血清钙磷水平与绝经期女性CIMT和颈动脉斑块的相关性研究

Correlation between serum calcium and phosphorus levels and CIMT and carotid plaque in postmenopausal women

目的探讨血清钙磷水平与绝经期女性颈动脉内膜中层厚度(CIMT)及颈动脉斑块之间的相关性。方法选取2020年1月至2021年12月在该院行颈动脉B型超声的绝经期女性438例作为研究对象。研究对象根据颈动脉B型超声检查的CIMT分为斑块组83例、颈动脉内膜中层增厚组(以下简称增厚组)168例及对照组(CIMT正常)187例。比较各组临床资料,并通过Logistic回归分析确定血清钙磷[血清钙离子(Ca^(2+))、血清磷(P)]水平对CIMT增厚及颈动脉斑块的相关性。结果斑块组年龄、绝经年龄大于其他两组,体重指数(BMI)、收缩压、舒张压高于其他两组,差异有统计学意义(P<0.05)。增厚组年龄、绝经年龄大于对照组,BMI、收缩压、舒张压高于对照组,差异有统计学意义(P<0.05)。对照组高血压、血管紧张素转化酶抑制剂、Ca^(2+)拮抗剂、利尿剂、胰岛素及他汀类药物占比低于其他两组,差异有统计学意义(P<0.05)。斑块组血清肌酐(Cr)、空腹血糖(FGP)、P、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)均高于其他两组,Ca^(2+)低于其他两组,差异有统计学意义(P<0.05)。增厚组Cr、FGP、P、TC、HDL-C、LDL-C均高于对照组,Ca^(2+)低于对照组,差异有统计学意义(P<0.05)。年龄、舒张压、收缩压、Cr、Ca^(2+)、P、LDL-C、他汀类药物是影响CIMT增厚的独立危险因素(P<0.05);而绝经年龄及Ca^(2+)是影响CIMT增厚的独立保护因素(P<0.05)。随着血清Ca^(2+)水平升高,颈动脉斑块的风险呈非线性下降趋势(χ^(2)=3.210,P=0.038);随着血清P水平升高,颈动脉斑块的风险呈非线性增高趋势(χ^(2)=6.210,P=0.003)。结论血清钙、磷水平与绝经期女性CIMT和颈动脉斑块的形成有关。

Objective To investigate the correlation between serum calcium and phosphorus levels and carotid intima-media thickness(CIMT)and carotid plaque in postmenopausal women.Methods A total of 438 postmenopausal women who received carotid artery B-mode ultrasound in a hospital from January 2020 to December 2021 were selected as subjects.According to the CIMT of carotid artery B-mode ultrasound,the subjects were divided into 83 cases in the plaque group,168 cases in the carotid intima-media thickening group(hereinafter referred to as the thickening group)and 187 cases in the control group(normal CIMT).The clinical data of each group were compared,and the correlation between serum calcium and phosphorus[serum calcium ion(Ca^(2+)),serum phosphorus(P)]levels on CIMT thickening and carotid plaque was determined by Logistic regression analysis.Results The age and menopause age of the plaque group were higher than those of the other two groups,and the body mass index(BMI),systolic blood pressure and diastolic blood pressure were higher than those of the other two groups,the difference was statistically significant(P<0.05).The age and menopause age of thickening group were higher than control group,and BMI,systolic blood pressure and diastolic blood pressure were higher than control group,the difference was statistically significant(P<0.05).The proportion of hypertension,angiotensin converting enzyme inhibitors,Ca^(2+)antagonists,diuretics,insulin and statins in the control group were lower than that in the other two groups,and the difference was statistically significant(P<0.05).Serum creatinine(Cr),fasting blood glucose(FGP),P,total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)in plaque group were higher than those in the other two groups,and Ca^(2+)was lower than those in the other two groups,with statistical significance(P<0.05).Cr,FGP,P,TC,HDL-C and LDL-C in thickening group were higher than those in control group,and Ca^(2+)was lower,the difference was statistically significant(P<0.05).Age,diastolic blood pressure,systolic blood pressure,Cr,Ca^(2+),P,LDL-C and statins were independent risk factors for CIMT thickening(P<0.05).Menopause age and Ca^(2+)were independent protective factors for CIMT thickening(P<0.05).With the increase of serum Ca^(2+)level,the risk of carotid plaque showed a non-linear decline(χ^(2)=3.210,P=0.038).The risk of carotid plaque increased nonlinearly with the increase of serum P level(χ^(2)=6.210,P=0.003).Conclusion Serum calcium and phosphorus levels are associated with CIMT and carotid plaque formation in postmenopausal women.