绝经后女性25羟维生素D与骨密度及骨折风险的相关性

Correlation of Bone Mineral Density, 25 Hydroxy Vitamin D and Fracture Risk in Postmenopausal Women

目的:探讨在社区绝经后女性这个普遍群体中,骨密度与血清25羟维生素D[25(OH)VD]及利用FRAX?得出的骨折风险相关性的研究。方法:选取符合标准的89位自社区来我院就诊的绝经后女性,检测患者左侧股骨颈近端部位和腰椎骨密度,依据T值水平分为:正常组(n=19)、减少组(n=30)、骨质疏松组(n=40),检测患者25(OH)VD,运用FRAX?来估算研究对象前臂、腰椎等主要部位的骨折风险(PMOF)及髋部的骨折风险(PHF)。结果:(1)25(OH)VD与L1-4BMD、左侧股骨颈BMD、主要部位骨折风险(PMOF)及髋部骨折风险(PHF)无相关性(P>0.05);(2)PMOF、PHF分别与L1-4BMD、L-NeckBMD均呈线性负相关;(3)各部位BMD、25(OH)VD表达水平由高到低为正常组、减少组、骨质疏松组,各部位BMD表达水平有统计学价值,但25(OH)VD水平无统计学价值;PMOF、PHF由高到低为骨质疏松组、减少组、正常组(P<0.05)。结论:25(OH)VD虽与骨折风险、骨密度无直接相关关系,但在绝经后女性人群中普遍存在骨质疏松及VD缺乏,对此类人群进行25(OH)VD水平的检测能够为临床治疗提供一定的参考,为骨质疏松或骨折的早发现、早治疗提供理论依据。在社区等缺乏骨密度之类精密仪器的医疗场所,更加简便的诊断出骨质疏松患者,可以作为社区体检中一项基本筛查工具进行推广。

Objective： To explore the relationship between BMD and serum 25（OH）D, fracture risk evaluated by FRAX in community postmenopausal women. Methods： A total of 89 cases of postmenopausal women who are from the community to our hospital physical examination from January 2016 to July 2017. To test the proximal part of the neck of the femoral neck and the density of the lumbar vertebra and test 25（OH）VD. On the basis of T value level is divided into normal group（n=19）, osteopenia group（n=30） and osteoporosis group（n=40）. The probability of osteoporotic hip fracture and the probability of osteoporotic fracture in the main part of the hip were calculated in the next 10 years with FRAX.Results：（1）There was no correlation between 25（OH）VD and L1-4 BMD, left femoral neck BMD, risk of brittle fracture of the main sites（PHF）and hip fracture risk（PMOF）（P0.05）;（2）The relationship between PMOF and PHF part with BMD of lumbar spine and femoral neck was negative.（3）Each place BMD, 25（OH）VD expression level from high to low：normal bone mass, bone loss group, osteoporosis group; The expression level of BMD in all parts was statistically significant,but the level of 25（OH）VD was no; The risk of fracture in each part from high to low： osteoporosis group, bone loss group, normal bone mass group（P0.05）. Conclusion： There is no direct correlation between 25（OH）VD and BMD,fracture risk.25（OH）VD is relationship is directly related to the risk of fractures, bone density, but the universal existence of osteoporosis in postmenopausal women crowd and VD lack of such people for the level of 25（OH）VD detection can provide certain reference for clinical treatment and the theory basis for early detection early treatment for osteoporosis or bone fracture.In the community such as a lack of bone mineral density health facilities, more simple diagnosis of osteoporosis patients, can be used as a basic on the community medical screening tool for promotion.