绝经后女性骨代谢指标和体重指数与骨密度的相关性分析

Analyze the correlation of body mass index and bone metabolism index with bone mineral density in postmenopausal women

目的了解绝经后妇女体重指数、骨钙素及25羟维生素D_(3)[25(OH)D_(3)]的情况,分析其与骨密度的关系,为防治绝经后骨质疏松症(PMO)提供依据。方法回顾性选择2018年1月至2020年1月就诊于首都医科大学附属北京友谊医院的50~70岁的绝经后女性75例,以双能X线骨密度仪检查研究对象腰椎和股骨颈骨密度,根据结果分为骨质疏松组、骨量减少组和骨质正常组,每组25例。记录研究对象年龄、身高、体重及既往病史等,采用化学发光免疫分析仪检测骨钙素和25(OH)D_(3)。比较3组研究对象的一般资料及骨密度、骨钙素和25(OH)D_(3)水平,分析体重指数、骨钙素和25(OH)D_(3)与骨密度的相关性。结果从骨质正常组、骨量减少组到骨质疏松组,腰椎及股骨颈骨密度水平依次降低,差异均有统计学意义(P<0.001)。3组研究对象的年龄、骨钙素和25(OH)D_(3)水平差异无统计学意义(P>0.05)。骨钙素、25(OH)D_(3)与股骨颈骨密度无明显相关性(r=-0.062,P=0.598;r=0.039,P=0.738),体重指数与股骨颈骨密度呈正相关(r=0.535,P<0.001),年龄与股骨颈骨密度呈负相关(r=-0.236,P=0.042)。所有研究对象平均25(OH)D_(3)水平是23.15 ng/mL,其中25(OH)D_(3)严重缺乏8例,缺乏41例,不足17例,充足9例。结论25(OH)D_(3)和骨钙素与股骨颈骨密度无相关性,不能用来监测PMO。绝经后妇女存在严重维生素D缺乏情况,应及时检测血清25(OH)D_(3)水平,及时补充缺乏的维生素D。绝经后妇女需避免低体质量,减少PMO危险因素发生,从而减少PMO并发症的出现。

Objective knowing the levels of the body mass index(BMI),serum osteocalcin and 25-hydroxy vitamin D_(3)[25(OH)D_(3)]of postmenopausal women,and analyzing their correlation with bone mineral density(BMD)to provide evidence for the prevention and treatment of postmenopausal osteoporosis(PMO).Methods Seventy five postmenopausal women aged 50-70 who were treated in Beijing Friendship Hospital,Capital Medical University from January 2018 to January 2020 were selected.The dual-energy X-ray bone densitometer was used to examine the bone density of the lumbar spine and the proximal femur.There were 25 patients in osteoporosis group,bone loss group and normal bone group,respectively.The patient's age,height,weight,and previous medical history were recorded,and OC and 25(OH)D_(3) were detected by chemiluminescence immunoassay.The general data and BMD,osteocalcin and 25(OH)D_(3) levels of the three groups were compared,and the correlation between BMI,osteocalcin and 25(OH)D_(3) and BMD was analyzed.Results The BMD levels of lumbar spine and femoral neck decreased successively from normal bone group,osteopenia group to osteoporosis group,and the difference was statistically significant(P<0.001).There was no statistically significant difference in age,osteocalcin and 25(OH)D_(3) levels among the three groups(P>0.05).Osteocalcin and 25(OH)D_(3) had no significant correlation with femoral neck BMD(r=-0.062,P=0.598;r=0.039,P=0.738),BMI had a positive correlation with femoral neck BMD(r=0.535,P<0.001),and age had a negative correlation with femoral neck BMD(r=-0.236,P=0.042).The average of 25(OH)D_(3) in all patients was 23.15 ng/mL,of which 25(OH)D_(3) was severely deficient in 8 cases,41 cases were deficient,less than 17 cases,and 9 cases were sufficient.Conclusion 25(OH)D_(3) and osteocalcin have no correlation with BMD and cannot be used to monitor PMO.Postmenopausal women have severe deficiency of vitamin D.Serum 25(OH)D_(3) levels should be detected in time to supplement vitamin D in timely.Postmenopausal women need to avoid low body mass and reduce the occurrence of PMO risk factors,so as to reduce the occurrence of PMO complications.