老年高血压病合并骨质疏松症患者血清Hcy水平与骨密度及骨代谢指标的相关性分析

Correlation analysis of serum Hcy level with bone mineral density and bone metabolism indexes in elderly patients with hypertension complicated with osteoporosis

目的探讨老年高血压病合并骨质疏松症患者血清血同型半胱氨酸(Hcy)水平与骨密度及骨代谢指标的相关性。方法回顾性分析自2014-03—2019-03诊治的197例老年高血压病,骨密度T值≥-1 SD 78例(骨量正常组),-2.5 SD≤骨密度T值<-1 SD 63例(骨量降低组),骨密度T值<-2.5 SD 56例(骨质疏松组)。比较3组Hcy水平、不同部位骨密度值、骨代谢指标水平,分析Hcy水平与骨密度值及骨代谢指标水平的相关性,探讨老年高血压病合并骨质疏松症的危险因素。结果骨量正常组、骨量降低组、骨质疏松组Hcy表达水平依次升高,在不同部位处骨密度值依次降低,差异有统计学意义(P<0.05)。3组血钙、血磷水平比较差异无统计学意义(P>0.05),骨量正常组、骨量降低组、骨质疏松组OC、PTH水平依次降低,β-CTX、BALP、PINP水平依次升高,差异有统计学意义(P<0.05)。Hcy水平与不同部位处骨密度值及PTH水平呈负相关(P<0.05),与β-CTX、BALP、PINP水平呈正相关(P<0.05);高水平的β-CTX、BALP、PINP、Hcy与低水平的PTH是老年高血压病合并骨质疏松症的危险因素(P<0.05)。结论老年高血压病合并骨质疏松症患者血清Hcy表达水平较高,与骨密度β-CTX、BALP、PINP及PTH水平变化有关,这些变化可能影响骨密度和骨代谢,参与老年高血压病合并骨质疏松症的发展。

Objective To investigate the correlation between serum homocysteine(Hcy)level and bone mineral density,bone metabolism indexes in elderly patients with hypertension complicated with osteoporosis.Methods From March 2014 to March 2019,197 elderly patients with hypertension were retrospectively analyzed,78 patients with bone mineral density T value≥-1 SD(normal bone mass group),63 patients with-2.5 SD≤bone mineral density T value<-1 SD(decreased bone mass group),and 56 patients with bone mineral density T value<-2.5 SD(osteoporosis group).The level of Hcy,bone mineral density in different parts and level of bone metabolism indexes were compared among the three groups,and the correlation between Hcy level and bone mineral density,level of bone metabolism indexes was analyzed,and the risk factors of elderly hypertension complicated with osteoporosis were explored.Results The expression level of Hcy in normal bone mass group,decreased bone mass group and osteoporosis group increased in turn,and bone mineral density in different parts decreased in turn,the differences were statistically significant(P<0.05).There was no significant difference in the levels of serum calcium and phosphorus among the three groups(P>0.05),while the levels of OC and PTH in normal bone mass group,decreased bone mass group and osteoporosis group decreased in turn,and the levels ofβ-CTX,BALP and PINP increased in turn,the differences were statistically significant(P<0.05).Hcy level was negatively correlated with bone mineral density in different parts and PTH(P<0.05),and positively correlated withβ-CTX,BALP and PINP(P<0.05);in addition,high levels ofβ-CTX,BALP,PINP,Hcy and low level of PTH were the risk factors of elderly hypertension complicated with osteoporosis(P<0.05).Conclusion The expression level of serum Hcy in elderly patients with hypertension complicated with osteoporosis is higher,which is related to the changes of bone mineral density,β-CTX,BALP,PINP and PTH levels,these changes may affect bone mineral density and bone metabolism,and then participate in the development of elderly hypertension complicated with osteoporosis.