绝经后女性非酒精性脂肪性肝病与骨密度的相关性研究

目的研究乌鲁木齐市绝经后女性非酒精性脂肪性肝病与骨密度的关系。方法根据非酒精性脂肪性肝病(NAFLD)诊断标准,将我院住院的66例绝经后中老年女性分为NAFLD组和正常对照组,NAFLD组34例,正常对照组32例。对所有研究对象的肝/脾CT比值、骨密度(BMD)、身高、体重和血液生化学指标进行数据收集及统计学处理。结果 (1)NAFLD组的体质指数(BMI)、谷酰转肽酶(GGT)、甘油三酯(TG)和空腹血糖(FBG)高于对照组,低密度脂蛋白(LDL)低于对照组(P0.05)。(2)NAFLD组的腰椎及髋部各部位BMD均低于对照组,但差异不具有统计学意义(P0.05)。(3)NAFLD组的肝/脾CT比值与大转子和全髋BMD呈正相关;谷丙转氨酶(ALT)、谷草转氨酶(AST)与股骨颈、Ward三角和全髋BMD呈正相关;FBG与股骨颈和Ward三角BMD呈正相关(P0.05)。对照组的LDL、脂蛋白a[LP(a)]与髋部BMD关系密切:LDL与股骨颈和Wards三角BMD呈正相关,LP(a)与髋部各部位BMD呈显著负相关(P0.05)。结论 (1)肝脂肪变可能会导致患NAFLD绝经后女性的髋部BMD减低,高血糖可能对患NAFLD的绝经后女性髋部BMD具有保护作用。(2)LP(a)可能是无NAFLD绝经后女性髋部发生BMD减低的危险因素。(3)NAFLD可能会使绝经后女性体内ALT、AST、LDL、LP(a)及血糖对髋部BMD的影响作用发生改变。

Correlation between non-alcoholic fatty liver disease and bone mineral density in postmenopausal women

Objective To investigate the relationship between non-alcoholic fatty liver disease (NAFLD) and bone mineral density (BMD) in postmenopausal women in Urumqi. Methods A total of 66 middle-aged and elderly postmenopausal women in the Sixth Affiliated Hospital of Xinjiang Medical University were selected. According to the diagnosis criteria of NAFLD, all the subjects were divided into the NAFLD group (34 cases) and the normal control group (32 cases). The data including the ratio of CT values of the liver and the spleen, BMD, the height, the weight, and the blood biochemical indexes of all the subjects were collected and statistically analyzed. Results The body mass index (BMI) and the concentrations of gamma-glutamyl transpeptidase (GGT), triglyceride (TG), and fasting blood glucose (FBG) in the NAFLD group were higher than those in the control group, while the concentration of low-density lipoprotein (LDL) was lower than that in the control group (P<0.05). BMD of the lumbar vertebrae and the hip in the NAFLD group was lower than that in the control group, but no statistical difference was observed (P>0.05). The ratio of CT values of the liver and the spleen was positively correlated with BMD of the greater trochanter and the total hip in the NAFLD group. The concentrations of ALT and AST were positively correlated with BMD of the femoral neck, the Ward''s triangle, and the total hip in the NAFLD group. The concentration of FBG in the NAFLD group was positively correlated with BMD of the femoral neck and the Ward''s triangle (P<0.05). The concentration of LDL in the control group was positively correlated with BMD of the femoral neck and the Ward''s triangle, while the concentration of lipoprotein (a) [LP(a)] was negatively correlated with BMD of each site of the hip (P<0.05). Conclusion Hepatic steatosis could lead to reduced BMD of the hip, while hyperglycemia may have protective effect on the hip BMD in postmenopausal women with NAFLD. LP(a) may be a risk factor for the hip BMD reduction in postmenopausal women without NAFLD. NAFLD may change the effect of ALT, AST, LDL, LP (a), and blood glucose on the hip BMD in postmenopausal women.