长期酒精摄入对中老年男性骨密度与骨代谢及抗骨折能力的影响  

Effect of chronic alcohol drinking on bone mineral density, bone metabolism and bone strength in middle and elderly males

作　　者：杨晖[1] 厉娜[1] 王燕[1] 

机构地区：[1]山东省日照市人民医院骨外科,276800

出　　处：《中国医药》2010年第8期748-750,共3页China Medicine

摘　　要：目的探讨长期酒精摄入对中老年男性骨密度、骨代谢指标及抗骨折能力的影响。方法以在我院查体中心进行体检的982例45～79岁的中老年男性为调查对象，如有饮酒史则至少5年，按酒精摄入量分为4个等级：不饮酒，少量饮酒（〈50g／d），中等量饮酒（50g～100g／d），大量饮酒（〉100g／d）；按开始饮酒年龄分为〈20岁、20～30岁、〉30岁3个等级。采用统一的问卷进行调查，测定血钙磷及碱性磷酸酶（ALP），放射免疫法测定骨钙素（BGP），酶联免疫吸附法测定尿脱氧吡啶啉（DPD），采用双能x线吸收法测量腰椎和股骨颈骨密度。结果①与不饮酒组相比，饮酒者血ALP和骨钙素水平明显降低，且随日酒精摄入量的增加以及开始饮酒年龄的提前而降低更为明显（P〈0．05）。②受试者各组间腰椎骨密度无显著差别，〈50g／d组受试者的股骨颈、Ward’s三角区和大转子骨密度亦无显著改变（P〉0．05），但50～100g／d、〉100g／d组和〈20岁、20～30岁组受试者的股骨颈、Ward’s三角区和大转子骨密度显著降低（P〈0．01），且其抗骨折能力和下肢最大肌力亦显著降低（P〈0．01）。③982例受试者髋部骨密度测定共检出骨质疏松者为423例（47．5％），50～100g／d组和〉100g／d组骨质疏松患病率明显高于不饮酒组和〈50g／d组（P〈0．05）；〈20组骨质疏松患病率明显高于小饮酒组、〉30岁组和20～30岁组（P〈0．01）。结论长期大量饮酒可抑制中老年男性骨的转换，降低股骨颈骨密度，从而降低股骨颈的抗骨折能力。Objective To study the Effect of chronic alcohol drinking on bone mineral density, bone metabolic index and bone strength in middle and elderly males. Method Nine hundred eighty two normal men aged 45 -79 with drinking history more than 5 years,who came to the clinic to do health examination,were divided into four groups：no drinking, 〈 50 g/d,50 g - and 〉 100 g/d group According to the different alcohol consumption and three groups： 〈 20 岁,20 -30 岁, 〉 30 岁 ccording to the different beginning age of alcohol drinking. The investigates of alcohol drinking conducted by unified questionnaires, and the serum level of calcium, phosphorus and alkaline phos- phatase were measured by fully automatic biochemistry analyzer,osteocalcin measured by radio-immunoassay, deoxy- pyridinoline measured by ELISA. BMD at the lumbar spine and the hip measured by dual energy X-ray absorptiometry. Result There was no significant difference in the age, body height, Body weight,body mass index, the serum level of calcium, phosphorus and the ratio of uric deoxypyridinoline andcreatiniue （ P 〉 0.05 ）. Compared to no drinking group, the serum level of alkaline phosphatase and osteocalciu significantly lower in the drinking groups, and with the increase of alcohol consumption and the more advanced beginning age of alcohol drinking, this difference became significantly greater（ P 〈 0.05）. There was no significant difference in BMD at the lumbar spine of all groups, and between 〈 50 g/d group and no drinking group at the hip（ P 〉 0. 05）, but BMD were lower in 〈 50 g/ d, 〉 100 g/d group and 〈 20、20- 30 group than other groups（ P 〉 0. 01 ）. The FS and MS were also decreased in these groups （P 〉 0. 01 ）. Of 982 normal men ,there was 423 osteoporosis by measurement of the hip BMD including 63ease in no drinking group,97case in 〈50 g/d group, 168 ease in 50 - g/d group,95 case in 〉 100 g/d group and 79 case in 〈20 group,179 case in 20-30 group,102 case in 〉30 group. The prevalence rate

关 键 词：酒精 骨密度 中老年男性 骨代谢 抗骨折能力 

分 类 号：R681[医药卫生—骨科学]