骨密度与血清白蛋白、钙、镁、磷及血红蛋白的相关性研究

The study of the correlation between serum albumin,calcium,magnesium,phosphate,hemoglobin,and bone mineral density

目的研究不同性别人群血清白蛋白水平,血清钙、镁、磷浓度,以及血红蛋白浓度与腰椎、股骨颈两部位骨密度的相关性。方法回顾性分析117例不同性别人群,每人检测腰、髋两部位双能x线骨密度值,以及血常规、血生化(包括血清白蛋白、前白蛋白、血钙、血镁、血磷)。将所有人分为女性组和男性组,每组按10岁为一个年龄段,分为5组,分别为≤40岁,41-50岁,51-60岁,61-70岁,≥71岁,分别进行各变量与骨密度的相关性研究和回归分析,并作对比研究。结果女性组中血清白蛋白和股骨颈骨密度明显相关(r=0.542,P<0.001),和腰椎骨密度明显相关(r=0.410,P=0.003);血红蛋白与股骨颈骨密度有明显相关(r=0.319,P=0.023),与腰椎骨密度也有相关(r=0.282,P=0.045)。男性组中白蛋白与股骨颈骨密度明显相关(r=0.278,P=0.024),与腰椎骨密度无明显相关;血红蛋白和股骨颈骨密度有明显相关性(r=0.414,P=0.001),而与腰椎相关性不显。控制年龄、体重、体质指数后,各变量(包括血清白蛋白和血红蛋白)和股骨颈和腰椎两个部位的骨密度均无明显相关性。随着年龄的增长,女性组和男性组中血清白蛋白总的趋势都是逐渐下降;男性组中血红蛋白随着年龄增长总的趋势逐渐下降。血清钙、镁、磷与骨密度无明显相关性(P>0.05)。结论血清白蛋白、血红蛋白与腰椎和股骨颈骨密度具有相关性,白蛋白、血红蛋白的降低可能是骨密度下降的依赖年龄的危险因素。在骨质疏松症的防治中,升高血清白蛋白、纠正贫血需要重视。

Objective To investigate the correlation between the serum albumin, calcium, magnesium, phosphate, hemoglobin, and the bone mineral density （BMD） of the lumbar spine （L1-4） and the femoral neck in people of different gender. Methods This retrospective study included 117 people of different gender. BMD of the hip and lumbar spine was measured using dual energy X-ray absorptiometry （DXA）. The blood routine and blood biochemistry including serum albumin, calcium, magnesium, and phosphate were examined. People were divided into male group and female group. Each group was further divided into 5 age groups by stratification of 10-year age interval （ ~〈40, 41 -50, 51 -60, 61 -70, and ≥ 71 years old）. The correlation between all the variables and BMD were studied. Multiple regression and partial correlation analyses were performed. Results In the female group serum albumin was significantly correlated with BMD of femoral neck （r = 0. 542 ,p 〈 0. 001 ） and the lumbar spine （r = 0.410,p = 0. 003）, and hemoglobin was significantly correlated with BMD of the femoral neck （ r = 0. 319, P = 0. 023 ） and the lumbar spine （ r = 0. 282, P = 0. 045 ）. In the male group, serum albumin was significantly correlated with BMD of the femoral neck （ r =0. 278, P = 0.024）, but not with the lumbar spine （ r = 0. 181, P = 0. 147 ）. Hemoglobin had a ＇positive and signicant correlation with BMD of the femoral neck （ r = 0. 414, P = 0. 001 ）, but not with the lumbar spine （ r - 0. 197, P = 0. 113 ）. After adjustment of age, weight, and BMI, all the variables, including serum albumin and hemoglobin, had no significant correlation with BMD of both the femoral neck and the lumbar spine. Along with the increase of age, serum albumin decreased in both females and males. Hemoglobin decreased with age only in the male group. No correlations were found among serum calcium, magnesium, phosphate, and BMD （ P 〉 0. 05 ）. Conclusion Serum albumin and hemoglobin have the correlation with BMD of the femoral neck and the lumbar spine. The decrease of serum albumin and hemoglobin may be age-depended risk factors of low BMD. To increase serum albumin and to treat anemia would be worth of attention in preventing osteoporosis.