合并不同疾病的男性骨量异常患者骨代谢、骨密度及骨折情况研究  

Study on bone metabolism,bone density and fracture of male patients with abnormal bone mass complicated with different diseases

作　　者：李丽 陈琳[1] 潘凌[1] 杨明 李思雨[1] 曾越茜 彭永德[1] 游利[1] LI Li;CHEN Lin;PAN Ling;YANG Ming;LI Siyu;ZENG Yueqian;PENG Yongde;YOU Li(Department of Endocrinology and Metabolism, The First People’s Hospital affiliated to Shanghai JiaoTong University, Shanghai 200080)

机构地区：[1]上海交通大学附属第一人民医院内分泌代谢科(骨质疏松亚专科),上海200080

出　　处：《中国骨质疏松杂志》2021年第2期238-243,共6页Chinese Journal of Osteoporosis

基　　金：国家自然科学基金面上项目(81570797)。

摘　　要：目的了解合并不同疾病的男性骨量异常患者骨代谢指标、骨密度(bone mineral density,BMD)及骨折的情况。方法对2006年1月至2017年12月在上海市第一人民医院内分泌科骨质疏松亚专科就诊的928例男性骨量异常患者进行回顾性研究。根据研究目的不同,将患者分为有或无糖尿病组、有或无慢性肝病组、有或无慢性肾病组、有或无慢性胃病组、有或无心血管疾病组及骨量减低组和骨质疏松组。分别观察各组各项指标的差异。结果单因素回归分析提示受试者年龄、体重、L1~4BMD、股骨颈BMD、全髋BMD、β-CTX、慢性胃病、骨质疏松症是骨折史的影响因素,差异具有统计学意义(P<0.05);骨折史与受试者年龄、β-CTX、慢性胃病、骨质疏松症因素成正相关,与体重、L1~4BMD、股骨颈BMD、全髋BMD成负相关;多因素回归分析提示年龄、BALP、2型糖尿病、骨质疏松是骨折的危险因素,而25OHD水平是骨折的保护性因素。结论对于男性骨量异常患者,需要重点关注年龄较大、β-CTX和BALP水平较高、合并慢性胃病以及2型糖尿病的患者,对这类患者应积极进行抗骨质疏松干预及治疗,以减少此类患者骨折的发生率。Objective To investigate the bone complicated index,bone density and fracture in male patients with abnormal bone mass with different diseases.Methods A retrospective study was conducted on 928 male patients with abnormal bone mass who were admitted to the department of endocrinology of the first people’s hospital of Shanghai from January 2006 to December 2017.According to different research purposes,the patients were divided into groups with or without diabetes,with or without chronic liver disease,with or without chronic kidney disease,with or without chronic stomach disease,with or without cardiovascular disease,and with or without bone mass loss and osteoporosis according to the study purpose.Observe the difference of various indicators in each group respectively.Results Univariate regression analysis suggested that the patients’age,weight,L1-4 BMD,femoral neck BMD,total hip BMD,β-CTX,chronic gastric disease and osteoporosis were the influencing factors of fracture history,the differences were statistically significant(P<0.05),and fracture history was positively correlated with patients’age,β-CTX,chronic gastric disease and osteoporosis.It was negatively correlated with body weight,L1-4 BMD,femoral neck BMD and total hip BMD.The multivariate regression analysis suggested that age,BALP,type 2 diabetes and osteoporosis were the risk factors for fractures,while the level of 25OHD was a protective factor for fractures.Conclusion Among the male patients with abnormal bone mass,it is necessary to focus on those older patients with higher levels ofβ-CTX and BALP,combined with chronic gastropathy and type 2 diabetes,and to carry out active anti-osteoporosis intervention and treatment to reduce the incidence of fractures in these patients.

关 键 词：男性 骨量异常 合并疾病 骨代谢指标 骨密度 骨折 

分 类 号：R681[医药卫生—骨科学]