中老年骨质疏松与下肢动脉粥样硬化的关系研究

Study on Relationship between Osteoporosis and Lower Extremity Atherosclerosis in Middle-aged and Elderly Patients

目的:探讨中老年人群骨质疏松与下肢动脉粥样硬化的相关性。方法:选取2018年5月-2021年6月暨南大学附属第六医院心内科收治的中老年患者共218例,所有患者均行髋关节骨密度检查和下肢血管超声检查,采集患者的所有临床资料。根据髋关节骨密度检查结果将患者分为非骨质疏松组和骨质疏松组,分析组间临床资料和动脉粥样硬化积分(Crouse积分)的差异,Logistic回归分析骨质疏松的危险因素。结果:218例患者中,非骨质疏松组156例,骨质疏松组62例,骨质疏松发生率为28.44%。骨质疏松组和非骨质疏松组年龄、体重指数(BMI)、甲状旁腺激素(PTH)、碱性磷酸酶(ALP)、25羟基维生素D_(3)[25(OH)D_(3)]、Crouse积分、吸烟史、高血压病史、糖尿病病史、高脂血症史、下肢动脉斑块发生率比较,差异均有统计学意义(P<0.05);腰椎骨密度T值与年龄、Crouse积分均呈负相关,与BMI、25(OH)D_(3)均呈正相关(P<0.05),但与钙、磷、PTH、ALP均无关(P>0.05);Logistic回归分析显示,Crouse积分和下肢动脉斑块均是骨质疏松的独立危险因素(P<0.05),BMI、25(OH)D_(3)均是骨质疏松的保护因素(P<0.05)。结论:中老年患者下肢动脉粥样硬化可增加骨质疏松的风险。

Objective:To investigate the correlation between osteoporosis and lower extremity atherosclerosis in middle-aged and elderly patients.Method:A total of 218 middle-aged and elderly patients admitted to the Department of Cardiology,the Sixth Affiliated Hospital of Jinan University from May 2018 to June 2021 were selected.All patients underwent hip bone mineral density examination and lower extremity vascular ultrasound examination,and all clinical data of patients were collected.The patients were divided into the non-osteoporosis group and the osteoporosis group according to the results of hip bone mineral density examination.The differences in clinical data and atherosclerosis score(Crouse score)between two groups were analyzed,and the risk factors of osteoporosis were analyzed by Logistic regression.Result:Among 218 patients,156 cases were in the non-osteoporosis group and 62 cases were in the osteoporosis group,the osteoporosis incidence rate was 28.44%.The differences in age,body mass index(BMI),parathyroid hormone(PTH),alkaline phosphatase(ALP),25 hydroxyvitamin D_(3)[25(OH)D_(3)],Crouse score,history of smoking,history of hyperemia,history of diabetes mellitus,history of hyperlipidemia and incidence of lower extremity arterial plaque between the osteoporotic group and non-osteoporotic group were statistically significant(P<0.05);lumbar spine bone mineral density T values were negatively correlated with age and Crouse score,and positively correlated with BMI,25(OH)D_(3)(P<0.05),but not with calcium,phosphorus,PTH and ALP(P>0.05);Logistic regression analysis showed that Crouse score and lower extremity arterial plaque were independent risk factors for osteoporosis(P<0.05),and BMI and 25(OH)D_(3)were protective factors for osteoporosis(P<0.05).Conclusion:Lower extremity atherosclerosis in middle-aged and elderly patients can increase the risk of osteoporosis.