老年人血管钙化与骨质疏松的相关分析

Correlation between vascular calcification and osteoporosis in the elderly

目的研究老年人血管钙化与骨质疏松(OP)的相关性。方法回顾性分析2013年3月至2016年9月在解放军第181医院老年病科住院的老年患者316例,利用双能X线骨密度仪测定骨密度(BMD),根据BMD测定结果分为OP组135例和非OP组181例,通过彩超检查患者颈动脉、腹主动脉和下肢动脉有无钙化。应用SPSS 18. 0统计软件对数据进行分析。组间比较采用t检验或χ~2检验。logistic回归分析颈动脉钙化、腹主动脉钙化(AAC)和下肢动脉钙化与OP的相关性。结果 OP组患者男性、糖尿病、高血压比例、体质量指数(BMI)、腰椎及髋部BMD均明显低于非OP组患者,总胆固醇水平高于非OP组患者,差异具有统计学意义(P <0. 01)。OP组患者AAC比例高于非OP组患者[83. 7%(113/135) vs 64. 1%(116/181)],差异具有统计学意义(P <0. 01)。logistic回归分析结果表明OP与AAC正相关(OR=3. 25,95%CI 1. 37～7. 70;P=0. 007)。结论无创定性检查条件下AAC与OP相关,可作为血管钙化与OP相关性研究的窗口。

Objective To investigate the correlation between vascular calcification and osteoporosis （OP） in the elderly. Methods A retrospective analysis was made of 316 elderly patients admitted to the Department of Geriatrics of Chinese PLA Hospital No. 181 from March 2013 to September 2016. The bone mineral density （BMD） was measured by dual energy X-ray absorptiometry, and the patients were divided into OP group （135 cases） and non-OP group （181 cases） according to T value. The carotid artery, abdominal aorta, and lower-extremity arteries were examined for calcification by color Doppler ultrasound. SPSS statistics 18.0 was used for data analysis. Student′s t test or Chi-square test was performed for comparison between groups, and logistic regression for analysis of the correlation between carotid calcification, abdominal aortic calcification （AAC） and lower-extremity artery calcification （LEAC） and osteoporosis. Results The OP group had fewer male patients, lower ratio of diabetes mellitus and hypertension, lower body mass index （BMI） and lower BMD in the lumbar spine and hip, but higher total cholesterol level than the non-OP group, the differences being statistically significant （ P 〈0.01）. The incidence of AAC in the OP group was significantly higher than that in non-OP group [83.7%（113/135） vs 64.1%（116/181）], and the difference was statistically significant （ P 〈0.01）. Logistic regression analysis showed a positive correlation between OP and AAC （ OR =3.25, 95% CI 1.37-7.70; P =0.007）. Conclusion AAC correlates with OP under non-invasive qualitative measurement, providing a pathway for the research of the correlation between vascular calcification and OP.