老年女性血HCY水平与骨密度的相关性研究

The correlation between serum homocysteine level and bone density in elderly women

目的探讨老年女性血清同型半胱氨酸(homocysteine,HCY)、脂质水平与骨质减少的关系。方法收集2016年9月至2017年3月我院门诊及住院的老年女性126例,根据DXA法测得的骨密度水平将其分为骨量正常组(41例)、骨量减少组(43例)和骨质疏松组(42例),测量记录年龄、绝经年龄、绝经时间、身高、体重,检测血钙(calcium,Ca)、磷(phosphorus,P)、碱性磷酸酶(alkaline phosphatase,ALP)、甘油三酯(triglycerides,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDLC)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDLC),酶联免疫法(enzyme linked immunosorbent assay,ELISA)测定HCY。结果骨质疏松组血清HCY、LDL-C水平明显高于骨量减少组及骨量正常组,骨质疏松组绝经年龄、体重低于骨量正常组,差异有统计学意义(P<0.05)。低体重、血清HCY、LDL-C水平升高是骨质减少的危险因素,OR(95%CI)分别为0.932(0.886~0.979)、2.284(1.487~3.509)、3.160(1.081~9.337),差异有统计学意义(P<0.05)。结论老年女性骨量减少组和骨质疏松组中HCY、LDL-C水平增高,HCY、LDL-C与骨密度水平呈负相关,HCY、LDL-C水平可作为老年女性评价骨量丢失的参考指标。

Objective To study the relationship between serum homocysteine（ HCY） and lipid levels and osteopenia in elderly women. Methods We collected data of 126 elderly female patients of our hospital from September 2016 to March 2017.According to the result of dual energy X-ray BMD examination,subjects were divided into normal bone mass group（ n = 41）,osteopenia group（ n = 43） and osteoporosis group（ n = 42）. Age,menopausal age,time since menopause,height and weight were recorded,and the levels of blood calcium（ Ca）,phosphorus（ P）,alkaline phosphatase（ ALP）,triglycerides（ TG）,low density lipoprotein cholesterol（ LDLC） and high-density lipoprotein cholesterol（ HDLC） were measured. HCY was measured using enzyme linked immunosorbent assay（ ELISA）. Results The levels of serum HCY and LDL-C in the osteoporosis group were higher than those in the osteopenia group and normal bone mass group,and there were significant differences between the osteoporosis group and the normal bone mass group in menopausal age and body weight（ P〈0. 05）. Low body weight and increased serum HCY and LDL-C levels were risk factors in elderly women for osteopenia. These variables were found to be significant different between the osteopenia group and the normal bone mass group（ P〈0. 05）,with odds ratios and 95%confidence intervals as 0. 932（ 0. 886-0. 979）,2. 284（ 1. 487-3. 509） and 1. 487（ 1. 081-9. 337）,respectively. Conclusion HCY and LDL-C in elderly women with osteopenia and osteoporosis were higher than those with normal bone mass（ P〈0. 05）.HCY and LDL-C were negatively related to the level of bone mineral density. The levels of HCY and LDL-C can be used as reference index for the evaluation of bone mass loss in elderly women.