绝经后女性血清鸢尾素、25羟维生素D水平与骨代谢、骨质疏松的相关性

目的观察绝经后女性血清鸢尾素(Irisin)、25羟维生素D25(OH)D]水平与骨代谢、骨密度(bone mineral density,BMD)、骨质疏松的相关性。方法选择2018年1月至2020年1月在河南科技大学第二附属医院健康中心体检的年龄>45岁的绝经后女性为研究对象,分为骨质疏松组(n=370)和非骨质疏松组(n=321),检测血生化、血清鸢尾素、25(OH)D、I型前胶原氨基端肽(procollagen typeⅠN-terminal propeptide,P1NP)和1型胶原羧基端肽β特殊序列(beta C-terminal cross-linked telopeptides of type icollagen,β-CTX)骨代谢指标,测量BMD,计算四肢骨骼肌指数(ASMI),并统计分析。结果绝经后女性骨质疏松组的鸢尾素(16.53±4.46)ng/mL VS(20.32±4.52)ng/mL,P<0.001]和25(OH)D(23.66±5.46)ng/mL VS(31.42±4.93)ng/mL,P<0.001]水平均低于非骨质疏松组。骨质疏松组的年龄、BMI、P1NP、β-CTX、三酰甘油、血糖、糖化血清蛋白均高于非骨质疏松组(P<0.05)。相关性分析结果:年龄(r=-0.205,P<0.001)、腰臀比(r=-0.280,P<0.001)、P1NP(r=-0.217,P<0.001)、β-CTX(r=-0.190,P<0.001)、三酰甘油(r=-0.084,P=0.026)、血糖(r=-0.197,P<0.001)、糖化血清蛋白水平(r=-0.128,P=0.001)与绝经后女性血清鸢尾素水平呈负相关。BMI(r=0.280,P<0.001)、ASMI(r=0.184,P<0.001)、BMD(r=0.497,P<0.001)与绝经后女性血清鸢尾素水平呈正相关。Logistic回归分析结果,P1NP(OR=0.838;95%CI:0.814,0.864)、β-CTX(OR=0.002;95%CI:0.001,0.108)、鸢尾素(OR=0.747;95%CI:0.706,0.791)和25(OH)D(OR=0.731;95%CI:0.698,0.765)为骨质疏松的保护因素。结论绝经后女性骨质疏松人群的血清鸢尾素、25(OH)D水平较低,鸢尾素与25(OH)D、ASMI、BMD呈正相关,鸢尾素、25(OH)D、P1NP、β-CTX为骨质疏松的保护因素。

The relationship between serum Irisin and 25 hydroxyvitamin D levels and bone metabolism and osteoporosis in postmenopausal women

Objective To observe the correlation between serum Irisin and 25 hydroxyvitamin D25(OH)D]levels and bone metabolism,bone mineral density(BMD)and osteoporosis in postmenopausal women.Methods Postmenopausal women>45 years old who underwent physical examination in the Health Center of the Second Affiliated Hospital of Henan University of Science and Technology from January 2018 to January 2020 were selected as the subjects.They were divided into osteoporosis group(n=370)and non-osteoporosis group(n=321).Blood biochemistry,serum Irisin,25(OH)D,procollagen typeⅠN-terminal propeptide(P1NP)and beta C-terminal cross-linked telopeptides of type icollagen(β-CTX)were detected.BMD was measured.Appendicular skeletal muscle mass index(ASMI)was calculated.All were statistically analyzed.Results Irisin in the postmenopausal women with osteoporosis group was lower than that in the non-osteoporotic group(16.53±4.46)ng/mL VS(20.32±4.52)ng/mL,P<0.001]and 25(OH)D(23.66±5.46)ng/mL VS(31.42±4.93)ng/mL,P<0.001].The age,BMI,P1NP,β-CTX,triglyceride,blood glucose and glycosylated serum protein in the osteoporosis group were higher than those in the non-osteoporosis group(P<0.05).Correlation analysis results:Age(r=-0.205,P<0.001),waist-hip ratio(r=-0.280,P<0.001),P1NP(r=-0.217,P<0.001),β-CTX(r=-0.190,P<0.001),triacylglycerol(r=-0.084,P=0.026),blood glucose(r=-0.197,P<0.001),glycosylated serum protein levels(r=-0.128,P=0.001)were negatively correlated with serum Irisin levels in postmenopausal women.BMI(r=0.280,P<0.001),ASMI(r=0.184,P<0.001),BMD(r=0.497,P<0.001)were positively correlated with serum Irisin level in postmenopausal women.Logistic regression analysis showed that P1NP(OR=0.838;95%CI:0.814,0.864),β-CTX(OR=0.002;95%CI:0.001,0.108),Irisin(OR=0.747;95%CI:0.706,0.791)and 25(OH)D(OR=0.731;95%CI:0.698,0.765)were protective factors for osteoporosis.Conclusion The levels of serum Irisin and 25(OH)D in postmenopausal women with osteoporosis were lower,and Irisin was positively correlated with 25(OH)D,ASMI and BMD.Irisin,25(OH)D,P1NP andβ-CTX were protective factors for osteoporosis.