基于骨脂代谢的血脂指标与绝经后妇女骨密度相关性研究

CORRELATION BETWEEN SERUM LIPIDS AND BONE MINERAL DENSITY IN POSTMENOPAUSAL WOMEN

目的 探讨绝经后妇女骨密度与血脂指标的相关性。方法 录入2016年3月至2021年3月在南京中医药大学附属医院骨伤科就诊的1686名绝经后妇女的基本临床数据,按BMI分为偏瘦组、正常组、超重组、肥胖组,检测患者腰椎、髋部不同部位的骨密度、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(APOA1)、载脂蛋白B(APOB)、载脂蛋白E(APOE)、脂蛋白a[LP(a)]等指标,对绝经后妇女的骨密度进行分组比较并研究其与血脂指标的相关性,并进行多元线性回归分析。结果 肥胖组绝经后妇女的股骨转子间、股骨内部、髋部骨密度较正常组、偏瘦组、超重组高,差异有统计学意义(P<0.05);TG、APOE是腰椎骨密度的独立影响因素,APOA1与HDL-C是髋部骨密度的独立影响因素。其中,TG与腰椎骨密度呈正相关,APOE与腰椎骨密度呈负相关,APOA1与髋部骨密度呈正相关,HDL-C与髋部骨密度呈负相关。结论 绝经后妇女相对较高的血脂水平可能是骨密度的保护因素,如HDL-C、TG、APOE、APOA1等指标是骨质疏松症的重要影响因素。

Objective To study the correlation between blood lipid and bone mineral density in postmenopausal women.Methods A total of 1686 postmenopausal women who were treated in the Department of Orthopedics,Affiliated Hospital of Nanjing University of Chinese Medicine from March 2016 to March 2021 were selected and divided into normal group,lean group,overweight group and obese group according to BMI index.The differences of bone mineral density among the groups were compared.Multiple linear regression analysis was performed on serum lipid index and bone mineral density in postmeno-pausal women.Results The total BMD of intertrochanteric,internal femur and hip in the obese group was higher than that in the normal group,the lean group and the obese group,and the difference was statistically significant(P<0.05).TG and APOE were independent influencing factors of lumbar bone mineral density,APOA1 and HDL-C were independent influencing fac-tors of hip bone mineral density.Among them,TG was positively correlated with lumbar BMD,APOE was negatively correlated with lumbar BMD,APOA1 was positively correlated with hip BMD,and HDL-C was negatively correlated with hip BMD.Con-clusion There is a certain correlation between bone mineral density and blood lipid level in postmenopausal women,and its clinical significance is worthy of further study.