骨密度与冠状动脉狭窄程度的关系

Study on the Relationship between Low Bone Mineral Density and Extent of Coronary Artery Disease

目的探讨骨密度值水平冠状动脉粥样硬化性心脏病和冠状动脉狭窄程度之间的关系,并与传统危险因素比较骨密度预测冠状动脉狭窄程度的能力。方法选取411例住院患者进行选择性冠状动脉造影。根据造影结果分为冠心病组和对照组,并同时测定骨密度仪水平。结果单因素分析提示骨密度与冠状动脉狭窄程度有明显的相关性,冠心病组有更多的骨量减少患者和骨质疏松患者;进一步分析表明股骨颈、股骨全部的骨密度数值在冠心病组和对照组间差异有统计学意义(P<0.05)。多因素回归分析表明,与其他冠心病传统危险因素如年龄、性别、吸烟、高脂血症、糖尿病、高血压等进行比较,低骨密度(包括骨量减少和骨质疏松)是冠心病和冠状动脉严重狭窄的独立的预测因素。结论骨密度和冠状动脉狭窄程度有显著的相关性,低骨密度(包括骨量减少和骨质疏松)是冠状动脉明显狭窄的独立预测因素。

Objective To investigate the relationship between bone mineral density （BMD） and extent of coronary artery disease （CAD） , and whether low BMD independently predicts CAD compared with traditional cardiovascular risk factors. Methods Totally 411 patients underwent selective coronary angiography. According to angiography, patients were divided into CAD and control groups. All patients underwent dual - energy x - ray absorptiometry to determine the levels of BMD. We used SPSS software for statistical analysis. Results BMD was significantly associated with the extent of coronary artery stenosis by one way analysis of variance. The patients with CHD had significantly lower BMD （osteopenia and osteoporosis） compared to those without CHD, and the extent of coronary artery stenosis were higher in the patients with lower BMD than those with normal BMD. The univariatc analysis based on dichotomous variables indicated that there were significant differences between the 2 groups for traditional cardiovascular risk factors, such as age, sex, smoking, hyperlipemia, diabetes, hypertension. But the numerical value of total cholesterol, triglyceride cholesterol, low- density -lipoprotein - cholesterol, systolic pressure and diastolic pressure was no difference. It was attributed, at least in part to midcation. Low BMD （osteopenia and osteoporosis） appeared to independently predict significant CAD compared with traditional cardiovascular risk factors by multivariate regression analysis. The degree of coronary artery stenosis was inversely associated with BMD in women but not in men. Conclusion BMD was significantly associated with the extent of coronary artery steuosis. Low BMD appears to independently predict significant CAD in women, hut not in men.