维生素D、维生素B_(12)和同型半胱氨酸水平与绝经后女性骨密度的相关性研究

Relationship between vitamin D, vitamin B_(12) and homocysteine levels and bone mineral density in postmenopausal women

目的探索绝经后非骨质疏松症和骨质疏松症女性患者高半胱氨酸、维生素D、维生素B_(12)和骨密度(bone mineral density,BMD)之间的关系。方法选取2017年8～12月在我院就诊的138名女性作为研究对象,根据骨密度将绝经后女性分为骨质疏松组(n=58)和非骨质疏松组(n=80)。记录两组患者的体质量指数(body mass index,BMI)、年龄、腰围等一般资料,检测腰椎L_(1～4)前后位、左侧股骨近端的BMD,测定血清同型半胱氨酸、维生素B_(12)、维生素D、碱性磷酸酶、钙、磷水平。分析两组患者不同指标的差异以及高半胱氨酸、维生素D、维生素B_(12)和BMD之间的相关性。结果两组患者的年龄、BMI、腰围、同型半胱氨酸、维生素D、维生素B_(12)、腰椎L_(1～4)和左股骨颈骨密度比较差异有统计学意义(P均<0.05);Rho相关性和回归分析表明,同型半胱氨酸与维生素D和B_(12)在绝经后非骨质疏松症和同型半胱氨酸与维生素B_(12)在绝经后骨质疏松症女性中呈显著负相关。结论高水平同型半胱氨酸可以通过绝经后非骨质疏松症患者维生素D水平和绝经后骨质疏松症女性维生素B_(12)水平预测。

Objective To explore the relationship between homocysteine, vitamin D and vitamin B12 levels and BMD in postmenopausal women with osteoporosis and without osteoporosis. Methods A total of 138 women from our hospital were enrolled from August 2017 to December 2017. According to bone density, postmenopausal women were divided into two groups, osteoporosis group(OP, n=58) and non-osteoporosis group(NOP, n=80). General clinical data such as body mass index(BMI), age, and waist circumference were recorded in the two groups. BMD of lumbar spine L1-4 anteroposterior and left femur was measured. Serum levels of homocysteine, vitamin D, vitamin B12, alkaline phosphatase, calcium and phosphorus were measured. The differences of indicators in the two groups of patients and the correlation between homocysteine, vitamin D, vitamin B12 and BMD were analyzed. Results The result showed a statistically significant difference in age, BMI, waist circumference, homocysteine, vitamin D, vitamin B12, and lumbar L1-4 and left femoral neck bone density between the two groups(all P<0.05). Rho correlation and regression analyses showed that homocysteine was significantly negatively correlated with vitamin D and B12 in postmenopausal women with no osteoporosis, and significantly negatively correlated with vitamin B12 in postmenopausal women with osteoporosis. Conclusion Serum homocysteine levels were predicted by vitamin D in postmenopausal non-osteoporotic women and by vitamin B12 in postmenopausal osteoporotic women.