日常膳食锌摄入水平与指骨骨质疏松症患病的横断面关系  

Cross-sectional association between dietary zinc intake and phalangeal osteoporosis

作　　者：熊云川[1] 王伊伦 吴静 何虹毅 王宁[1] 雷光华[1] XIONG Yunchuan;WANG Yilun;WU Jing;HE Hongyi;WANG Ning;LEI Guanghua(Department of Orthopedics,Xiangya Hospital,Central South University,Changsha 410008;Department of Epidemiology and HealthStatistics,Xiangya School of Public Health,Central South University,Changsha 410078,China)

机构地区：[1]中南大学湘雅医院骨科,长沙410008 [2]中南大学湘雅公共卫生学院流行病与卫生统计学系,长沙410078

出　　处：《中南大学学报（医学版）》2019年第7期784-789,共6页Journal of Central South University ：Medical Science

基　　金：中南大学研究生自主探索创新项目(2018zzts045,2018zzts909,2018zzts256)~~

摘　　要：目的:明确日常膳食锌摄入水平与指骨骨质疏松症患病之间的相关性。方法:研究对象为2013年10月至2015年12月在中南大学湘雅医院健康管理中心行健康体检的年龄40岁及以上的体检者。使用半定量膳食频率问卷评估研究对象日常膳食锌摄入水平,根据骨密度检测结果并参考WHO诊断标准诊断研究对象指骨骨质疏松症患病情况。根据四分位数分布,日常膳食锌摄入水平分为:Q1≤15.40 mg/d,Q2 15.41~18.67 mg/d,Q3 18.68~22.76 mg/d,Q4≥22.77 mg/d。使用多因素logistic回归分析方法明确日常膳食锌摄入水平与指骨骨质疏松症的横断面关系,使用限制性立方样条图分析两者的剂量反应关系。结果:共计纳入6 267名研究对象,其中602人(9.6%)为指骨骨质疏松症患者。经多因素校正后的模型显示:在总人群中,与最低分类组相比,日常膳食锌摄入二、三、四分类组指骨骨质疏松症患病的OR值更低(模型2的趋势性P=0.045,模型3的趋势性P=0.031);在男性亚组人群中,与最低分类组相比,日常膳食锌摄入三、四分类组指骨骨质疏松症患病的OR值更低(均趋势性P=0.018);在女性亚组人群中,与最低分类组相比,日常膳食锌摄入二、三、四分类组指骨骨质疏松症患病的OR值更低(模型2的趋势性P=0.227,模型3的趋势性P=0.217)。限制性立方样条图结果显示:日常膳食锌摄入水平与指骨骨质疏松症患病之间存在剂量反应关系(P<0.001)。结论:日常膳食锌摄入水平与指骨骨质疏松症患病呈负相关,该相关性仅在总人群和男性亚组人群中成立,在女性亚组人群中不成立。Objective:To examine the association between dietary zinc intake and phalangeal osteoporosis.Methods:The subjects of this study were members aged over 40 years or above of the general population who had undergone routine health examinations at Xiangya Hospital,Central South University in Changsha,Hunan,China,between October 2013 and December 2015.Dietary zinc intake was measured using the semi-quantitative food frequency questionnaire.Phalangeal osteoporosis was diagnosed according to the WHO criteria based on the assessment of bone mineral density.According to the quartile distribution,serum zinc concentrations were classified into categories:Q1≤15.40 mg/d,Q2 15.41–18.67 mg/d,Q3 18.68–22.76 mg/d,and Q4≥22.77 mg/d.The association between dietary zinc intake with phalangeal osteoporosis was evaluated by conducting multivariable adjusted logistic regression.The dose-response relationship between them was assessed by restricted cubic spline regression.Results:A total of 6 267 subjects were included,602(9.6%)among them were suffered from phalangeal osteoporosis.The multivariable-adjusted models(i.e.Model 2 and 3)showed that,compared with the lowest quartile,the odds ratios(ORs)for phalangeal osteoporosis were lower in the second,third and fourth quartiles of dietary zinc intake(Model 2:P for trend=0.045;Model 3:P for trend=0.031)in the total population;the ORs for phalangeal osteoporosis were lower in the third and fourth quartiles of dietary zinc intake(Model 2 and 3:P for trend=0.018)in the male population;and the ORs for phalangeal osteoporosis were lower in the second,third and fourth dietary zinc intake quartiles(Model 2:P for trend=0.227;Model 3:P for trend=0.217)in the female population.There also existed dose-response relationship between dietary zinc intake and the prevalence of phalangeal osteoporosis(P<0.001).Conclusion:Dietary zinc intake is negatively associated with phalangeal osteoporosis in the total population and male subgroup,but not female subgroup.

关 键 词：锌 骨密度 横断面研究 指骨 骨质疏松症 

分 类 号：R58[医药卫生—内分泌]