绝经期女性骨密度变化及其与糖脂代谢、颈动脉粥样硬化及远期心血管预后的关系

Changes in bone mineral density and its relationship with glucose and lipid metabolism,carotid atherosclerosis,and long-term cardiovascular prognosis in menopausal women

目的 探讨绝经期女性骨密度变化及其与糖脂代谢、颈动脉粥样硬化及近远期心血管预后的关系。方法 选取150例行体检的绝经期女性设为研究组,根据骨密度检查结果分为正常组(骨密度正常)和异常组(骨密度降低),并选取同期行体检的150例非绝经期女性设为对照组。比较两组的骨密度(BMD)、空腹血糖、血浆总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平及颈动脉内膜中层厚度(CIMT),采用Pearson线性相关法分析绝经期女性超声BMD与糖脂代谢、颈动脉粥样硬化及远期心血管预后的相关性。结果 三组研究对象的年龄、足跟BMD、CIMT、TC、LDL-C、TG水平比较,差异有统计学意义(P<0.05)。与骨密度正常组绝经妇女相比,骨密度异常绝经妇女的年龄、CIMT、TC、LDL-C、TG水平均显著增加,而足跟BMD显著降低。绝经妇女的雌激素水平为(15.39±2.57)ng/L,显著低于对照组的(117.39±8.17)ng/L,且绝经后骨密度正常组妇女的雌激素水平显著高于骨密度异常妇女。绝经后妇女的绝经时间与雌激素水平呈负相关(r=-0.47,P<0.05);绝经后妇女骨密度与雌激素水平呈正相关(r=0.51,P<0.05),与颈动脉粥样硬化呈负相关(r=-0.73,P<0.05)。绝经妇女的骨密度与TC、TG、LDL-C、HDL-C、CIMT、尿素、尿酸、肌酐和空腹血糖水平无相关性(P>0.05)。结论 绝经后妇女雌激素水平显著降低,且其骨质疏松与颈动脉粥样硬化呈显著相关。

Objective To explore the change of bone mineral density and its relationship with glucose and lipid metabolism,carotid atherosclerosis and near and future cardiovascular prognosis in menopausal women.Methods A total of 150 postmenopausal women who underwent physical examination were selected as the study group,and they were divided into the normal group(nonnal bone mineral density)and the abnormal group(decreased bone mineral density)according to the results of bone mineral density examination.And 150 non-menopausal women who underwent physical examination at the same time were selected as the control group.Bone mineral density(BMD),fasting blood glucose,plasma total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and carotid intima-media thickness(CIMT)were compared between the two groups.Pearson linear correlation method was used to analyze the correlation between ultrasound BMD and glucose lipid metabolism,carotid atherosclerosis and long-term cardiovascular prognosis in menopausal women.Results There were statistically signficant difierences in the age,heel BMD,CIMT,TC,LDL-C,TG levels among the three groups of subjects(P<0.05).Compared with postmenopausal women with normal bone mineral density,the age,CIMT,TC,LDL-C,TG levels of postmenopausal women with abnormal bone mineral density were significantly increased,while the heel BMD was significantly decreased.The estrogen level of postmenopausal women was(15.39±2.57)ng/L,which was significantly lower than that of the control group of(117.39±8.17)ng/L,and the estrogen level of postmenopausal women with normal bone mineral density was significantly higher than that of women with abnormal bone mineral density.There was significant negative correlation between postmenopausal time and estrogen level in postmenopausal women(r=-0.47,P<0.05).Bone mineral density in postmenopausal women was significantly positively correlated with estrogen level(r=0.51,P<0.05),and significantly negatively correlated with carotid atherosclerosis(r=-0.73,P<0.05).The bone mineral density of postmenopausal women has no correlation with TC,TG,LDL-C,HDL-C,CIMT,urea,uric acid,creatinine and fasting blood glucose levels(P>0.05).Conclusion The estrogen level in postmenopausal women decrease significantly,and their osteoporosis is significantly correlated with carotid atherosclerosis.