男性吸烟与骨密度及骨生化指标关系的调查与分析  

Relationship between smoking, bone turnover and bone mineral density in healthy Chinese men

作　　者：杨玲凤[1] 赵勤[1] 张红[1] 伍贤平[1] 谢辉[1] 刘丽君[1] 单鹏飞[1] 曹行之[1] 罗湘杭[1] 廖二元[1] 

机构地区：[1]中南大学湘雅二医院代谢内分泌研究所,湖南长沙410011

出　　处：《中国现代医学杂志》2007年第18期2240-2243,共4页China Journal of Modern Medicine

摘　　要：目的探讨男性吸烟与骨密度及骨生化指标关系。方法用DXA仪测定腰椎及髋部BMD,用ELISA测定389例20～80岁健康男性血清骨特异性碱性磷酸酶(sBAP)、血清骨钙素(sOC)和Ⅰ型胶原氨基末端肽(sNTX)。结果腰椎正位总体、腰椎侧位、髋部总体、股骨颈及Ward's区BMD均与年龄呈显著负相关(均P<0.05)。各部位BMD均在20～29岁年龄组最高,29岁之后随增龄而缓慢下降;40～60岁各年龄组之间的BMD差异无显著性。除腰椎侧位BMD外,吸烟组其他各部位BMD显著低于非吸烟组;吸烟组的sOC和BAP显著高于非吸烟组,两组之间的sNTX差异无显著性。校正年龄与BMI后,烟龄与腰椎正位,髋部总体,股骨颈及Ward's区BMD均呈显著负相关(P<0.05)。每日吸烟量与腰椎正位及Ward's区BMD呈显著负相关(P<0.05)。结论男性随年龄增长骨量丢失。男性吸烟者骨生化指标与骨转换水平增高,骨量丢失加速。吸烟等生活方式增高骨转换水平,影响骨转换的增龄性变化并加速骨量的丢失。吸烟是骨质疏松的一个危险因素。预防骨质疏松症(OP)应提倡戒烟。[Objective] To study the relationships of smoking and bone alkaline phosphatase （BAP）, serum osteocalcin （sOC） and cross-linked N-telopeptides of type 1 collegen （sNTX）and bone mineral density in healthy men aged 20-80. [Methods] BAP, sOC, and sNTX were measured using ELISA and BMD at lumbar spine and hip was measured by dual energy x-ray densitometer, and correlation of bone biochemical marker with age and BMD were fitted by ten kinds of regression models. [Result] All subjectes were categorized into two groups according to smoking or not, and there was a lower mean BMD of all sites and a higher sOC and BAP values in those smoking men （all P 〈0.05）. After adjusted age and BMI, the year of smoking was negatively correlated with BMD values at at all sites but supine lateral lumbar spine and positively with the sOC values. Daily smoking amount was negatively correlated with BMD values at anteroposterior （AP） lumbar spine and Ward＇s region while positively with the sOC values （all P 〈0.05）. [Conclusion] Smoking raises bone turnover rate and accelerates bone lose. In order to prevent osteoporosis, smoking should be inhibited.

关 键 词：吸烟 骨密度 骨钙素 骨碱性磷酸酶 I型胶原氨基末端肽 

分 类 号：R113[医药卫生—公共卫生与预防医学]