老年高血压合并骨质疏松症患者血清内脂素和抵抗素水平与心脏代谢指数、骨密度的相关性

Correlation of serum visfatin and resistin levels with cardiometabolic index and bone mineral density in elderly patients with essential hypertension complicated with osteoporosis

目的探究老年原发性高血压(essential hypertension,EH)合并骨质疏松症(osteoporosis,OP)患者血清内脂素和抵抗素水平与心脏代谢指数(cardiac Metabolic Index,CMI)、骨密度(bone mineral density,BMD)的相关性。方法2021年2月至2023年2月期间,在杭州市中医院心血管内科选取老年EH合并OP患者120例作为研究对象(EH合并OP组),同时选取50例健康体检者(NC组)和50例EH合并骨量降低者(EH合并骨量降低组)进行对照。采集所有患者的静脉血样本,测定血清内脂素和抵抗素水平,并进行CMI和BMD的检测。采用统计学方法对数据进行分析。结果EH患者若伴有骨量降低或OP,其血清中的内脂素水平往往较低、抵抗素升高,与NC组相比差异有统计学意义(F内脂素=26.02、F抵抗素=9.50,P<0.001)。NC组的CMI小于EH合并骨量降低组、EH合并OP组(F=52.54,P<0.001)。在骨量方面,NC组的BMD高于EH合并骨量降低组、EH合并OP组,尤其是腰椎(F=21.44,P<0.001)、股骨颈(F=10.54,P<0.001)、华式三角(F=12.30,P<0.001)和股骨粗隆(F=4.87,P<0.001)等关键部位。EH合并骨量降低组的各部位BMD也高于EH合并OP组,部位有腰椎(t=4.60,P<0.001)、股骨颈(t=2.32,P=0.022)、华式三角(t=4.58,P<0.001)和股骨粗隆(t=4.33,P<0.001)。此外,内脂素与骨量呈正相关(P<0.05),部位有腰椎(r=0.36,P<0.001)、股骨颈(r=0.38,P<0.001)、华式三角(r=0.28,P=0.020)和股骨粗隆(r=0.37,P<0.001);而抵抗素与骨量呈负相关,部位有腰椎(r=-0.40,P<0.001)、股骨颈(r=-0.50,P<0.001)和股骨粗隆(r=-0.40,P<0.001)。而CMI与内脂素(r=0.06,P>0.05)、抵抗素(r=0.11,P>0.05)之间并无显著相关性。Logistic分析显示,血清中内脂素水平是EH患者并发OP的危险因素(P<0.001),抵抗素水平是其保护因素(P=0.008)。结论老年EH合并OP患者的血清内脂素和抵抗素水平与BMD存在相关性,提示其在疾病发展和治疗中可能有重要作用。

ObjectiveTo investigate the correlation of serum visfatin and resistin levels with cardiometabolic index(CMI)and bone mineral density(BMD)in elderly patients with essential hypertension(EH)complicated with osteoporosis(OP).MethodsFrom Feb.2021 to Feb.2023,120 elderly patients with EH complicated with OP in Department of Cardiovascular Medicine,Hangzhou Hospital of Traditional Chinese Medicine were chosen(the EH complicated with OP group),and 50 healthy physical examination subjects(the NC group)and 50 EH complicated with low bone mass(the EH complicated with low bone mass group)were chosen as the control.Venous blood samples were collected from all patients,serum visfatin and resistin levels were measured,and CMI and BMD were tested.Statistical methods were used to analyze the data.ResultsIn EH patients with decreased bone mass or OP,the level of serum visfatin was often low,but resistin was elevated,which showed significant differences compared with that in the NC group(F visfatin=26.02,F resistin=9.50,P<0.001).The CMI in NC group was lower than that in the other two groups(F=52.54,P<0.001).In terms of bone mass,BMD in NC group was higher than that in the other two groups,especially in the key parts of lumbar spine(F=21.44,P<0.001),femoral neck(F=10.54,P<0.001),Chinese triangle(F=12.30,P<0.001)and femoral trochanter(F=4.87,P<0.001),etc.BMD in EH complicated with low bone mass was also higher than that in EH complicated with OP group,including lumbar spine(t=4.60,P<0.001),femoral neck(t=2.32,P=0.022),Chinese triangle(t=4.58,P<0.001)and femoral trochoid(t=4.33,P<0.001).In addition,visfatin was positively correlated with bone mass(P<0.05),lumbar spine(r=0.36,P<0.001),femoral neck(r=0.38,P<0.001),Chinese triangle(r=0.28,P=0.020)and femoral trochoid(r=0.37,P<0.001),while resistin was negatively correlated with bone mass,lumbar spine(r=-0.40,P<0.001),femoral neck(r=-0.50,P<0.001),and femoral trochanter(r=-0.40,P<0.001).However,there was no significant correlation between CMI and visfatin(r=0.06,P>0.05)and resistin(r=0.11,P>0.05).Logistic analysis showed that visfatin level was a risk factor of OP in EH patients(P<0.001),and resistin was a protective factor(P=0.008).ConclusionSerum visfatin and resistin levels in elderly EH patients complicated with OP are correlated with BMD,suggesting that they may play an important role in disease development and treatment.