硒与骨质疏松和骨关节炎的相关性研究

Study on the Relationship Between Selenium and Osteoporosis and Osteoarthritis

目的对人体内硒水平与骨质疏松及关节炎的相关性进行分析。方法将2017年1月至2020年1月于我院就诊的125例骨质疏松患者(骨质疏松组)及117例骨关节炎患者(骨关节炎组)纳入研究,并选取同期121例于我院行常规体检的健康人群作为对照组;其中骨质疏松组患者男21例,女104例;平均年龄(66.15±4.78)岁,身体质量指数(body mass index,BMI)为(23.11±2.09)kg/m^(2),骨关节炎组患者男25例,女92例;平均年龄(67.83±4.81)岁,BMI(24.06±2.11)kg/m^(2)。对照组患者男37例,女84例;平均年龄(65.39±4.92)岁,BMI(22.98±2.14)kg/m^(2)。比较三组研究对象的血硒水平及骨密度等相关指标,并对血硒水平与骨质疏松及骨关节炎的相关性进行分析。结果对照组及骨质疏松组的年龄、BMI明显低于骨关节炎组(P<0.05),而对照组患者的年龄及BMI与骨质疏松组相比,差异无统计学意义(P>0.05);骨质疏松组及骨关节炎组患者的骨密度、硒及骨钙素水平明显低于对照组,同时骨质疏松组明显低于骨关节炎组,Ⅰ型胶原交联C末端肽(C-telopeptide of typeⅠ,CTX-Ⅰ)、Ⅰ型原胶原N端前肽(procollagenⅠN-terminal propeptide,PⅠNP)水平明显高于对照组及骨关节炎组,差异均有统计学意义(P<0.05)。多因素Logistic分析示,高CTX-Ⅰ及PⅠNP水平是骨质疏松及骨关节炎的独立危险因素,而高骨密度、硒及骨钙素是防止骨质疏松及骨关节炎发生的保护因素。此外,女性为骨质疏松发生的独立危险因素,高龄及高BMI则为骨关节炎的独立危险因素(P<0.05);人体血硒水平与骨密度呈正相关(r=0.688,P<0.001)。结论低血硒水平是发生骨质疏松及骨关节炎的独立危险因素,且血硒水平与患者骨密度呈正相关,可作为相关干预靶点。

Objective To analyze the correlation between selenium level in human body and osteoporosis and arthritis.Methods 125 cases of osteoporosi(osteoporosis group)and 117 cases of osteoarthriti(osteoarthritis group)treated in our hospital from January 2017 to January 2020 were included in the study.121 cases were selected in our hospital during the same period.Healthy people undergoing routine physical examination in the hospital served as the control group.There were 21 males and 104 females in the osteoporosis group,with an average age of(66.15±4.78)years and a BMI of(23.11±2.09)kg/m^(2).There were 25 males and 92 females in the osteoarthritis group.The average age was(67.83±4.81)years old,and the BMI was(24.06±2.11)kg/m^(2).The control group included 37 males and 84 females.The average age was(65.39±4.92)years and the BMI was(22.98±2.14)kg/m^(2);The blood selenium level and bone density of the three groups of subjects were compared,and the correlation between the blood selenium level and osteoporosis and osteoarthritis was analyzed.Results The age and BMI of the control group and the osteoporosis group were significantly lower than those of the osteoarthritis group(P<0.05),while the age and BMI of the control group patients were not statistically different from those of the osteoporosis group(P>0.05).The bone density,selenium,and osteocalcin levels of the osteoporosis group and the osteoarthritis group were significantly lower than those of the control group,while the osteoporosis group was significantly lower than the osteoarthritis group.TypeⅠcollagen cross-linked C-terminal peptide(C-The levels of telopeptide of typeⅠcol I,CTX-Ⅰ)and procollagenⅠN-terminal propeptide(PⅠNP)were significantly higher than those of the control group and the osteoarthritis group,and the differences were statistically significant(P<0.05).Multivariate logistic analysis showed that high CTX-Ⅰand PⅠNP levels were independent risk factors for osteoporosis and osteoarthritis,while high bone density,selenium and osteocalcin were protective factors to prevent osteoporosis and osteoarthritis.In addition,femalewas independent risk factors for osteoporosis,while advanced age and high BMI were independent risk factors for osteoarthritis(P<0.05);Human blood selenium level was positively correlated with bone density(r=0.688,P<0.001).Conclusion Low blood selenium level is an independent risk factor for osteoporosis and osteoarthritis,and blood selenium level is positively correlated with patients'bone mineral density,which can be used as a relevant intervention target.