绝经后骨质疏松症与醛固酮/肾素比率相关性研究  

Correlation between postmenopausal osteoporosis and aldosterone/renin ratio

作　　者：闵竞[1] 黎洋[2] MIN Jing;LI Yang(Department of Trauma Orthopedics,Chongqing Medical University Hospital,Yongchuan 402160;Department of Kidney Rheumatology,Chongqing Medical University Hospital,Yongchuan 402160,China)

机构地区：[1]重庆医科大学附属永川医院创伤骨科,重庆永川402160 [2]重庆医科大学附属永川医院肾病风湿科,重庆永川402160

出　　处：《中国骨质疏松杂志》2019年第11期1566-1570,共5页Chinese Journal of Osteoporosis

摘　　要：目的观察绝经后骨质疏松症(postmenopausal osteoporosis,PMO)与血清醛固酮/肾素比率(aldosterone/renin ratio,ARR)的相关性。方法通过双能X射线吸收测定法对300名血压正常的绝经后妇女髋部和腰椎的骨密度(bone mineral density,BMD)进行测量。根据临床特征和BMD检测结果,170名和90名受试者分别被诊断为PMO和骨质减少,其余40名受试者被归类为正常BMD。检测血清醛固酮(plasma aldosterone concentration,PAC)、肾素(plasma renin concentration,PRC)、甲状旁腺激素(parathyroid hormone,PTH)、骨碱性磷酸酶(bone alkaline phosphatase,BALP)和25-羟基维生素D[25-(OH)D]水平。结果与具有正常BMD和骨质减少的女性相比,PMO受试者的PAC和ARR水平显著升高(P<0.05)。使用ARR≥37.0 pg/μU作为阳性筛查的截止值,与正常BMD组(25.9%对2.5%)和骨质减少组(25.9%对8.8%)相比,PMO组发现更高假阳性。PAC与腰椎BMD T评分,股骨颈BMD T评分和全髋BMD T评分呈负相关(P<0.05)。PTH与PAC和ARR呈正相关(P<0.05)。结论PMO患者的PAC和ARR升高,这可能会增加PA病例检测的假阳性风险。Objective To observe the relationship between postmenopausal osteoporosis(PMO)and serum aldosterone/renin ratio(ARR).Methods Bone mineral density(BMD)was measured by dual-energy X-ray-absorptiometry(DXA)in 300 normotensive postmenopausal women.Based on clinical characteristics and BMD,170 and 90 subjects were diagnosed PMO and osteopenia,respectively,and the remaining 40 subjects had normal BMD.Plasma aldosterone concentration(PAC),plasma renin concentration(PRC),parathyroid hormone(PTH),bone alkaline phosphatase(BALP)and 25-Hydroxyvitamin D(25-(OH)D)were determined.Results Subjects with PMO had significantly higher levels of PAC and ARR compared to women with normal BMD and osteopenia.Using ARR≥37.0 pg/μU as the cutoff for positive screening,more false-positive was found in the PMO group compared with the normal BMD group(25.9%vs 2.5%)and the osteopenia group(25.9%vs 8.8%).PAC was negatively associated with lumbar spine BMD T-score,femur neck BMD T-score and total hip BMD T-score(P<0.05).PTH was positively associated with PAC and ARR(P<0.05).Conclusion Patients with PMO have elevated PAC and ARR,which may increase the risk of false positives in PA case detection.

关 键 词：绝经后骨质疏松症 骨密度 醛固酮 肾素 甲状旁腺激素 

分 类 号：R589.5[医药卫生—内分泌]