老年超重或肥胖男性体检人群正常血尿酸水平对腰椎骨密度的影响  

Effect of normal serum uric acid level on lumbar bone mineral density in elderly overweight or obese men

作　　者：虎静[1] 樊雨曦 杜婧[1] HU Jing;FAN Yuxi;DU Jing(Department of Endocrinology,People’s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750001,China)

机构地区：[1]宁夏回族自治区人民医院内分泌科,宁夏银川750001

出　　处：《中国骨质疏松杂志》2024年第10期1438-1443,共6页Chinese Journal of Osteoporosis

基　　金：宁夏回族自治区科技惠民项目(2022CMG03034)。

摘　　要：目的探讨60岁以上男性超重或肥胖体检人群正常血清尿酸水平(serum uric acid,SUA)与腰椎骨密度(bone mineral density,BMD)的关系。方法选取470名于2022年1~12月在宁夏回族自治区人民医院体检的60岁及以上男性,利用双能X线骨密度仪对腰椎L1~4的BMD进行检测,依据T值将所有患者分为3组:骨量正常G1组、骨量减少G2组和骨质疏松G3组,所有纳入患者的SUA水平均在正常水平(180~428μmol/L)。先将各组进行指标差异对比,再依据体质量指数(body mass index,BMI)把所有研究对象分为超重组、肥胖组,观察BMI的变化对BMD值、T值、骨质疏松症患病率高低的影响;把BMD、T值分别与其他指标如SUA、BMI等进行Pearson相关性分析;把数据进行赋值定义,再分别做单因素Logistic回归分析、有序多分类Logistic回归分析。结果(1)G3组SUA水平均高于G1组和G2组,G3组年龄、BMI、糖尿病的患病率均高于G1组和G2组,而eGFR、BMD、T值则低于G1组和G2组,差异具有统计学意义(P<0.05)。(2)将血尿酸按三分位法分为低1/3组(S1组)、中1/3组(S2)、高1/3组(S3)组共3组,其中组间比较发现S3组的BMD值、T值、骨质疏松症患病率均高于S1、S2组,S2组骨质疏松症患病率高于S1组,差异均有统计学意义(P<0.05)。(3)相较于肥胖组,超重组的BMD值、T值更低,且骨质疏松症患病率更高。(4)Pearson相关分析显示,eGFR的变化与BMD、T值的变化趋势较为一致,相反,BMI、SUA、年龄的数值升高,伴随BMD及T值的降低(P<0.05)。(5)单因素Logistic回归分析结果提示,年龄增加、BMI增高、SUA升高、eGFR降低以及糖尿病病史会增加骨量异常的罹患风险(P<0.05);经有序多分类Logistic回归分析显示,年龄、BMI、SUA、患有糖尿病与骨量异常的风险呈正相关性(P<0.05)。结论在60岁以上的男性超重或肥胖体检人群中,SUA、BMI、糖尿病促进老年男性发生骨量异常。Objective To explore the relationship between normal serum uric acid(SUA)and lumbar bone mineral density(BMD)in overweight or obese men over 60 years old.Methods 470 males aged 60 and above who underwent physical examination in People's Hospital of Ningxia Hui Autonomous Region from January to December 2022 were selected.The BMD of lumbar vertebra L1-4 was detected by dual-energy X-ray bone densitometer.According to the T value,all patients were divided into three groups:G1group with normal bone mass,G2 group with osteopenia and G3group with osteoporosis.The SUA level of all patients was at normal level(180-428umool/L).Firstly,compared the index differences of each group,and then dividedall the subjects into overweight and obesity groups according to BMI,and the effects of BMI changes on BMD value,T value and osteoporosis prevalence rate were observed.Pearson correlation analysis was carried out between BMD and T values and other indicators such as SUA and BMI.Define the data by assignment,and then performed univariate logistic regression analysis and ordered multiclass logistic regression analysis separately.Results(1)The level of SUA in G3 was higher than that in G1 and G2.The age,BMI and diabetes prevalence in G3 were higher than those in G1 and G2,while the values of eGFR,BMD and T were lower than those in G1 and G2,with statistical significance(P<0.05).(2)Serum uric acid was divided into three groups according to the three-point method:low 1/3 group(S1 group),middle 1/3 group(S2)and high 1/3 group(S3 group),among which the BMD value,T value and osteoporosis prevalence rate in S3 group were higher than those in S1 and S2 groups,and the osteoporosis prevalence rate in S2 group was higher than that in S1 group,with statistical significance(P<0.05).(3)Compared with the obese group,the BMD and T values of the superrecombinant group were lower,and the prevalence of osteoporosis is higher.(4)Pearson correlation analysis showed that the change of eGFR was consistent with the change trend of BMD and T value.On the co

关 键 词：血清尿酸 超重 肥胖 老年男性 骨密度 骨质疏松 

分 类 号：R681[医药卫生—骨科学]