颈动脉粥样硬化与女性绝经后骨质疏松的关系

Association between osteoporosis and atherosclerosis in postmenopausal women

目的探讨女性绝经后骨质疏松(osteoporosis, OP)与颈动脉内膜-中层厚度(carotid intima-media thickness,CIMT)及颈动脉斑块的相关性。方法选择2016年10月至2017年10月在日照市中医医院体检的绝经后女性144例,应用双能X线骨密度仪检测腰椎(L1～L4)的骨密度(bone mineral density, BMD),依据BMD检测结果分为OP组(52例)和非OP组(92例);应用彩色多普勒超声检测颈动脉CIMT及颈动脉斑块。评价颈动脉粥样硬化与OP的关系。结果 OP组颈动脉斑块比例高于非OP组(28.8%vs. 13.0%),差异有统计学意义(P=0.020);OP组CIMT虽高于非OP组[(1.01±0.42)mm vs.(0.89±0.36)mm],但差异无统计学意义(P=0.078)。多因素分析提示,颈动脉斑块是OP的独立危险因素(OR=3.488,95%CI 1.318～9.226,P=0.012),而CIMT增厚与OP无关(OR=1.906,95%CI 0.891～4.079,P=0.096);相关性分析提示,CIMT与L1～L4的BMD无相关性(r=-0.151,P=0.072),颈动脉斑块与L1～L4 BMD呈负相关(r=-0.223,P=0.007)。结论女性绝经后颈动脉斑块形成可增加OP风险,而CIMT与OP无相关性。

Objective To investigate the association between carotid intima-media thickness (CIMT), carotid plaque and osteoporosis in postmenopausal women. Methods A total of 144 postmenopausal women in Rizhao Hospital of Traditional Chinese Medicine were included from October 2016 to October 2017. Bone mineral density (BMD) of lumber vertebrae (1- 4) was detected by the dual-energy X-ray absorptiometry. All patients were divided into osteoporosis (OP) group and non-os? teoporotic (non-OP) group according to the BMD results. CIMT and carotid plaque were measured by color Doppler ultraso? nography.The association between osteoporosis and atherosclerosis was evaluated. Results The presence of carotid plaque in OP group was significantly higher than in non-OP group (28.8% vs. 13.0%, P = 0.020). CIMT in OP group was higher than in non-OP group, while there was no significant difference](1.01 ±0.42)mm vs.(0.89±0.36)mm, P = 0.078]. Multivariate analysis suggested that carotid plaque was an independent risk factor for OP (OR = 3.48& 95% CI 1.318-9.226, P = 0.012), while CIMT thickening was not associated with OP (OR = 1.906, 95% CI 0.891-4.079, P = 0.096). Correlation analysis revealed that there was no correlation between CIMT and lumbar 1-4 BMD (r =-0.151, P= 0.072), and carotid plaque was negatively corre lated with lumbar 1-4 BMD (r =-0.223, P = 0.007). Conclusions The formation of carotid plaques in postmenopausal women may increases the risk of OP, while there is no relationship between CTMT and OP.