老年男性冠心病与骨质疏松的相关性

The association of coronary heart disease and osteoporosis in elderly men

目的探讨老年男性冠心病(CHD)患者不同部位骨密度、血清骨桥蛋白(OPN)对CHD严重程度的评估价值,分析老年男性CHD患者与骨质疏松的相关性。方法将405例老年男性患者分为CHD组(205例)和非CHD组(200例),再根据冠脉病变严重程度再将CHD组患者分为严重病变组(68例)和轻度病变组(137例);比较CHD和非CHD组患者、CHD严重病变组和轻度病变组患者的一般资料、血生化、血清骨桥蛋白(OPN)以及不同部位[左股骨近端股骨颈、腰椎前后位(L1-L4)及全髋部]的骨密度,采用Logistic回归分析各部位骨密度、血清OPN与老年男性CHD病变程度的相关性。结果CHD组患者各部位骨密度值均低于非CHD组(P<0.05),CHD组血清OPN水平高于非CHD组(P<0.01);CHD组中,严重病变组患者的骨质疏松发生率、血清OPN水平高于轻度病变组(P<0.01),严重病变组左股骨近端股骨颈骨密度低于轻度病变组(P<0.01);Logistic回归分析显示,CHD与骨质疏松存在显著相关性(OR=5.868,P<0.01),LDL-C(OR=3.264)、HCY(OR=2.378)、血清OPN(OR=2.864)、股骨颈骨密度(OR=2.686)均与CHD的严重程度相关(P<0.05)。结论老年男性CHD与骨质疏松密切相关,患者的股骨颈骨密度、血清OPN可作为老年男性CHD严重程度的预测指标。

Objective To investigate the evaluation value of bone mineral density and serum osteopontin(OPN)in different parts of elderly men with coronary heart disease(CHD)in assessing CHD severity and analyze the correlation between CHD and osteoporosis in elderly men with CHD.Methods A total of 405 elderly male patients were divided into CHD group(205 cases)and non-CHD group(200 cases).According to CHD severity,CHD group was further divided into severe disease group(68 cases)and mild disease group(137 cases).The general information,blood biochemistry,serum osteopontin(OPN),and bone mineral density in different parts[left proximal femur,femoral neck,lumbar anteroposterior(L1-L4),and total hip]were compared between CHD and non-CHD groups.Logistic regression was used to analyze the association of bone mineral density,serum OPN with CHD severity in elderly men.Results The bone mineral density of each part in CHD group was lower than that of non-CHD group(P<0.05).Serum OPN level was greater in CHD group than that in non-CHD group(P<0.01).In CHD group,osteoporosis incidence and serum OPN level were higher in severely diseased group than mild disease group(P<0.01).The bone mineral density of the left proximal femur neck in the severe disease group was lower than that in the mild disease group(P<0.01).Logistic regression analysis showed that CHD was positively correlated with osteoporosis(OR=5.868,P<0.01).Moreover,CHD severity was associated with LDL-C(OR=3.264),HCY(OR=2.378),serum OPN(OR=2.864),and femoral neck bone mineral density(OR=2.686,P<0.05).Conclusion CHD in elderly men is closely related to osteoporosis.The femoral neck bone mineral density and serum OPN can be used as predictors of CHD severity in elderly men.