老年女性骨质疏松患者髋部骨折的危险因素及骨转换标志物、髋部骨密度与25-羟基维生素D和雌激素的相关性  

Risk factors of hip fracture and correlation analysis of bone turnover markers,hip bone mineral density and 25-hydroxyvitamin D and estrogen in aged female osteoporosis patients

作　　者：刘志鹏[1] 宋昊 徐又佳[1] 华俊[1] LIU Zhi-peng;SONG Hao;XU You-jia;HUA Jun(Department of Orthopaedics,Second Affiliated Hospital of Soochow University,Suzhou 215004,Jiangsu,China)

机构地区：[1]苏州大学附属第二医院骨科,江苏苏州215004

出　　处：《川北医学院学报》2023年第5期603-607,共5页Journal of North Sichuan Medical College

基　　金：国家重点研发计划资助项目(2021YFC2501700);老年医学临床技术应用研究项目(LR2021022)。

摘　　要：目的:分析老年女性骨质疏松患者髋部骨折的危险因素及骨转换标志物、髋部骨密度与25-羟基维生素D[25(OH)D]和雌激素的相关性。方法:选取156例老年女性骨质疏松患者作为研究对象,按照有无髋部骨折分为骨折组(n=61)与未骨折组(n=95)。Logistics回归分析探讨影响老年女性骨质疏松患者髋部骨折的危险因素,Pearson相关性分析探讨老年女性骨质疏松患者25(OH)D和雌激素与髋部骨密度、股骨颈骨密度(FN-BMD)、转子间骨密度(IT-BMD)、股骨干骨密度(FS-BMD)、骨转换标志物Ⅰ型原胶原氨基端肽(P1NP)及Ⅰ型胶原羧基端肽交联(β-CTX)的相关性。结果:骨折组BMI、高血压史、孕次、产次、绝经年龄、母乳喂养时间及β-CTX、P1NP水平均高于未骨折组,髋部骨密度、FN-BMD、IT-BMD、FS-BMD、25(OH)D和E2水平均低于未骨折组(P<0.05)。Logistics回归分析显示,髋部骨密度、FN-BMD、IT-BMD、FS-BMD、25(OH)D及E2水平降低是影响老年女性骨质疏松患者髋部骨折的危险因素(P<0.05),BMI、绝经年龄、P1NP和β-CTX水平降低是影响老年女性骨质疏松患者髋部骨折的保护性因素(P<0.05)。血清β-CTX、P1NP与25(OH)D和雌激素均呈负相关(P<0.05),髋部骨密度、FN-BMD、IT-BMD和FS-BMD与25(OH)D和雌激素均呈正相关(P<0.05)。结论:影响老年女性骨质疏松患者髋部骨折的危险因素较多,25(OH)D和雌激素与骨转换标志物呈负相关,与骨密度呈正相关,临床应加强对合并危险因素患者的防治工作,并重视25(OH)D和雌激素在骨质疏松性骨折中的作用。Objective:To analyze the risk factors of hip fracture and the correlation between bone turnover markers,hip bone mineral density and 25-hydroxyvitamin D[25(OH)D]and estrogen in aged female osteoporosis patients.Methods:A total of 156 osteoporosis patients were included.They were divided into fracture group(n=61)and non-fracture group(n=95)according to whether there was hip fracture or not.Clinical data were collected and the risk factors for hip fracture in elderly women with osteoporosis were explored by Logistics regression analysis.Pearson correlation analysis was wsed to explore the correlation between 25(OH)D and estrogen and hip bone mineral density,femoral neck bone mineral density(FN-BMD),intertrochanteric bone mineral density(IT-BMD),femoral shaft bone mineral density(FS-BMD),bone markers typeⅠprocollagen amino-terminal peptide(P1NP)and typeⅠcollagen carboxyl-terminal peptide crosslinking(β-CTX)in elderly female patients with osteoporosis.Results:BMI,history of hypertension,pregnancy frequency,childbirth frequency,menopausal age,breastfeeding time,and levels ofβ-CTX and P1NP of the fracture group were higher than those in the non-fracture group,while hip bone density,FN-BMD,IT-BMD,FS-BMD,25(OH)D,and E 2 levels were lower than those in the unfractured group(P<0.05).Logistics regression analysis showed that the hip bone density,FN-BMD,IT-BMD,FS-BMD,25(OH)D and E 2 levels were the risk factors for hip fracture in elderly women with osteoporosis,while BMI,menopausal age,P1NP andβ-CTX levels were the protective factors for hip fracture in elderly women with osteoporosis(P<0.05).Serum P1NP andβ-CTX had negative correlation with 25-(OH)D and estrogen(P<0.05),while hip bone mineral density,FN-BMD,IT-BMD and FS-BMD had positive correlation with 25-(OH)D and estrogen(P<0.05).Conclusion:There are many risk factors affecting hip fracture in elderly women with osteoporosis.25-(OH)D and estrogen have a negative correlation with bone markers and a positive correlation with bone mineral density.It is necessary t

关 键 词：骨质疏松 髋部骨折 骨密度 25-羟基维生素D 雌激素 骨转换标志物 

分 类 号：R687.3[医药卫生—骨科学]