老年女性骨密度与体质指数细胞因子等相关性研究  

The association of bone mineral density and other factors in elderly women with different body mass indices

作　　者：张秀珍[1] 韩峻峰[1] 钱国锋[1] 赵家胜[1] 陈亚青[1] 李红[1] 孟健[1] 谷磊[1] 杨黎娟[1] 

机构地区：[1]同济大学附属同济医院内分泌科,上海市200065

出　　处：《中华老年医学杂志》2004年第10期701-704,共4页Chinese Journal of Geriatrics

基　　金：国家自然科学基金资助项目 (3 0 0 70 3 5 7)

摘　　要：目的　探讨不同体质指数 (BMI)的老年女性骨密度与性激素水平、骨代谢指标及细胞因子的相关性。　方法　 12 8例BMI≥ 2 5kg/m2 、12 6例BMI≤ 2 0kg/m2 健康老年女性 ,根据年龄分为 5 5～岁组 ,6 0～岁组 ,6 6～ 70岁组 ,并与BMI≥ 2 5kg/m2 和BMI≤ 2 0kg/m2 的 31～ 35岁月经正常者各 2 0例作对照。采用双能X线骨密度仪 (DEXA)测定骨密度、生化指标及细胞因子等 ,并与骨密度进行相关性分析。　结果　BMI≥ 2 5kg/m2 和BMI≤ 2 0kg/m2 组不同部位的骨密度均随增龄而下降 ,且各年龄段BMI≥ 2 5kg/m2 骨密度均高于BMI≤ 2 0kg/m2 组 (P <0 0 5 ) ;血清雌二醇 (E2 )、碱性磷酸酶 (ALP)、骨钙素 (BGP)水平随增龄而下降 ,而I型胶原N末端肽 (NTx)、卵泡刺激素 (FSH)水平随增龄而升高。白介素 6 (IL 6 )、肿瘤坏死因子α(TNF α)、胰岛素样生长因子 1(IGF 1)随增龄改变无明显规律 ;BMI≥ 2 5kg/m2 组血清E2 、ALP、BGP、IGF 1水平高于BMI≤ 2 0kg/m2 组 (P <0 0 5 ) ,NTx、FSH、促黄体生成素 (LH)、IL 6、TNF α水平BMI≥ 2 5kg/m2 组低于BMI≤ 2 0kg/m2 组 (P <0 0 5 ) ;两组各部位的骨密度均与E2 、ALP、BGP呈正相关 ,与NTx、FSH、LH呈负相关 (P <0 0 5 ) ;BMI≤ 2 0kg/m2 组各部位的骨密度均与IL 6、Objective To investigate the relationship of bone mineral density (BMD) and other factors in elderly women with different body mass indices (BMI). Methods One hundred and twenty eight healthy elderly women with BMI≥25 kg/m 2 ,A group) and 126 healthy women with (BMI≤20 kg/m 2 ,B group) were included in the study. They were randomized into three groups 55 ,61 ,66 70years according to their age. Another 40 women at 31 35 years old were used as normal controls. Dual energy X ray absorptiometry (DEXA) and measurements of a series of biochemical indices were performed and the relationship with BMD was analysed. Results BMD decreased with the ages. But BMD in A group was higher than that in B group(P<0 05). The serum levels of estradiol(E 2 ), alkaline phosphatase(ALP), osteocalin(BGP) decreased with the ages, but the levels of collagen type I N telepeptide(NTx) and follicle stimulating hormone(FSH) increased and accompanied with irregular changes of interleukin 6(IL 6), toxic nodular goiter α(TNF α), insulin like growth factor 1(IGF 1) levels. The levels of E 2 , ALP, BGP, IGF 1 in A group were higher than that in B group(P<0 05), while the level of NTx, FSH, luteotrophic hermone(LH), IL 6, TNF α was lower than that in B group(P<0 05). BMD of L 2 4 , Ward’s triangle, Neck, Troch were positively correlated with the level of E 2 , ALP, BGP and negatively correlated with the level of NTx, FSH, LH in two groups. There was no significant difference in IL 6, TNF α, IGF 1 and BMD in obese group(P>0 05), while BMD negatively correlated with the level of IL 6, TNF α(P<0 05), positively correlated with the levels of IGF 1(P<0 05). Conclusions BMD decreased with the age. Women with heavy body weight conserve bone better than those with lower body weight.

关 键 词：BMI 骨密度 增龄 老年女性 细胞因子 体质指数 IL-6 水平 结论 负相关 

分 类 号：R58[医药卫生—内分泌]