脊柱退行性疾病需手术治疗患者的血脂及血细胞计数比值与骨密度、骨质疏松的关系

The relationship between serum lipid profiles,blood cell count ratio and bone mineral density,osteoporosis in patients with spine degeneration diseases indicating for surgery

目的探讨脊柱退行性疾病需手术治疗患者的血脂、血细胞计数比值与骨密度、骨质疏松的关系。方法选取符合纳入标准的110例脊柱退行性疾病需手术治疗患者,均于术前行定量CT(QCT)腰椎骨密度(BMD)测量,同时间段空腹采集静脉血测定血清中总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)以及全血中血小板(P)、中性粒细胞(N)、淋巴细胞(L)、单核细胞(M)计数值,计算P/L、N/L、M/L。采用Spearman秩相关分析指标与BMD的相关性,多重线性回归分析BMD的影响因素,二分类Logistic回归分析指标与骨质疏松之间的关联。结果研究对象平均年龄(63.00±7.00)岁,骨质疏松发生率为41.0%。年龄(rs=-0.427,P<0.001)、TC(rs=-0.196,P=0.040)和HDL-C(rs=-0.280,P=0.003)与BMD呈负相关;年龄(β=-0.010,P<0.001)、HDL-C(β=-0.088,P=0.034)与lgBMD之间的关联具有统计学意义。骨质疏松组年龄(t=-4.326、P<0.001)、HDL-C(U=1816.500、P=0.031)高于非骨质疏松组,差异具有统计学意义;年龄(β=0.164,P<0.001)与骨质疏松的关联具有统计学意义。结论脊柱退行性疾病需手术治疗患者的骨质疏松发生率较高,年龄和HDL-C是QCT腰椎BMD的主要影响因素,但是只有年龄与骨质疏松与否存在关联。

Objective To explore the relationships between bone mineral density,osteoporosis and serum lipid profiles,blood cell count ratio in patients with spine degeneration diseases indicating for surgery.Methods One hundred and eleven patients with spine degeneration diseases indicating for surgery who met the inclusion criteria were recruited.Lumbar BMD was measured using quantitative computed tomography(QCT)before the surgery.Total cholesterol,triglyceride,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol in serum were measured simultaneously.The platelet,neutrophil,lymphocyte,and monocyte in whole blood were counted to calculate platelet-lymphocyte ratio,neutrophil-lymphocyte ratio,and monocyte-lymphocyte ratio.Spearman rank correlation was used to analyze the correlation between each index and BMD.Multiple linear regression was used to analyze the influence factors of BMD.Binary logistic regression was used to explore factors associated with osteoporosis.Results The average age of 111 patients was 63.00±7.00 years.The incidence of osteoporosis was 41.0%.BMD was negatively correlated with age(rs=-0.427,P<0.001),TC(rs=-0.196,P=0.040),and HDL-C(rs=-0.280,P=0.003).The associations between age(β=-0.010,P<0.001),HDL-C(β=-0.088,P=0.034)and lgBMD were statistically significant.Age and HDL-C were higher in osteoporosis group than in non-osteoporosis group,and the difference was statistically significant(t=-4.326,P<0.001;U=1816.500,P=0.031).However,only the association between age(β=0.164,P<0.001)and osteoporosis was statistically significant.Conclusion Patients with spine degeneration diseases indicating for surgery have a higher incidence of osteoporosis.Age and HDL-C are the significant independent predictors of BMD of the lumbar spine,but only age is associated with osteoporosis.