江苏正常男性维生素D水平与骨微结构的相关性  

Relationship between serum vitamin D and micro-structure of bone in healthy men in Jiangsu province

作　　者：吕珊[1] 汤婷婷[1] 祁寒梅[1] 狄文娟[1] 程鹏[1] 俞静[1] 刘娟[1] 蔡金梅[1] 赖滨[1] 丁国宪[1] 姜敏[2] 

机构地区：[1]南京医科大学第一附属医院老年医学科,南京210029 [2]南京鼓楼医院南京大学医学院附属鼓楼医院老年医学科,南京210008

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2016年第3期283-288,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

摘　　要：目的探讨江苏正常男性人群血清维生素D水平与骨密度、骨微结构的相关性。方法收集自2013年至2015年在南京医科大学第一附属医院老年医学科住院体检的234例男性患者资料,患者平均年龄为58岁。对其进行双能X线吸收仪(dual energy X-ray absorptiometry,DXA)扫描,采用TBS Insight软件进行骨小梁分数(trabecular bone score,TBS)计算,测定血清25-羟维生素D(25-hydroxy vitamin D,25OHD)、空腹血糖、三酰甘油、胆固醇、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)等临床指标。结果 234例男性受试者血清25OHD的平均水平是(46.19±19.41)nmol/L,25OHD与腰椎骨密度(bone mineral density,BMD)无明显相关性(r=0.060,P=0.390),而与骨微结构(trabecular bone score,TBS)呈正相关(r=0.140,P=0.030)。将研究对象按年龄分成2组:≤55岁组(n=108),>55岁组(n=126),对比≤55岁组,>55岁组TBS数值随年龄降低(P<0.05),而BMD、25OHD随年龄无明显变化;同时发现,年龄与TBS呈负相关(r=-0.230,P=0.001),但与BMD无相关性(r=-0.080,P=0.260)。多元回归分析在校正了年龄、腰围、臀围、血糖、HDL-C这些影响骨代谢的因素之后,25OHD(nmo/L)与TBS依然存在相关性(β=0.001,P=0.010)。结论血清25OHD水平在江苏正常男性人群可能与骨微结构相关,TBS较BMD更为灵敏。Objective To investigate the serum vitamin D level in healthy men in Jiangsu province and the relationship between serum vitamin D and trabecular bone score（ TBS）. Methods A total of 234 men,aged from 32 to 89 years,were recruited. Bone mineral density（ BMD）,trabecular bone score（ TBS） were measured by dual-energy X-ray absorptiometry. Serum 25-hydroxy vitamin D（ 25OHD） and multiple clinical variables such as glucose,Hb A1c（ %）,triglyceride（ TG）,cholesterol（ TC）,high-density lipoprotein cholesterol（ HDL-C）,low-density lipoprotein cholesterol（ LDL-C） were measured. Results The average level of 25 OHD was（ 46. 19 ± 19. 41） nmol / L. In the Pearson correlation analysis,serum 25 OHD exhibited positive association with lumbar spine TBS（ r = 0. 140,P = 0. 030）,but not with BMD（ r = 0. 060,P = 0. 390）. The study was divided into two groups according to age： ≤55 years（ n = 108） and 〉55 years（ n = 126）. The TBS in the 〉55 years group was significantly lower than ≤55 years group,while BMD and25 OHD level had no significant change with age. Correlation analysis also showed that age was negatively correlated with TBS（ r =- 0. 230,P = 0. 001）. However,the correlation disappeared between age with BMD（ r =- 0. 080,P =0. 260）. Multiple linear regression model analysis showed that TBS was inversely associated with 25OHD（ β = 0. 001,P = 0. 010） with adjusted covariables. Conclusion Serum 25 OHD levels is more correlated with bone microarchitecture than BMD in healthy men in Jiangsu province.

关 键 词：骨微结构 骨密度 维生素D 江苏正常男性 

分 类 号：R681[医药卫生—骨科学]