老年男性骨质疏松病人骨代谢标志物与心脑血管疾病相关性的研究

Correlation between bone metabolism markers and cardio-cerebrovascular diseases in elderly male patients with osteoporosis

目的分析老年男性骨质疏松病人骨代谢标志物与心脑血管疾病的相关性。方法选取2018年10月至2019年9月在我院治疗的90例老年男性骨质疏松病人,根据病人有无心脑血管疾病分为心脑血管疾病组(40例)和无心脑血管疾病组(50例)。检测并比较2组病人的颈动脉内膜厚度、HbA1c、TG、TC、LDL-C、HDL-C、骨密度、骨钙素(osteocalcin,OC)、血清1型原胶原N-端前肽(serum type1 procollagen N-terminal peptide,P1NP)、血清I型胶原交联C-末端肽(collagen cross-linking C-terminal peptide,CTX)、血钙、血磷、甲状旁腺激素(parathyrin,PTH)、25羟维生素D(25-OH-D)水平。采用Logistic回归分析评价老年男性骨质疏松病人发生心脑血管疾病的危险因素。结果心脑血管疾病组的骨密度T值、P1NP、OC、HDL-C水平明显低于无心脑血管疾病组,CTX、HbA1c、颈动脉内膜厚度、TG、TC、LDL-C水平明显高于无心脑血管疾病组(P<0.05);2组病人的PTH、25-OH-D、血钙、血磷水平差异无统计学意义(P>0.05)。Logistic回归分析表明,引起心脑血管疾病的相关因素包括P1NP、CTX、OC、骨密度、HbA1c、TG、TC、LDL-C、HDL-C。结论老年男性心脑血管疾病与骨代谢标志物P1NP、CTX、OC具有相关性;老年骨质疏松病人行早期干预、早期预防对心脑血管疾病的防治具有临床指导意义。

Objective To analyze the correlation between bone metabolism markers and cardio-cerebrovascular diseases in the elderly male patients with osteoporosis.Methods Ninety elderly male patients with osteoporosis from October 2018 to October 2019 in our hospital were selected.The patients were divided into cardio-cerebrovascular group(40 cases)and non-cardio-cerebrovascular group(50 cases)according to wheather they suffered from cardio-cerebrovascular diseases.Carotic artery intimal thickness glycosylated hemoglobin(HbAIc),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol,high density lipoperotein chdesterdl(HDL-C)bone mineral density,osteocalcin(OC),serum type 1 procollagen N-terminal peptide(P1NP)as well as collagen cross-linking C-terminal peptide(CTX),calcium,phosphorus,parathyrin(PTH),25-OH-D were detected and compared between the two groups.The risk factors for cardio-cerebrovascular diseases were analyzed byLogistic regression analysis.Results The levels of bone mineral density,P1NP,OC,HDL-C in cardio-cerebrovascular group were lower than those in non-cardio-cerebrovascular group,while the levels of CTX,HbA1c,carotid intimal thickness,TG,TC,LDL-C were significantly higher than those in non-cardio-cerebrovascular group(P<0.05).There were no significant differences in the levels of PTH,25-OH-D,calcium,phosphorus between the two groups(P>0.05).Logistic regression analysis showed that the levels of P1NP,CTX,OC,bone mineral density,HbA1c,TG,TC,LDL-C,HDL-C were the relative factors for cardio-cerebrovascular diseases in the patients with osteoporosis.Conclusions There are close relationship between cardiovascular and cerebrovascular diseases and bone metabolic markers.It is of critical significance to elderly patients with osteoporosis to carry out early intervention and prevention.