体质量及骨代谢指标与绝经后女性骨质疏松的相关性  

Correlation among body weight,bone metabolic markers and osteoporosis of postmenopausal women

作　　者：徐新[1] 李姝婷 代芳[1] 何勇[1] 张楠[1] 杨洋[3] 赵广碧[4] 章秋[1] XU Xin;LI Shu-ting;DAI Fang;HE Yong;ZHANG Nan;YANG Yang;ZHAO Guang-bi;ZHANG Qiu(Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei 230001, China;Department of Endocrinology, Liu＇an People＇s Hospital, Liu＇an 237016, Anhui, China;Department of Bone Density, the First Affiliated Hospital of Anhui Medical Urdversity, Hefei 230001, China;Endocrine Laboratou, the First Affiliated Hospital of Anhui Medical University, Hefei 230001, China)

机构地区：[1]安徽医科大学第一附属医院内分泌科,合肥230001 [2]六安市人民医院内分泌科,安徽六安237016 [3]安徽医科大学第一附属医院骨密度室,合肥230001 [4]安徽医科大学第一附属医院内分泌实验室,合肥230001

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2018年第3期255-260,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

摘　　要：目的探讨绝经后女性体质量、体脂、骨代谢指标与骨质疏松的关系,分析亚洲人骨质疏松自我筛查工具(osteoporosis self-assessment tool for Asians,OSTA)识别骨质疏松症(osteoporosis,OP)的准确性。方法选取健康绝经后女性131例,根据体质量指数(body mass idex,BMI)及双能X线骨密度结果将受试者分为体质量正常组、超重肥胖组;骨质疏松组及非骨质疏松组。比较组间骨密度差异及体质量、体脂、骨代谢指标并进行相关性分析。分析OSTA指数识别OP的受试者工作特征(receiver operating characteristic,ROC)曲线。结果超重肥胖组股骨颈、股骨大转子及腰椎L2-4部位骨密度较正常组升高,超重肥胖组分别为(0.82±0.12)g/cm^3,(0.72±0.11)g/cm^3,(1.06±0.17)g/cm^3,正常组分别为(0.76±0.14)g/cm^3,(0.64±0.12)g/cm^3,(0.96±0.20)g/cm^3,差异有统计学意义(均P<0.05)。OP组体质量、BMI、体脂百分比、25羟维生素D3(25 hydroxy vitamin D_3,25OHD_3)、雌二醇(estradiol,E2)较正常组低,差异有统计学意义(均P<0.05)。OSTA指数、E2、体质量、体脂百分比、BMI与骨密度呈正相关性。OSTA指数识别OP的ROC曲线下面积为0.754。结论健康绝经后女性适量增加体质量和体脂有利于骨密度增加,骨代谢指标可指导骨质疏松的早期诊断,OSTA指数可用于中国绝经后女性OP筛检。Objective To explore the correlation among bone mineral density （BMD） and body weight, body fat, bone metabolic markers in postmenopausal women and the ability of osteoporosis self-assessment tool for Asian （OS-TA） index to diagnose osteoporosis. Methods Totally 131 healthy postmenopausal women were enrolled. According to body mass index （BMI）, we divided patients into two groups： normal body weight group and obese group, compare bone mineral density of each group. According to BMD, we divided them into normal bone mineral density group and osteopo-rotic group, compare the body weight, body fat, and biochemical index of each group. Analyze the ROC curve of OSTA. Results The BMD of lumbar 2-4, femoral neck and greater trochanter of obesity group are higher than which of the nor-mal weight group （P〈0. 05）, for obesity group respectively （0. 82±0. 12） g/cm3, （0. 72±0. 11） g/cm3, （1. 06± 0. 17） g/cm3, for normal body weight group respectively （0. 76±0. 14） g/cm3, （0. 64±0. 12） g/cm3, （0. 96±0. 20） g/cm3. The body weight, body fat, BMI, body fat percentage, estradiol （E2）, 25 hydroxyvitamin D3（25OHD3） of osteoporosis group were lower than those of normal BMD group （P〈0. 05）. There was a positive correlation between BMD and body weight, body fat percentage, OSTA score and E2 level. The area under receiver operator characteristic curve of OSTA diagnose osteoporosis was 0. 754. Conclusion The moderate increase of body weight and body fat are beneficial to the gain of BMD in healthy postmenopausal women. Markers of bone metabolism are helpful to indicate osteoporosis. OSTA index is helpful to screen osteoporosis of postmenopausal women.

关 键 词：骨质疏松症 骨密度 体质量 骨代谢指标 OSTA指数 

分 类 号：R681[医药卫生—骨科学]