他汀类药物对中老年人群骨小梁微结构的影响

摘要： 目的 采用骨小梁分数 （TBS） 这种新型的骨微结构评价指标， 探讨他汀类药物对骨小梁微结构的影响。方法 回顾南京医科大学第一附属医院老年医学科 2014 年 1 月—2016 年 3 月收治的中老年患者 253 例， 根据是否服用他汀类药物分为他汀组 （服用他汀类药物 1 年以上） 90 例和对照组 （从未服用过他汀类药物） 163 例。观察 2 组血清三酰甘油、 总胆固醇、 高密度脂蛋白胆固醇、 低密度脂蛋白胆固醇、 碱性磷酸酶、 空腹血糖等生化指标及 25 羟维生素 D 水平。双能 X 线骨密度仪 （DXA） 检测腰椎及股骨颈骨密度， TBS iNsight ®软件分析腰椎 DXA 图像得出 TBS 值。结果 他汀组的总胆固醇及低密度脂蛋白胆固醇水平低于对照组 （P＜0.01）， 而 2 组其他生化指标差异均无统计学意义 （P＞0.05）。他汀组较对照组具有更高的腰椎 BMD （g/cm2 ： 1.04±0.19 vs. 0.96±0.14， P＜0.01） 及 TBS （1.31± 0.09 vs. 1.26±0.09， P＜0.01）， 但 2 组股骨颈 BMD 差异无统计学意义 （P＞0.05）。结论 他汀类药物使用可以提高中老年人群腰椎骨密度， 并改善骨小梁微结构。

Effects of statin on trabecular bone microstructure in middle and aged people

Abstract：Objective To investigate the effect of statin on trabecular bone microstructure by using trabecular bone score (TBS), a new type of bone microstructure evaluation index. Methods A total of 253 middle and aged patients hospitalized in the First Affiliated Hospital of Nanjing Medical University between January 2014 and March 2016 were retrospectively analyzed. According to whether statin was used or not, patients were divided into two groups: 90 patients in the statin use group (statin was use for more than 1 year) and 163 in the control group (not taken any statin). Serum biochemical indicators, such as triacylglycerol, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, alkaline phosphatase, fasting blood glucose and 25 hydroxy vitamin D, were compared between the two groups. Dual energy X-ray absorptiometry (DXA) was used to measure the bone mineral density (BMD) of lumbar spine and femoral neck. TBS was calculated with TBS iNsight ® software, and the DXA image of lumbar spine were analyzed. Results Values of total cholesterol and low density lipoprotein cholesterol were significantly lower in statin group compared with those of control group (P＜0.001), while no significant differences in other biochemical indicators between two groups (P＞0.05). There was higher lumbar spine BMD statin group compared to that of control group (g/cm2 :1.04±0.19 vs. 0.96±0.14, P＜ 0.01). There was higher lumbar spine BMD and higher TBS (1.31±0.09 vs. 1.26±0.09, P＜0.01) in statin group than that of control group. There was no difference in the femoral neck BMD between the two groups (P＞0.05). Conclusion Statin increases lumbar spine BMD and improves trabecular bone microstructure in middle and aged people.