血脂代谢对骨折康复期患者骨密度的影响

Effect of blood lipid metabolism on bone mineral density in patients with fracture rehabilitation period

目的分析血脂代谢对骨折康复期患者骨密度的影响。方法回顾性分析2020年1月至2022年1月该院收治的358例骨折患者的临床资料,所有患者均为康复期。依据患者的腰椎L_(1)~L_(4)处骨密度检测结果将其分为异常组(骨量减少或骨质疏松,223例)及正常组(骨密度正常,135例)。比较两组患者的一般资料和临床资料,并采用多因素Logistic回归分析骨折康复期患者腰椎L_(1)~L_(4)处骨密度异常的危险因素,采用Pearson或Spearman相关分析总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平与各危险因素的相关性。结果异常组的男性、体质量指数(BMI)<18.5 kg/m^(2)、异常饮食、骨损伤重度、骨折部位数量>2处的患者占比高于正常组,异常组的TC、HDL-C、LDL-C、载脂蛋白A、载脂蛋白B水平均升高,各部位T值均降低,差异均有统计学有意义(P<0.05)。多因素Logistic回归分析结果显示,BMI<18.5 kg/m^(2)、骨损伤重度、骨折部位数量>2处、TC>5.18 mmol/L、HDL-C>1.91 mmol/L、LDL-C>3.40 mmol/L为骨折康复期患者腰椎L_(1)~L_(4)处骨密度异常的危险因素(P<0.05)。TC、HDL-C、LDL-C水平与BMI呈负相关(P<0.05),与其余各项危险因素均呈正相关(P<0.05)。结论血脂代谢异常为骨折康复期患者腰椎L_(1)~L_(4)处骨密度异常的危险因素,临床对于早期发现血脂代谢紊乱的骨折康复期患者,应积极给予有效措施调控,以改善预后。

Objective To analyze the effect of blood lipid metabolism on bone mineral density in the patients with fracture rehabilitation period.Methods The clinical data of 358 fracture patients admitted and treated in this hospital from January 2020 to January 2022 were analyzed retrospectively.All patients were in the recovery stage.The patients were divided into the abnormal group(223 cases of osteopenia or osteoporosis)and normal group(135 cases of normal bone mineral density)according to the bone mineral density test results at L_(1)-L_(4)of lumbar vertebrae.The general data and clinical data were compared between the two groups,and the risk factors of abnormal bone mineral density at L_(1)-L_(4)of the lumbar vertebrae in the patients with fracture rehabilitation period were analyzed by multifactor Logistic regression,and the correlation between the levels of total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)with various risk factors was analyzed by Pearson or Spearman correlation.Results The proportions of male,body mass index(BMI)<18.5 kg/m^(2),abnormal diet,severe bone injury and the number of fracture sites>2 in the abnormal group were higher than those in the normal group.The TC,HDL-C,LDL-C,apolipoprotein A and apolipoprotein B levels in the abnormal group were increased,and the T values of each part were decreased,and the differences were statistically significant(P<0.05).The multivariate Logistic regression analysis results showed that BMI<18.5 kg/m^(2),severe bone injury,number of fracture sites>2,TC>5.18 mmol/L,HDL-C>1.91 mmol/L and LDL-C>3.40 mmol/L were the risk factors for abnormal bone mineral density at L_(1)-L_(4)of lumbar vertebrae in the patients with fracture rehabilitation period(P<0.05).The TC,HDL-C and LDL-C levels were negatively correlated BMI(P<0.05),and positively correlated with other risk factors(P<0.05).Conclusion Abnormal blood lipid metabolism is a risk factor for abnormal bone mineral density at L_(1)-L_(4)of lumbar vertebrae in the patients with fracture rehabilitation period.The fracture rehabilitation period patients of abnormal blood lipid metabolism in the clinical early stage,the effective measures should be actively given to control so as to improve the prognosis.