中年体检人群血尿酸与骨密度及骨代谢标记物的相关性

Correlation of serum uric acid with bone mineral density and bone metabolic markers in middle-aged Chinese physical examination population

目的 观察中年体检人群血尿酸水平与骨密度及骨代谢标记物的相关性,探讨尿酸在骨代谢中的可能作用。方法 对214例中年（45~65岁）体检人群进行横断面研究,观察尿酸与骨密度及骨代谢标记物之间的相关性。运用双能X线法测定腰椎、全髋、股骨颈及全身骨密度,用电化学发光免疫分析测定骨转换指标,包括：骨形成标记物骨钙素（osteocalcin,OC）、Ⅰ型前胶原氨基端肽（procollagen typeⅠN-terminal propeptide,PⅠNP）和骨吸收标记物β-CrossLaps（β-CTX）以及25-羟基维生素D3（25-hydroxy vitamin D3,25-OHD3）、甲状旁腺激素（parathyroid hormone,PTH）水平。结果 校正可能的混杂因素后,血清尿酸水平与腰椎、全髋及全身骨密度正相关（P≤0.001）,与OC负相关（P〈0.01）,与logPTH和log25-OHD3正相关（P=0.039、P=0.032）。根据血尿酸水平将所有参试者分为高尿酸组（UA≥60mg/L）及低尿酸组（UA〈60mg/L）,高尿酸组OC、PⅠNP和β-CTX水平均低于低尿酸组（P〈0.01）。将参试者根据尿酸水平分成3组（T1：UA〈47 mg/L;T2：47mg/L≤UA〈60mg/L;T3：UA≥60mg/L）,与T3组相比,T1组发生骨质疏松症和至少骨量减少（包括骨质疏松和骨量减少）的危险度分别增加41%和158%。结论 尿酸对中年人群骨代谢发挥一定的保护作用,相关结论仍有待进一步研究证实。

Objective To investigate the correlation of uric acid（UA）levels with bone mineral density（BMD）and serum bone metabolic markers in middle-aged Chinese physical examination population,so as to discuss the possible role of UA in bone metabolism.Methods A cross-sectional study with 214middle-aged（45to 65years）Chinese physical examination participants was carried out.The correlation of UA levels with BMD and serum bone metabolic markers was observed.BMD values of the lumbar spine,total hip,femur neck and the whole body were measured by dual energy X-ray method.Bone turnover markers,including bone formation markers osteocalcin（OC）and procollagen type Ⅰ amino-terminal propeptide（PⅠ NP）,bone resorption markerβ-CrossLaps（β-CTX）,25-hydroxyvitamin D3（25-OHD3）,and parathyroid hormone（PTH）were measured by ECL immunoassay.Results After adjusting for multiple confounders,serum UA levels were found positively correlated with BMD at the lumbar spine,total hip and whole body（P≤0.001）,negatively correlated with OC（P〈0.01）,and positively correlated with logPTH and log25-OHD3（P=0.039,P=0.032）.The participants were divided into high UA group（UA≥60mg/mL）and low UA group（UA〈60 mg/L）according to the serum UA level.OC,PⅠNP andβ-CTX were found significantly lower in the high UA group than in the low UA group（P〈0.01）.Then we divided the participants into three groups（T1：UA〈 47mg/L,T2：47mg/L≤UA〈60mg/L;T3：UA≥60mg/L）according to the serum UA level,and we found that the odds for osteoporosis and at least osteopenia increased by 41% and 158% in T1 group compared with in T3 group,respectively.Conclusion UA plays a protective role in bone metabolism of middle-aged Chinese population,and the relative conclusions need to be confirmed by further studies.