中国健康体检人群脊柱定量CT骨密度与血红蛋白及白蛋白的相关性

Correlation analysis of bone mineral density, hemoglobin and serum albumin in healthy population

目的采用定量CT技术测量中国健康体检人群脊柱骨密度, 探讨其与血红蛋白及人血白蛋白的相关性。方法本研究数据来自中国健康定量CT大数据项目数据(China Biobank), 脊柱骨密度测量采用 QCT Pro图像分析系统, 所有合作中心均采用欧洲脊柱体模(NO.145)进行质量控制。选取符合入组标准的50 053例健康体检者作为研究对象, 按照年龄分为7组, 收集研究对象一般资料、脊柱骨密度、人血白蛋白、血红蛋白, 采用单因素方差分析、Pearson相关分析、多分类logistic回归模型分析骨密度与血红蛋白、人血白蛋白相关性。结果健康体检者骨密度随年龄增长均降低(P<0.05), 血红蛋白、人血白蛋白、体质指数(BMI)在不同年龄组之间差异均有统计学意义(均P<0.05), 线性相关分析显示不同年龄段男性健康体检者骨密度与血红蛋白呈正相关(分别r=0.086、0.101、0.076、0.090、0.072、0.123、0.100;均P<0.01);而女性健康体检者部分年龄组骨密度与血红蛋白相关(分别40~49岁组:r=-0.027;70~79岁组:r=-0.077;均P<0.05);部分年龄段健康体检者骨密度与血白蛋白相关(其中男性分别为30~39岁组:r=-0.048;40~49岁组r=-0.027;70~79岁组r=-0.051;女性分别为30~39岁组:r=-0.044;40~49岁组r=-0.042;50~59岁组r=-0.086;70~79岁组r=-0.070;均P<0.05)。多分类logistic回归分析显示校正年龄、BMI后血红蛋白水平是男性健康体检者骨密度正常(OR=1.022, 95%CI:1.017~1.027)、骨密度减少(OR=1.012, 95%CI:1.007~1.016)的保护因素;血白蛋白是女性健康体检者骨密度正常(OR=0.926, 95%CI:0.905~0.948)、骨密度减少(OR=1.006, 95%CI:0.951~1.011)危险因素。结论中国健康体检人群骨密度与血红蛋白、人血白蛋白存在相关性。血红蛋白是男性健康体检者骨密度保护因素, 人血白蛋白是女性健康体检者骨密度危险因素。

Objective To use quantitative computed tomography(QCT)technology to measure the bone mineral density of the spine of the Chinese healthy population,and to explore its correlation with hemoglobin and serum albumin.Methods The data in this study came from the China Health Quantitative CT Big Data Project(China Biobank).The spine bone density was measured by using QCT Pro Image Analysis System and all cooperating centers used the European spine phantom(NO.145)for quality control.Total of 50053 healthy persons who met the criteria for entry were selected as the research subjects.The subjects were divided into 7 groups according to age.The general data,spine bone density,serum albumin,hemoglobin of the subjects were collected.The single-factor analysis of variance,Pearson correlation analysis and multi-classification logistic regression model were applied to analyze the correlation between bone density and hemoglobin and serum albumin.Results The bone mineral density of healthy people decreased with age(P<0.05),and there were significant differences in hemoglobin,serum albumin and body mass index(BMI)among different age groups(all P<0.05).Linear correlation analysis showed that there were positive correlation between bone mineral density and hemoglobin in healthy males in different age groups(r=0.086,0.101,0.076,0.090,0.072,0.123,0.100,all P<0.01).There were negative correlation between bone mineral density and hemoglobin in certain age groups in women(40-49 years group:r=-0.027;70-79 yearsgroup:r=-0.077;both P<0.05).And corelation were found between bone mineral density and serum levels of albumin in certain age groups of healthy subjects(among men,30-39 years group:r=-0.048;40-49 years group,r=-0.027;70-79 years group,r=-0.051;among women,30-39 years group:r=-0.044;40-49 years group,r=-0.042;50-59 years group,r=-0.086;70-79 years group,r=-0.070;all P<0.05).After adjusting for age and BMI,the multi-category logistic regression analysis showed that the hemoglobin level was protective factor of normal bone density(OR=1.022,95%CI:1.017-1.027)and decreased bone density(OR=1.012,95%CI:1.007-1.016)in healthy males,and the serum albumin was risk factor for normal bone density(OR=0.926,95%CI:0.905-0.948)and decreased bone density(OR=1.006,95%CI:0.951-1.011)in healthy women.Conclusion There is a correlation between bone mineral density and hemoglobin and serum albumin in Chinese healthy population.Hemoglobin is a protective factor for bone mineral density in men,and serum albumin is a risk factor for bone mineral densityin women.