高原男性骨质疏松症患者血清叶酸水平变化与股骨颈骨密度的相关性

Relationship between serum folate levels and femoral neck bone mineral density in male patients with osteoporosis at high altitudes

目的 探讨高原骨质疏松症患者血清叶酸水平与股骨颈骨密度(BMD)的相关性。方法 随机选取2023年6~8月间于兴海县人民医院行健康体检的60例老年男性作为研究对象,应用双能X线骨密度仪(DXA)测定受试者股骨颈BMD,按1994年WHO标准将其分为骨量正常的对照组(n=29)和骨质疏松组(n=31);采集两组受试者空腹静脉血检测叶酸浓度;同时测量全髋及腰椎BMD,并采用Spearman等级相关性分析叶酸与股骨颈、全髋、腰椎BMD的相关性。结果 两组受试者的年龄、身高、体质量、体质量指数比较差异均无统计学意义(P>0.05);骨质疏松组患者的血清叶酸浓度为(46.88±4.02) nmol/L,明显低于对照组的(54.01±4.79) nmol/L,差异有统计学意义(P<0.05);骨质疏松组患者的股骨颈、全髋和腰椎的BMD分别为(0.922 9±0.1813) g/cm^(2)、(1.065±0.054 03) g/cm^(2)、(1.255±0.061 58) g/cm^(2),明显低于对照组的(1.026±0.098 39) g/cm^(2)、(1.112±0.065 27) g/cm^(2),(1.315±0.075 81) g/cm^(2),差异均有统计学意义(P<0.05);经Spearman等级相关性分析结果显示,血清叶酸浓度与股骨颈、全髋和腰椎BMD均呈正相关(r=0.644 5、0.650 6、0.574 2,P<0.001)。结论 叶酸浓度降低与高原骨质疏松症密切相关,高原骨质疏松症患者血叶酸水平的缺乏可能是骨质疏松发生的一个重要风险因素,为高原骨质疏松性骨折的治疗及预防提供了新的理论指导和实验依据。

Objective To explore the correlation between serum folate levels and femoral neck bone mineral density(BMD) in male patients with osteoporosis at high altitudes.Methods Sixty elderly males who underwent health examinations at Xinghai People's Hospital from June 2023 to August 2023 were randomly selected as the study subjects.Dual-energy X-ray absorptiometry(DXA) was employed to measure the femoral neck BMD of the participants.According to the 1994 World Health Organization(WHO) standards,the subjects were categorized into a control group(n=29,with normal bone mass) and an osteoporosis group(n=31).Fasting venous blood samples were collected to measure folate concentrations.Simultaneously,total hip and lumbar spine BMD were measured,and Spearman rank correlation analysis was conducted between folate levels and femoral neck,total hip,and lumbar spine BMD.Results The differences in age,height,weight,and body mass index between the osteoporosis group and the control group were not statistically significant(P>0.05).The serum folate concentration in the osteoporosis group was(46.88±4.02) nmol/L,significantly lower than(54.01±4.79) nmol/L in the control group(P<0.05).The BMD of femoral neck,total hip,lumbar spine in the osteoporosis group were(0.9229±0.1813) g/cm2,(1.065±0.054 03) g/cm2,(1.255±0.061 58) g/cm2,significantly lower than(1.026±0.098 39) g/cm2,(1.112±0.065 27) g/cm2,(1.315±0.075 81) g/cm2in the control group(P<0.05).Spearman analysis results showed a positive correlation between serum folate concentration and femoral neck BMD(r=0.644 5,P<0.001),total hip BMD(r=0.650 6,P<0.001),and lumbar spine BMD(r=0.574 2,P<0.001).Conclusion The reduction in folate concentration is closely associated with osteoporosis at high altitudes.The deficiency of serum folate levels may be an important risk factor for the occurrence of osteoporosis.This study provides new theoretical guidance and experimental evidence for the treatment and prevention of osteoporosis at high altitudes.