绝经后女性相关代谢指标与腰椎骨密度的关系探讨

目的探讨绝经后女性相关代谢指标与骨矿密度(BMD)及校正骨矿含量(c BMC)的关系。方法195例绝经后女性测量身高、体质量、腰围(W)、臀围(H)、收缩压(SBP)、舒张压(DBP),计算体质量指数(BMI);测定空腹血糖(FBG)、空腹胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、腰椎骨密度,计算HOMA-胰岛素抵抗指数(HOMA-IR)、校正骨矿含量,分析相关代谢指标与BMD、c BMC的相关性,并分析各因素对二者的影响。结果 1腰椎(L)1⁴BMD与年龄、绝经年限、TC、LDL呈负相关,与BMI、W、FINS、HOMA-IR、HDL呈正相关;L14BMD与年龄、绝经年限、TC、LDL呈负相关,与BMI、W、FINS、HOMA-IR、HDL呈正相关;L1⁴c BMC与年龄、绝经年限、TC、LDL、HOMA-IR呈负相关,与FINS、HDL呈正相关;2以L14c BMC与年龄、绝经年限、TC、LDL、HOMA-IR呈负相关,与FINS、HDL呈正相关;2以L1⁴BMD为应变量行多重线性回归,年龄、BMI、LDL、HDL、W对其有影响;以L14BMD为应变量行多重线性回归,年龄、BMI、LDL、HDL、W对其有影响;以L1⁴c BMC为应变量行多重线性回归,年龄、BMI、LDL、HDL、HOMA-IR对其有影响。结论 1BMI与BMD呈正相关,与c BMC呈负相关,故肥胖患者发生骨折的危险性增高;2血胰岛素水平与BMD呈正相关,胰岛素抵抗与c BMC呈负相关,故胰岛素抵抗患者发生骨折的危险性增高;3LDL与BMD、c BMC呈负相关、HDL与BMD、c BMC呈正相关,高LDL、低HDL增加骨质疏松及骨折的发生。

Relationship between major metabolic indexes and lumbar vertebrae bone mineral density in postmenopausal women

Objective To investigate the relationship among major metabolic indexes, bone mineral density （BMD） and correcting bone mineral content （cBMC） in postmenopausal women. Methods The height, weight, waist-line （W）, hipline （H）, systolic blood pressure （SBP）, diastolic blood pressure （DBP） of 195 postmenopausal women were measured and their body mass index （BMI） were calculated. The fasting blood glucose （FBG）, fasting insulin （FINS）, triglyceride （TG）, total cholesterol （TC）, high density lipoprotein （HDL）, low density lipoprotein （LDL）, and lumbar vertebrae bone mineral density of these patients were determined, and then, HOMA-insulin resistance index （HOMA-IR） and cBMC were calculated. The correlation among major metabolic indexes, BMD and cBMC were ana-lyzed, and the influences of these factors on BMD and cBMC were analyzed. Results ①L1-4 BMD were negatively correlated with age, menopausal years, TC and LDL, while positively correlated with BMI, W, FINS, HOMA-IR and HDL. ②In multiple linear regression models, the effect factors L 1-4 BMD as the dependent variable were age, BMI, LDL, HDL and W; the effect factors L1-4 cBMC as the dependent variable were age, BMI, LDL, HDL and HOMA-IR. Conclusion ①BMI was positively correlated with BMD and negatively correlated with cBMC. Hence, obese patients have increased risk for fractures. ②Serum insulin level was positively correlated with BMD, while insulin resistance was negatively correlated with cBMC. Therefore, patients with insulin resistance have higher risk for fractures. ③LDL was negatively correlated with BMD and cBMC. HDL was positively correlated with BMD and cBMC. High LDL and low HDL levels may increase the incidence of osteoporosis and fracture.