绝经前后妇女骨密度及骨代谢相关指标变化探析  

Changes and correlation of bone mineral density and bone metabolism in postmenopausal women

作　　者：吴蓓蕾 李伟 周海鸥 倪冰颖 黄秋菊 WU Beilei;LI Wei;ZHOU Haiou;NI Bingying;HUANG Qiuju(Department of Physical Examination Center,Wenzhou Central Hospital,Zhejiang Wenzhou 325003,China)

机构地区：[1]温州市中心医院体检中心,浙江温州325003

出　　处：《中国妇幼健康研究》2020年第3期387-390,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的探究绝经前后妇女骨密度与骨代谢相关指标变化及相关性。方法前瞻性选择2018年10月至2019年10月在我院体检的123例绝经妇女为绝经组,选取同期50例未绝经妇女为未绝经组。比较两组腰椎L1-4、股骨颈的骨密度(BMD),比较两组骨代谢指标,钙(Ca)、磷(P)、碱性磷酸酶(ALP)、骨钙素(OC)。根据骨密度T值将绝经组的123例妇女分为骨量正常组(n=51)和骨质疏松组(n=72),比较两组上述指标的水平,采用Pearson相关分析骨密度与骨代谢指标相关性。结果绝经组腰椎L1-4、股骨颈BMD值及血清Ca、P水平显著低于未绝经组(t值分别为20.248,17.961,6.465,6.749,均P<0.05);绝经组血清ALP、OC水平显著高于未绝经组(t值分别为60.778,14.409,均P<0.05)。骨质疏松组腰椎L1-4、股骨颈BMD值及血清Ca、P水平显著低于骨量正常组(t值分别为12.778,10.400,7.260,9.033,均P<0.05);骨质疏松组血清ALP、OC水平显著高于骨量正常组(t值分别为10.586,6.655,均P<0.05)。骨量正常组和骨质疏松组腰椎L1-4、股骨颈BMD均与血清Ca、P呈正相关(r值分别为,骨质正常组:0.223,0.289,0.206,0.310,骨质疏松组:0.371,0.286,0.289,0.280,均P<0.05);骨量正常组和骨质疏松组腰椎L1-4、股骨颈BMD均与血清ALP、OC呈负相关(r值分别为,骨质正常组:-0.347,-0.516,-0.441,-0.712,骨质疏松组:-0.458,-0.687,-0.325,-0.583,均P<0.05)。结论绝经后妇女的骨密度及骨代谢相关指标有显著变化,且其骨密度与骨代谢指标具有显著相关性,结合临床信息采用简便迅速的血清学指标对绝经后妇女骨密度进行动态监测,有助于及时了解绝经后妇女的骨代谢状态,提高诊疗效率,从而降低骨折发生的风险。Objective To investigate the changes and correlation of bone mineral density and bone metabolism in postmenopausal women.Methods 123postmenopausal women who underwent physical examination in our hospital from October 2018to October 2019were prospectively selected as the menopausal group,and 50non-menopausal women were selected as the non-menopausal group during the same period.The bone mineral density(BMD)of lumbar spine L1-4and femoral neck were compared between two groups.The bone metabolism indicators osteocalcin(OC),alkaline phosphatase(ALP),calcium(Ca),phosphorus(P)were compared between two groups.According to the t-value of bone mineral density,123women in the menopausal group were divided into the normal bone mass group(n=51)and the osteoporosis group(n=72).The above indexes were also compared between two subgroups.The correlation between bone mineral density and bone metabolism was analyzed by Pearson correlation.Results The BMD of lumbar spine L1-4and femoral neck,and serum Ca,P levels in the menopausal group were significantly lower than those in the premenopausal group(t values were 20.248,17.961,6.465,6.749,all P<0.05);Serum ALP and OC levels in the menopausal group were significantly higher than those in the non-menopausal group(t values were 60.778,14.409,both P<0.05).The BMD of lumbar spine L1-4and femoral neck,and serum Ca,P levels in the osteoporosis group were significantly lower than those in the normal bone mass group(t values were 12.778,10.400,7.260,9.033,all P<0.05);serum ALP,and osteocalcin levels in the osteoporosis group were significantly higher than those in the normal bone mass group(t values were 10.586,6.655,both P<0.05);The BMD of lumbar spine L1-4and femoral neck in the normal bone mass group and osteoporosis group were positively correlated with Ca and P(r values were 0.223,0.289,0.206,0.310in the normal bone mass group and 0.371,0.286,0.289,0.280in the osteoporosis group,respectively,all P<0.05),and were negatively correlated with ALP and osteocalcin(r values were-0.347,-0.516,-

关 键 词：绝经 骨质疏松 骨密度 骨代谢 表达水平 相关性 

分 类 号：R580[医药卫生—内分泌]