that in normal group,and the difference was statistically significant among the 3 groups（P 0.01）.3）Compared with the traditional risk factors of CHD,the relative risks of low BMD,diabetes,hypertension were 20.1,3.12,and4.85,respectively.Conclusion The incidence of CHD in the low BMD groups is higher than that in normal group.There is a certain correlation between incidence of CHD and low BMD.