性激素水平与围绝经期综合征患者骨密度的关系及对骨质疏松症的预测价值研究

Relationship between sex hormone levels and bone mineral density in patients with perimenopausal syndrome and its predictive value for osteoporosis

目的分析性激素水平与围绝经期综合征患者骨密度的关系及对骨质疏松症的预测价值。方法选择自2017年1月~2019年1月接诊的143例围绝经期综合征患者作为观察组,另选143例健康体检妇女作为对照组,比较两组性激素、骨密度(BMD)水平,使用Pearson相关性分析性激素水平与骨密度的关系,分析骨质疏松症发生情况及其独立危险因素,通过受试者工作特征(ROC)曲线下面积(AUC)量化评价性激素对骨质疏松症的预测价值。结果观察组与对照组在血清雌二醇(E_(2))、卵泡刺激素(FSH)水平和腰椎、股骨颈及髋部BMD上差异均有统计学意义(P<0.05);经Pearson相关性分析,围绝经期综合征患者血清E_(2)水平与腰椎、股骨颈及髋部BMD均呈正相关(P<0.05),FSH水平与腰椎、股骨颈及髋部BMD均负正相关(P<0.05);经多因素Logistic回归分析,低水平E_(2)、高水平FSH均是骨质疏松症的独立危险因素(P<0.05);经ROC曲线分析,围绝经期综合征患者血清E_(2)联合FSH预测骨质疏松症的AUC为0.936。结论围绝经期综合征患者血清E_(2)、FSH水平均与骨密度的关系紧密,两者联合预测骨质疏松症发生的临床价值较高,可为强化临床管理提供依据。

Objective To analyze the relationship between sex hormone levels and bone mineral density in patients with perimenopausal syndrome and its predictive value for osteoporosis.Methods 143 patients with perimenopausal syndrome in our hospital from January 2017 to January 2019 were selected as the observation group,and 143 healthy women were selected as the control group,the levels of sex hormone and bone mineral density(BMD)were compared between the two groups.Pearson correlation was used to analyze the relationship between sex hormone levels and bone mineral density,and the occurrence of osteoporosis and its independent risk factors Area under curve(AUC)was used to evaluate the predictive value of sex hormones on osteoporosis.Results There were statistically significant differences between the observation group and the control group in serum estradiol(E_(2)),folliclestimulating hormone(FSH)levels,lumbar spine,femoral neck and hip BMD(P<0.05);according to Pearson correlation analysis,serum E_(2) level of perimenopausal syndrome patients was positively correlated with BMD of lumbar spine,femoral neck and hip(P<0.05),while FSH level was negatively correlated with BMD of lumbar spine,femoral neck and hip(P<0.05);according to multivariate Logistic regression analysis,both low E_(2) and high FSH were independent risk factors for osteoporosis(P<0.05);by ROC curve analysis,serum E_(2) combined with FSH predicted the AUC of osteoporosis in perimenopausal syndrome patients with 0.936.Conclusion Serum E_(2) and FSH levels in patients with perimenopausal syndrome are closely related to bone mineral density,the combined prediction of E_(2) and FSH levels in patients with perimenopausal syndrome is of high clinical value,which can provide basis for strengthening clinical management.