绝经后女性血脂水平与骨密度的相关性研究

赵萍; 王涛; 侯传云; 孙超

doi:10.13898/j.cnki.issn.1000-2200.2022.09.013

摘要:

目的研究绝经后女性骨密度与血脂水平、体质量指数(BMI)及绝经年限的相关性。

方法选择141例绝经后女性作为研究对象，均在骨密度实验室检测骨密度(BMD)水平(主要检测部位为腰椎L_1~4、股骨颈和髋关节，部分病人加做前臂)，并根据检测结果(T值为标准)将研究对象分为3组，A组(骨质疏松者，T≤-2.5)、B组(骨量减少者，-2.5 < T < -1.0)和C组(正常骨量病人，T≥-1.0)。同时采集所有研究对象的空腹血，检测其总胆固醇(TC)、低密度脂蛋白(LDL)、三酰甘油(TG) 和高密度脂蛋白(HDL)水平。详细记录病人的身高、体质量、年龄、绝经年龄，计算BMI和绝经年限。

结果3组腰椎BMD(LBMD)、股骨颈BMD、全髋关节BMD比较，C组>B组>A组(P < 0.05)。3组HDL、TG、TC水平比较，差异均有统计学意义(P < 0.05~P < 0.01)，其中A组HDL水平高于C组(P < 0.05)；A组和B组TG水平均低于C组(P < 0.01)；C组TC水平低于A组(P < 0.05)。3组LDL水平差异无统计学意义(P < 0.05)。相关性分析显示，年龄和绝经年限与各部位BMD值呈负相关关系(P < 0.05~P < 0.01)；身高、体质量及BMI与各部位的BMD呈正相关关系(P < 0.05~P < 0.01)。TG水平与LBMD、股骨颈BMD、全髋关节BMD呈正相关关系(P < 0.01)；TC水平与LBMD呈负相关关系(P < 0.05~P < 0.01)。多因素logistic回归分析结果显示，高BMI、高TG者骨质疏松症(OP)发生风险较低，高龄、绝经年限长及高TC者OP发生风险较高。绘制ROC曲线分析TC预测绝经后女性发生OP的价值，计算出AUC为0.636(P < 0.05)。

结论绝经后女性不同血脂与不同部位BMD的相关性不同，TC升高与LBMD下降有关，低BMI、高龄、绝经年限长及高TC的绝经后女性更易发生骨质疏松。

Abstract:

ObjectiveTo study the correlation between bone mineral density (BMD) level and blood lipid level, body mass index (BMI), menopausal years in postmenopausal women.

MethodsA total of 141 postmenopausal women were selected as the research objects.All research objects were tested for BMD (including lumbar L_1-4, femoral neck and hip joint, some patients added forearm) in the BMD testing room.According to the results (T value as the standard), the research objects were divided into three groups: group A(osteoporosis, T ≤-2.5), group B(osteopenia, -2.5 < T < -1.0) and group C(normal bone mass, T ≥-1.0).Fasting blood from all subjects were collected to detect the levels of total cholesterol (TC), low density lipoprotein (LDL), triglycerides (TG) and high density lipoprotein (HDL).The height, weight, age, and menopause age of patients were recorded.The BMI and menopause years were calculated.

ResultsThe comparison results of LBMD, FBMD and TBMD in the three groups were group C>group B>group A (P < 0.05).There were significant differences in HDL, TG and TC levels among the three groups (P < 0.05 to P < 0.01), and the HDL level in group A was higher than that in group C (P < 0.05);TG levels in group A and group B were lower than those in group C (P < 0.01);TC level in group C was lower than that in group A(P < 0.05).There was no significant difference in LDL levels among the three groups(P>0.05).Correlation analysis showed that age and menopausal years were negatively correlated with BMD values in all parts (P < 0.05 to P < 0.01).Height, body weight and BMI were positively correlated with BMD in all parts (P < 0.05 to P < 0.01).TG level was positively correlated with LBMD, FBMD and TBMD (P < 0.01).TC level was negatively correlated with LBMD (P < 0.05 to P < 0.01).Multivariate logistic regression analysis showed that the risk of OP was lower in those with high BMI and TG, and higher in those with old age, long menopause and high TC.The ROC curve was drawn to analyze the value of TC in predicting OP in postmenopausal women, and the area under ROC curve was calculated to be 0.636 (P < 0.05).

ConclusionsThe correlation between different blood lipids and BMD in different parts of postmenopausal women is different.The increase of TC is related to the decrease of LBMD.Postmenopausal women with low BMI, old age, long menopause years and high TC are more prone to osteoporosis.

绝经后女性血脂水平与骨密度的相关性研究

orrelation between blood lipid level and bone mineral density in postmenopausal women