血清E_2及E_2/T比值对老年妇女骨密度与骨转换指标的影响

Effects of serum E_2 and E_2/T ratio on bone mineral density and bone transplantation indexes in elderly women

目的探讨血清雌二醇(E_2)及E_2/睾酮(T)比值对老年妇女骨密度与骨转换指标的影响。方法选取2016年1月至2017年10月76例绝经后老年妇女作为研究对象,按照BMD测定结果将其分为骨量正常组、骨量减少组和骨质疏松组。测定三组患者骨密度(BMD)、血清E_2、T水平、血钙(Ca)、碱性磷酸酶(ALP)、Ⅰ型前胶原氨端肽原(PINP)、Ⅰ型胶原交联羧基端肽β特殊序列(β-CTX)含量,进行相关性比较。结果三组患者E_2、E_2/T及PINP等指标比较,差异有统计学意义(P <0. 05)。血清E_2与骨形成标志物PINP呈负相关(r=-0. 318,P <0. 01)。E_2/T与骨形成标志物PINP呈负相关(r=-0. 355,P <0. 01)。校正患者年龄、绝经年限以及BMI等因素后,血清E_2和E_2/T与骨形成标志物PINP均仍存在较为显著的负相关性(r=-0. 265、-0. 285,P <0. 05)。血清E_2以及E_2/T与骨吸收标志物β-CTX呈显著负相关(r=-0. 231、-0. 221,P <0. 05),但是校正患者年龄绝经年限以及BMI等因素后,不存在显著相关性。患者全髋部位BMD随着和E_2、E_2/T呈正相关,在校正年龄、绝经年限、以及BMI等因素前后差异均有统计学意义(P <0. 05)。结论 E_2以及E_2/T与骨质疏松的发生密切相关,对老年妇女进行E_2以及E_2/T进行特异性检测有望于在早期对患者骨质疏松进行有效的监测,值得临床推广和应用。

Objective To investigate the effects of serum E2 and density and bone turnover in elderly women. Methods A total of 76 elderly January 2016 to October 2017 were selected as study subjects. According to E2/T ratio on bone mineral postmenopausal women from the results of BMD, the patients were divided into the normal group, the osteopenia group and the osteoporosis group. The levels of BMD, E2, T, Ga, ALP, PINP and β-CTX in three groups were measured and compared. Results There were significant differences in the indexes of E2, E2/T, and PINP among the three groups （P 〈 0. 05）. There was negative correlation of serum E2 and with （r = -0. 318, P 〈 0. 01 ）. There was negative correlation of E2/T with PINP （r = -0. 355, P 〈 0. 01 ）. There was negative correlation of E2 and E2/T with PINP （ r = - 0. 265, - 0. 285） after adjusting for patients＇ age, menopause and BMI, （P 〈0.05 ）. Serum E2 and E2/T were negatively correlated with the bone resorption marker β-CTX （r = -0. 231, - 0. 221, P 〈 0. 05 ）, but after adjusting for the patients＇ age at menopause and BMI And other factors, there was no significant correlation. The total hip BMD was positively correlated with E2 and E2/T, and the difference was significant before and after the adjustment for age, menopause, and BMI （P 〈 0. 05）. Conclusions E2 and E2/T are closely correlated with the occurrence of osteoporosis. The specific detection of E2 and E2/T for elderly women is expected to be effective in early osteopo- rosis monitoring, which is worthy of clinical popularization and application.