老年男性吸烟与骨转换标志物、骨密度和骨质疏松性骨折风险的关系

Relationship between smoking and bone turnover markers,bone mineral density,and probability of osteoporotic fractures in elder men

目的调查老年男性吸烟与骨转换标志物、骨密度和骨质疏松性骨折风险的关系。方法调查576例60~97岁老年男性吸烟等情况,按照是否吸烟分成吸烟组31例和非吸烟组545例。检测两组骨转换标志物[包括I型胶原羧基末端肽交联(CTX)、I型前胶原氨基端前肽(P1NP)和骨钙素(OC)]、骨密度[包括股骨颈骨密度(FNBMD)、总髋部骨密度(THBMD)、腰椎1~4正位骨密度(LSBMD)],计算未来10年主要骨质疏松性骨折风险(PMOF)和髋部骨折风险(PHF),再进行相应分析。结果与不吸烟组比较,吸烟组血清CTX、OC水平较高,FNBMD、THBMD较低,PMOF、PHF较高,差异均有统计学意义(t分别=2.20、2.44、-2.28、-2.23、2.03、4.11,P均<0.05)。结论吸烟可能会加快老年男性的骨质丢失,进而增加其骨质疏松性骨折的风险。

Objective To explore the relationship between smoking,and serum bone turnover markers(BTMs),bone mineral density(BMD),and probability of osteoporotic fractures in elderly men.Methods A total of 576 men aged 60-97 years were enrolled in the study,and grouped into smoking group(31 cases)and non-smoking group(545 cases).The levels of serum BTMs including C-terminal telopeptide of type 1 collagen(CTX),procollagen type 1 N-peptide(P1NP),and osteocalcin(OC)and BMD including femoral neck bone mineral density(FNBMD),total hip bone mineral density(THBMD)and lumbar spine bone mineral density(LSBMD)were detected,probability of major osteoporotic fracture(PMOF)and probability of hip fracture(PHF)were calculated by fracture risk assessment tool.The differences in those parameters between smoking group and non-smoking group were analyzed.Results Compared to the non-smoking group,the levels of serum CTX and OC in the smoking group were significantly higher,FNBMD and THBMD were significantly lower,and PMOF and PHF were significantly higher(t=2.20,2.44,-2.28,-2.23,2.03,4.11,P<0.05).Conclusion Smoking could increase bone loss,therefore increasing the probability of osteoporotic fracture in elder men.