摘要
目的探讨老年骨质疏松症(osteoporosis,OP)患者血清1,25-二羟维生素D_3〔1,25-(OH)_2D_3〕与骨骼肌减少症(sarcopenia,SAR)的相关性。方法选取2013年10月—2015年4月到云南省第一人民医院就诊的老年OP患者390例。根据是否合并SAR,将纳入患者分为合并SAR组(n=286)和未合并SAR组(n=104)。患者均进行体格检查、骨密度和身体组织成分检测及实验室检查,并分析血清1,25-(OH)_2D_3与SAR评价指标和影响因素的相关性。结果两组患者性别、年龄及BMI比较,差异无统计学意义(P>0.05)。未合并SAR组患者血清1,25-(OH)_2D_3高于合并SAR组,差异有统计学意义(P<0.05)。Spearman秩相关分析结果显示,男性/女性OP患者血清1,25-(OH)_2D_3与步速、握力呈正相关(P<0.05),而与四肢骨骼肌量指数(ASMI)不相关(P>0.05);血清1,25-(OH)_2D_3与雌二醇(E_2)、睾酮(T)、胰岛素样生长因子-1(IGF-1)、白介素10(IL-10)呈正相关(P<0.05),与活性氧(ROS)、全段甲状旁腺激素(i PTH)、肿瘤坏死因子α(TNF-α)、白介素6(IL-6)呈负相关(P<0.05),而与BMI、胰岛素抵抗指数(HOMA-IR)、超敏C反应蛋白(hs-CRP)不相关(P>0.05)。结论OP患者血清1,25-(OH)_2D_3水平与部分SAR评价指标和影响因素相关,可能是早期预测和评估SAR的指标之一。
Objective To explore the correlation between serum 1,25- dihydroxyvitamin D_3〔1,25-( OH)_2D_3〕of patients with senile osteoporosis( osteoporosis, OP) and sarcopenia( sarcopenia, SAR). Methods 390 patients with senile OP,who received treatment in First People' s Hospital of Yunnan Province from October 2013 to April 2015 were selected. Depending on whether merging SAR,they were assigned to group combined with SAR( n = 286) and group combined without SAR( n = 104). All the patients received physical examination,bone density and body tissue composition testing and laboratory examination to analyze the correlation between serum 1,25-( OH)_2D_3level and the evaluation indexes and influencing factors of SAR. Results Gender,age and BMI of the two groups were not significantly different( P〈0. 05). Serum1,25-( OH)_2D_3of group combined with SAR was significantly higher than that in group without SAR( P〈0. 05). Spearman rank correlation analysis showed that male / female OP patients' serum OP 1,25-( OH)_2D_3was positively correlated with walking speed,grip strength( P〈0. 05),and not correlated with arms and legs skeletal muscle mass index( ASMI); serum1,25-( OH)_2D_3presented positive correlation with estradiol( E_2),testosterone( T),insulin- like growth factor- 1( IGF- 1),interleukin- 10( IL- 10,P〉0. 05),while negatively correlated with reactive oxygen species( ROS),intact parathyroid hormone( i PTH),tumor necrosis factor α( TNF- α),interleukin- 6( IL- 6,P〈0. 05),and not correlated with BMI, homeostasis model assessment of insulin resistance( HOMA- IR), high- sensitivity C- reactive protein( hs- CRP,P〉0. 05). Conclusion Serum 1,25-( OH)_2D_3level of OP patients is correlated with some of the evaluation indexes and influencing factors,and may be one of the indicators of early prediction.
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第25期3050-3054,共5页
Chinese General Practice
基金
云南省应用基础研究面上项目(2013FZ183)
云南省老年病防治研究中心基金项目(2014NS240)
云南省第一人民医院王陇德院士工作站基金项目(2013年)