血清胆红素水平与绝经后骨质疏松症相关性的临床分析

Clinical analysis of the correlation between serum total bilirubin level and postmenopausal osteoporosis

目的探讨血清总胆红素在绝经后骨质疏松症发病机制中的作用。方法通过双能X线骨密度仪检查,将282例绝经后女性分为正常骨量组(n=93)和早期绝经后骨质疏松症组(n=61)、中期绝经后骨质疏松症组(n=58)和晚期绝经后骨质疏松症组(n=70)。测定血清总胆红素和骨转换标志物水平,分析血清总胆红素与骨密度、骨代谢的关系。结果骨密度与年龄、I型胶原交联C-末端顶端肽(β-CTX)、甲状旁腺激素(parathyroid hormone,PTH)呈负相关,与体重指数(body mass index,BMI)、25羟基维生素D3(25(OH_2)D_3)、血清总胆红素(total bilirubin,TBIL)呈正相关。Logistics回归分析显示,年龄、BMI、TBIL、PTH、总I型前胶原N-末端肽与骨质疏松症的发生独立相关,而血清碱性磷酸酶(alkaline phosphatase,ALP)、β-CTX与绝经后骨质疏松无独立相关性。结论血清总胆红素水平下降为绝经后骨质疏松症的独立危险因素。

Objective To investigate the effect of serum total bilirubin in the pathogenesis of postmenopausal osteoporosis.Methods By dual energy X-ray bone density instrument examination,a total of 282 postmenopausal women were divided normal bone mass group（n=93）,early postmenopausal osteoporosis group（n=61）,middle postmenopausal osteoporosis group（n=58）,and late postmenopausal osteoporosis group（n=70）.Serum total bilirubin and bone turnover markers were detected.The relationship between serum total bilirubin,bone mineral density,and bone metabolism was analyzed.Results Bone mineral density was negatively correlated with age,β-CTX,and PTH,but positively correlated with BMI,25（OH_2）D_3,and serum total bilirubin.Logistics regression analysis revealed that age,BMI,TBIL,PTH,and PINP were independently associated with the occurrence of osteoporosis,and ALP and β-CTX were not associated with postmenopausal osteoporosis.Conclusion The decrease of serum total bilirubin level is an independent risk factor of postmenopausal osteoporosis.