中青年男性痛风患者血尿酸水平与骨密度及骨转换标志物的相关性分析  

Correlation analysis of serum uric acid level with bone mineral density and bone turnover markers in young and middle-aged male gout patients

作　　者：方天 张丽卿 谢戬芳[3] FANG Tian;ZHANG Liqing;XIE Jianfang(Fenyang College of Shanxi Medical University,Fenyang 032200,Shanxi,China;Department of Rheumatology and Immunology,Fenyang Hospital of Shanxi Province,Fenyang 032200,Shanxi,China;Department of Rheumatology and Immunology,the second Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi,China)

机构地区：[1]山西医科大学汾阳学院,山西汾阳032200 [2]山西省汾阳医院风湿免疫科,山西汾阳032200 [3]山西医科大学第二医院风湿免疫科,山西太原030001

出　　处：《贵州医科大学学报》2025年第1期147-152,共6页Journal of Guizhou Medical University

基　　金：山西省重点研发计划项目(201803D31127);山西省吕梁市重点研发项目(2022SHFZ19)。

摘　　要：目的 探讨中青年男性痛风患者血尿酸水平(serum uric acid,SUA)与骨密度(bone mineral density,BMD)及骨转换标志物(bone turnover markers,BTMs)的相关性。方法 选取2018年1月—2021年10月于山西省汾阳医院风湿免疫科就诊的110例中青年男性痛风患者,根据SUA水平分为低血尿酸水平S1组(≤420μmol/L)、中血尿酸水平S2组(420~600μmol/L)及高血尿酸水平S3组(≥600μmol/L),比较3组患者年龄、身高、体质量和就诊当日的血清肌酐(creatinine,Cr)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate transaminase,AST)、钙(calcium,Ca)、磷(phosphorus,P)、25-羟维生素D[25-hydroxyvitamin D,25(OH)D]、甲状旁腺激素(parathormone,PTH)、碱性磷酸酶(alkaline phosphatase,ALP)水平;比较3组患者入院时的血清β-胶原特殊系列(β-CTX)、总Ⅰ型胶原氨基端延长肽(PINP)、骨钙素(OC)及患者腰椎(L1-L4)、左股骨颈的BMD;采用Pearson相关性分析及多元线性回归分析患者SUA与BMD及BTMs的关系。结果 3组患者入院时的TG、PTH、25(OH)D、腰椎BMD、β-CTX比较,差异有统计学意义(P<0.05);Pearson相关性分析结果显示,在3组中SUA与左股骨颈BMD均呈负相关,但仅在S2组差异有统计学意义(r=-0.502,P<0.05),在S2、S3组中,SUA与腰椎BMD呈负相关,差异有统计学意义(r=-0.560、-0.491,P<0.05);在校正各种混杂因素[年龄、体质量指数(BMI)、TC、TG、Ca、P、PTH、25(OH)D、ALP]干扰后,SUA与腰椎、左股骨颈BMD及BTMs间均无显著相关性。结论 在中青年男性痛风患者中,在校正混杂因素后未发现SUA水平与BMD和BTMs间存在相关性。Objective To investigate the correlation of serum uric acid(SUA) with bone mineral density(BMD) and bone turnover markers in young and middle-aged male gout patients.Methods A total of 110 young and middle-aged male gout patients were selected from the department of rheumatology and immunology,Fenyang Hospital Affiliated to Shanxi Medical University from January 2018 to October 2021.According to SUA levels,the patients were divided into low SUA(S1 group,≤420 μ mol/L),medium SUA(S2 group,420-600 μ mol/L) and high SUA(S3 group,≥600 μ mol/L).Three groups were compared for age,body height,and body mass,the levels of serum creatinine(Cr),triglycerides(TG),total cholesterol(TC),alanine aminotransferase(ALT),aspartate aminotransferase(AST),calcium(Ca),phosphorus(P),25 hydroxyvitamin D [25(OH) D],parathyroid hormone(PTH),and alkaline phosphatase(ALP) on the day of visit.Three groups were compared for serum beta-crosslaps(β-CTx),aminoterminal propeptide of typeⅠ procollagen(PINP),osteocalcin(OC),and BMD of the patient's lumbar spine(L1–L4) and left femoral neck at admission.Pearson correlation and multiple linear regression were used to analyze the relationship of SUA with BMD and BTMs in the patients.Results There were statistically significant differences in TG,PTH,25(OH)D,lumbar spine BMD and β-CTX(P<0.05) among three groups.Pearson correlation analysis results showed that SUA was negatively correlated with left femoral neck BMD in all three groups,but Pearson correlation was statistically significant only in S2 group(r=-0.502,P<0.05).In S2 and S3 groups,SUA was statistically,significantly and negatively correlated with lumbar spine BMD(r=-0.560,-0.491;P<0.05).After adjusting for various confounding factors such as age,body mass index(BMI),TC,TG,Ca,P,PTH,25(OH) D,and ALP interference,there was no significant association of SUA with lumbar spine,left femoral neck BMD and BTMs.Conclusion There were no significant association of SUA level with BMD and BTMs after correction for various confounding factors.

关 键 词：痛风 血尿酸 骨密度 骨转换标记物 骨质疏松 

分 类 号：R589.7[医药卫生—内分泌]