老年人骨质疏松与主动脉硬化的相关性研究

To study the relationship of osteoporosis and atherosclerosis of the aorta in the elderly

目的探讨老年骨质疏松与动脉硬化的关系。方法测定100例老年患者(60～93岁)血脂、碱性磷酸酶(ALP)、血钙、血磷、高敏C反应蛋白(hs-CRP)。用双能X线骨密度仪测定腰椎(L_(2-4))、股骨颈、大转子及Ward's三角骨矿密度(BMD)。用高分辨率彩超测定颈动脉内中膜厚度(IMT)。结果骨质疏松组年龄、hs-CRP和IMT均较非骨质疏松组高(均P<0.05),两组性别、体质指数(BMI)、血脂、ALP、血钙和血磷差异无统计学意义(均P>0.05);主动脉硬化组年龄、hs-CRP和IMT均较非主动脉硬化组高(均P<0.05),而L_(2-4)、股骨颈及大转子BMD均较非主动脉硬化组低(均P<0.05),两组性别、BMI、血脂、ALP、血钙和血磷差异无统计学意义(均P>0.05);相关分析表明L_(2-4)、股骨颈、大转子及Ward's三角BMD与颈动脉IMT呈负相关(均P<0.05)。结论骨质疏松与动脉硬化密切相关,炎症反应可能是骨质疏松与动脉硬化发病机制的共同基础。

Objective To investigate the association between osteoporosis and atherosclerosis in the elderly. Methods Serum lipids,total alkaline phosphatase(ALP),calcium,phosphate and high sensitive C reacitve protein (hs-CRP) were measured in the elderly(n = 100) aged 60 years and older.Bone mineral density(BMD) was measured at the femoral neck and lumbar spine(L_(2-4)) using dual energy X-ray absorptiometry.Carotid intima-media thickness (IMT) was measured using high resolution B-Mode ultrasonography.Results Compared with non-osteoporotic subjects, age,serum hs-CRP levels and carotid IMT were higher in osteoporotic subjects(all,P < 0.05 ).Sex,body mass index (BMI),serum lipids,ALP,calcium and phosphate had no significant difference in two groups(all,P >0.05).Compared with non-aortosclerotic subjects,age,serum hs-CRP levels and carotid IMT were higher in aortosclerotic subjects (all,P < 0.05 ).BMD at the femoral neck and lumbar spine was lower in aortosclerotic subjects(all,P < 0.05 ).Otherwise, sex,BMI,serum lipids,ALP,calcium and phosphate had no significant difference in two groups(all,P > 0.05 ). BMD at the femoral neck and lumbar spine was negative correlated with carotid IMT in the bivariate analysis(all,P < 0.05).Conclusion Osteoporosis was significandy associated with atherosclerosis.Inflammatory reaction may be common soil for pathogenesis in osteoporosis and atherosclerosis.