绝经后女性骨密度与冠状动脉粥样硬化性心脏病发生风险的相关性

Correlation between bone mineral density and risk of coronary heart disease in postmenopausal women

目的 探讨绝经后女性骨密度与冠状动脉粥样硬化性心脏病（冠心病）发生风险的相关性。方法 回顾性分析2013年1月至2016年1月于首都医科大学附属北京安贞医院心内科就诊的绝经后女性患者248例的病历资料。根据冠状动脉造影检查结果分为冠心病组（108例）和非冠心病组（140例）；根据骨密度测量结果分为骨质疏松组（132例）和非骨质疏松组（116例）。统计冠心病发生的危险因素，采用多因素Logistic回归分析骨质疏松与冠心病之间的相关性。结果 冠心病组的骨密度值明显低于非冠心病组［（-2.3±0.8）kg/m2比（-1.3±1.2）kg/m2］；骨质疏松组的冠心病发生率明显高于非骨质疏松组［53.8%（71/132）比31.9%（37/116）］；差异均有统计学意义（均P＜0.05）。多因素Logistic回归分析显示，吸烟［比值比＝5.328，95%置信区间：1.735～16.926］、锻炼情况［比值比＝0.348，95%置信区间：0.205～0.602］、骨密度［比值比＝0.251，95%置信区间：0.118～0.542］是影响绝经后女性冠心病发生的危险因素（均P＜0.05）。结论 绝经后女性骨质疏松患者的冠心病发生率高于非骨质疏松者；骨质疏松可能为冠心病发生的危险因素。

Objective To explore the correlation between bone mineral density（BMD） and risk of coronary heart disease（CHD） in postmenopausal women. Methods Totally 248 postmenopausal women with CHD from January 2013 to January 2016 in Beijing Anzhen Hospital, Capital Medical University were retrospectively analyzed. The patients were divided into CHD group（n=108） and non-CHD group（n=140） according to results of coronary angiography; they were divided into osteoporosis group（n=132）and non-osteoporosis group（n=116） according to bone density test. The correlation between osteoporosis and CHD risk factors were analyzed. Results The BMD value in CHD group was significantly lower than that in non-CHD group[（-2.3±0.8）kg/m2 vs （-1.3±1.2）kg/m2]（P〈0.05）. The incidence of CHD in osteoporosis group was significantly higher than that in non-osteoporosis group[53.8%（71/132） vs 31.9%（37/116）]（P〈0.05）. Multivariate logistic analysis showed that smoking[odds ratio（OR）=5.328, 95% confidence interval（CI）： 1.735～16.926], exercise[OR=0.348, 95% CI： 0.205～0.602] and BMD[OR=0.251, 95% CI： 0.118～0.542] were risk factors of CHD in postmenopausal women（P〈0.05）. Conclusion Osteoporosis is a risk factor of CHD in postmenopausal women.