绝经后老年女性脆性骨折与心血管疾病的相关性研究:成都社区7年随访  

A study of correlations between fragility fracture and cardiovascular diseases in elderly postmenopausal women:a seven-years follow-up in community in Chengdu

作　　者：曾理[1] 丁群芳[1] 罗方[1] 葛宁[1] 张新军[1] 李诗彤[1] 张俊[1] 李君[1] 曹立[1] 李峻[1] 万朝晖[1] 

机构地区：[1]四川大学华西医院老年病科,四川成都610041

出　　处：《现代预防医学》2012年第19期4992-4996,共5页Modern Preventive Medicine

摘　　要：目的骨质疏松相关脆性骨折与心脑血管疾病(CVD)是影响绝经后老年女性生活质量的重要疾病,二者之间的关联逐渐引起关注。本研究从一般危险因素、CVD患病情况及雌激素受体ESR1PvuII(rs2234693)基因多态性的角度,探讨影响社区绝经后老年女性脆性骨折的危险因素,以及CVD与脆性骨折之间的可能联系和机制。方法在2004～2011年期间,对成都两个社区的174名绝经后老年女性(入组平均年龄66.74±4.85岁)进行随访观察(平均7年)。入组时记录研究对象是否有既往脆性骨折史、慢性疾病史,是否长期吸烟、饮酒,及运动情况;测量身高、体重、腰围及血压;检测空腹血糖(FPG)、血脂、胰岛素水平;检测血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、以及ESR1PvuII(rs2234693)基因多态性。随访该人群7年中是否发生脆性骨折及部位。利用统计学软件SPSS17.0对结果进行分析。结果 7年间,有25人(15.9%)发生脆性骨折。既往脆性骨折史阳性者再发骨折风险比阴性者显著增加(OR值3.965;95%CI1.555～10.111;P=0.004);长期吸烟及饮酒者比不吸烟及饮酒者脆性骨折风险显著增加(OR值6.095;95%CI1.415～26.264;P=0.015);每天坚持运动者比不运动者脆性骨折风险显著降低(OR值0.379;95%CI0.144～0.997;P=0.049)。CVD患者的脆性骨折发生率略高于无CVD组(19.1%VS11.8%),二组间差异无统计学意义(P=0.774);ESR1PvuII基因多态性分析显示:CC基因携带组脆性骨折发生率(22.7%)较TC组(16.7%)、TT组(12.7%)略高,组间相比未达到统计学显著差异(P=0.266)。结论既往脆性骨折史、吸烟及饮酒是导致绝经后女性脆性骨折的重要危险因素;运动是防止脆性骨折的保护性因素;CVD有增加脆性骨折风险的趋势;ESR1PvuII基因多态性的CC基因型可能是脆性骨折发生的危险因素。OBJECTIVE To study the correlations between osteoporosis related fragility fracture and cardiovascular diseases（CVD） in a 7-years community based following-up,by analyzing relations among general risk factors,baseline cardiovascular states,and polymorphism of ESR1PvuII（rs2234693）,in elderly postmenopausal women.METHODS 174 community-dwelled PMWs（average aged 66.74 ± 4.85） were recruited in the year 2004 and followed up annually till 2011 in two communities in Chengdu.Details of past history of fragility fracture,habits of smoking,alcohol drinking,and exercising were carefully inquired.Anthropologic parameters,ig,body height,body weight,waist circumferences,BMI,and blood pressure were measured and recorded.Serum fasting glucose level,lipids profile,fasting insulin level,interlukin-6（IL-6）,and TNF-α were detected.Polymorphisms of ESR1PvuII（rs2234693） were analyzed by PCR-ELISA kits.Events of fragility fracture were recorded during follow-up.Results were analyzed by SPSS17.0 software.RESULTS Totally,25（15.9%） PMW experienced fragility fracture during the 7-year follow up.Individuals with positive past history of fragility fracture（OR 3.965;95%CI 1.55510.111;P = 0.004）,habits of smoking and alcohol-drinking（OR 6.095;95%CI 1.415-26.264;P = 0.015） were revealed tohave a significant higher prone of fragility fracture.Regular exercisers had a significant lower prevalence of fragility fracture than non-exercisers（OR 0.379;95%CI 0.1440.997;P = 0.049）.The prevalence of fragility fracture in CVD group was higher than non-CVD group（19.1% VS11.8%） without significant difference（P = 0.774）.Analysis of polymorphism of ESR1PvuII showed that prevalence of fragility fracture in CC genotype（22.7%） was comparatively higher than TC（16.7%） and TT genotype（12.7%）,no significant differences were revealed among three genotypes（P = 0.266）.CONCLUSION It has been revealed by our 7-year follow-up that past history of fragility fracture,habits of smoking and alcohol drinking are imp

关 键 词：绝经后女性 脆性骨折 前瞻性研究 心血管疾病 ESR1PvuII基因多态性 

分 类 号：R543[医药卫生—心血管疾病]