深圳市中老年女性骨代谢指标与体质类型的相关性研究

Research on the Correlation between TCM Constitution Type and Bone Metabolism Index of Middle-Aged and Old Women in Shenzhen

目的:探讨深圳市50岁及以上中老年女性的骨代谢指标(Ⅰ型前胶原氨基末端前肽(PINP)、β-Ⅰ型胶原交联羧基末端肽(β-CTX)和25羟基维生素D(25(OH)VD))与中医体质类型的差异,并分析二者联合应用对于预防慢性骨病特别是骨质疏松症的意义。方法:选取在本院参与调查的585例中老年女性,检测其骨代谢指标和中医体质类型,根据体质类型进行分组,平和质组150例、阳虚质组109例、阴虚质组75例、气虚质组57例、血瘀质组57例、湿热质组48例、痰湿质组40例、气郁质组40例、特禀质组9例。其中符合正态分布的骨代谢指标与体质类型的关系采用多元线性回归分析,否则采用Spearman相关分析。结果:气郁质组、阴虚质组、阳虚质组的PINP明显高于平和质组(P<0.05),差异均有统计学意义;气虚质组、阴虚质组、气郁质组的β-CTX比平和质组高,阴虚质组的25(OH)VD水平高于平和质,但差异无统计学意义。气虚质得分、阳虚质得分和阴虚质得分是β-CTX升高的保护因素(回归系数依次为0.001、0.001和0.003),特禀质得分是β-CTX升高的危险因素(回归系数为-0.002);气虚质得分、血瘀质得分是25(OH)VD升高的危险因素(回归系数分别为-0.004和-0.002)。结论:气虚质、阳虚质和阴虚质女性较正常女性更容易发生骨质流失,导致骨质疏松症发病的风险更大,气虚质和血瘀质女性发生25(OH)VD低下可能诱发的相关骨病的风险更大。此外,气郁质和阴虚质女性更可能产生高转换型骨质疏松症。当中老年女性进行体质类型检测结果呈现为上述类型时,应当进行骨密度及相关骨代谢指标的检测,以做到疾病的早发现早预防。

Objective:To explore the difference among TCM constitution types and bone metabolism indexes(type Ⅰ procollagen amino terminal propeptide(PINP),β-Ⅰ collagen cross-linked carboxy terminal peptide(β-CTX) and 25 hydroxyl group) Vitamin D(25(OH) VD)) of women above 50 years old and in Shenzhen, and analyze the significance of the combination of the two for the prevention of chronic bone diseases, especially osteoporosis.Methods:585 middle-aged and old women who participated in the investigation in the author’s hospital were selected to test their bone metabolism indexes and TCM constitution types, and then they were grouped according to their TCM constitution types.There were 150 cases in the Gentleness type group, 109 cases in the Yang-deficiency group, 75 cases in the Yin-deficiency type group, and 57 cases in Qi-deficiency group, 57 cases in the Blood-stasis type group;48 cases in the Damp-heat type group;40 cases in the Phlegm-damp type group, 40 cases in the Qi-depression type group, and 9 cases in the Special-constitution type group.Among them, the relationship between bone metabolism indexes, normal distributed, and TCM Constitution type was analyzed by multiple linear regression analysis, otherwise, spearman correlation analysis was used.Results:The PINP of Qi-depression type, Yin-deficiency type and Yang-deficiency group were significantly higher than that of Gentleness type group, and the differences were statistically significant(P<0.05).The β-CTX of Qi-deficiency type, Yin-deficiency type and Qi-depression type group were higher than that of Gentleness type group, and the 25(OH)VD level of Yin-deficiency type group was higher than that of Gentleness type group, but the difference was not statistically significant.The scores of Qi-deficiency, Yang-deficiency and Yin-deficiency type were the protective factors(regression coefficients were 0.001,0.001 and 0.003 respectively) of the β-CTX increase, the score of Special-constitution type was the risk factor of the β-CTX increase(the regression coefficient was-0.002),the scores of Qi-deficiency and Blood-stasis type were the risk factors of the increase of 25(OH)VD(the regression coefficients were-0.004,-0.002).Conclusion:Middle-aged and old women with Qi-deficiency, Yang-deficiency and Yin-deficiency type are more likely to have bone loss than normal women, which lead to a greater risk of osteoporosis.Women with Qi-deficiency and Blood-stasis type have a higher risk of related bone diseases induced by low 25(OH)VD.In addition, Qi-depression and Yin-deficiency type women are more likely to have high conversion osteoporosis.Therefore, the middle-aged and old women should be tested for bone mineral density and related bone metabolism indicators when the results show the above-mentioned types, so as to achieve early onset and prevention of diseases.