男性骨关节炎与骨质疏松的相关性研究

Correlation Between Osteoarthritis and Osteoporosis in Men

目的 通过分析男性不同部位、不同程度的骨关节炎(osteoarthritis, OA)对骨质疏松(osteoporosis, OP)患病率、腰椎骨密度(lumbar bone mineral density, L-BMD)的影响,探讨OA与OP的关系。方法 对2017年1月–2020年12月因骨关节疼痛在四川大学华西第四医院骨质疏松科就诊的1 206例男性患者,记录其年龄、身高、体质量、疼痛病程、吸烟情况、运动情况、高血压史和糖尿病史。使用双能X线骨密度仪测定患者L-BMD,根据数字X线,CT/MRI评估OA部位和程度。采用χ^(2)检验比较各组间OP患病率,采用协方差分析比较各组间L-BMD,采用二分类logistic回归分析与OP相关的危险因素。结果 OA组OP患病率低于无OA组,差异有统计学意义(P<0.05)。腰椎OA组患病率低于无OA组,差异有统计学意义(P<0.05)。轻度和中度OA组患病率低于无OA组,差异有统计学意义(P<0.05)。OA组L-BMD高于无OA组,差异有统计学意义(P<0.05)。不同部位OA组间L-BMD差异有统计学意义(P<0.05),其中腰椎OA组,多部位OA组L-BMD大于无OA组(P<0.05)。不同程度OA组间L-BMD差异有统计学意义上(P<0.05),其中轻度和中度OA组L-BMD大于无OA组(P<0.05)。OA和运动是OP的保护因素(OR=0.715和0.625,95%CI=0.550~0.928和0.481~0.814,P<0.05),而年龄和BMI是男性OP的危险因素(OR=1.018和1.081,95%CI=1.008~1.028和1.042~1.122,P<0.05)。结论 腰椎OA、轻-中度OA会减少男性OP患病率,腰椎OA、多部位OA、轻-中度OA会增加男性L-BMD。OA和运动会减少男性OP的发生,年龄、BMI会增加男性OP的危险性。

Objective To investigate the influence of osteoarthritis(OA) at different sites and of different degrees on the prevalence of osteoporosis(OP) and lumbar bone mineral density(L-BMD) in men, and thereby to analyze the relationship between OA and OP. Methods We collected information on the age, height, body mass, the course of pain, smoking status, exercise status, and history of hypertension and diabetes of 1 206 male patients who received treatment for bone and joint pain at the Department of Osteoporosis and Rheumatology, West China Fourth Hospital,Sichuan University between January 2017 and December 2020. The patients’ L-BMD was determined with dual-energy Xray absorptiometry. The sites and the degrees of OA were evaluated by digital radiography and CT or MRI. χ^(2) test was performed to compare the OP prevalence of different groups. Analysis of covariance was carried out to compare the LBMD of different groups. Binary logistic regression was conducted to analyze the risk factors of OP. Results OP prevalence of the OA group was significantly lower than that of the non-OA group(P<0.05). OP prevalence of the lumbar vertebra OA group was significantly lower than that of the non-OA group(P<0.05). In addition, OP prevalence of the mild OA group and moderate OA group was significantly lower than of the non-OA group(P<0.05). The L-BMD of the OA group was significantly higher than that of the non-OA group(P<0.05). In addition, there were significant differences in L-BMD between groups with OA at different sites(P<0.05). Furthermore, the L-BMD of the lumbar vertebra OA group and the multi-site OA group was significantly higher than that of the non-OA group(P<0.05). There were significant differences in L-BMD between groups with different degrees of OA(P<0.05). Furthermore, the L-BMD of the mild OA group and moderate OA group was significantly higher than that of the non-OA group(P<0.05). OA and exercise were found to be protective factors for OP(odds ratio [OR]=0.715 and 0.625, 95% confidence interval [CI]: 0.550-0.928 and0.481-0.814, P<0.05). Age and BMI were found to be risk factors for OP in men(OR=1.018 and 1.081, 95% CI: 1.008-1.028and 1.042-1.122, P<0.05). Conclusion Lumbar vertebra OA and mild and moderate OA decrease OP prevalence in men, while lumbar vertebra OA, multi-site OA, and mild and moderate OA increase L-BMD in men. OA and exercise decrease the occurrence of OP in men, while age and BMI increase the risk of OP in men.