绝经后女性骨密度与脂代谢的相关性研究

摘要

Objective To investigate the correlation between bone mineral density( BMD)and lipid metabolism of postmenopausal women. Methods From March to August 2014 , we enrolled 167 healthy postmenopausal women who received physical examination in the First Affiliated Hospital of Anhui Medical University. According to BMD results by dual energy X-ray,the patients were divided into three groups:control group(n=30),bone mass decrease group(n=79),and osteoporosis group ( n = 58 ) . A series of indexes were detected, including FPG, TC, TG, HDL-C, LDL-C, VLDL-C, E2 , 25-( OH) D,ALP,Ca,P and adiponectin and resistin level. Results The three groups were not significantly different in FPG,TC,TG,VLDL-C,25-(OH)D,Ca,P and adiponectin and resistin level(P ﹥0. 05),but were significantly different in HDL-C,LDL-C,E2 and ALP(P﹤0. 05). L2 -4 BMD had positive linear correlation with BMI(B=0. 013,P=0.001),HDL-C(B =0.110,P =0.011),E2(B =0.001,P ﹤0.001),Ca(B =0.202,P =0.014)and P(B=0. 191,P=0. 040),but had negative linear correlation with menopausal years(B = -0. 004,P =0. 002),LDL-C(B= -0. 026,P=0. 041)and ALP(B= -0. 003,P﹤0. 001). Conclusion Female BMD after menopause is correlated with BMI,menopausal years, HDL-C, LDL-C, E2 , ALP, Ca and P. Timely adjustment of abnormal lipid metabolism, proper calcium supplement, hormone replacement therapy and maintaining appropriate body weight can avoid the occurrence of osteoporosis to some extent.%目的：探讨绝经后女性骨密度与脂代谢的相关性。方法选取2014年3—8月在安徽医科大学第一附属医院体检中心进行体检的健康绝经后女性167例。按双能X线骨密度结果分为正常组（ n＝30）、骨量减少组（ n＝79）、骨质疏松组（n＝58），检测空腹血糖（FPG）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（ HDL-C）、低密度脂蛋白胆固醇（ LDL-C ）、极低密度脂蛋白胆固醇（ VLDL-C ）、雌二醇（ E2）、25-羟维生素D〔25-（OH）D〕、碱性磷酸酶（ALP）、血清钙（Ca）、血清磷（P）及脂联素、抵抗素水平。结果3组 FPG、TC、TG、VLDL-C、25-（ OH） D、Ca、P 及脂联素、抵抗素间差异无统计学意义（ P ﹥0.05），而HDL-C、LDL-C、E2、ALP间差异有统计学意义（P ﹤0.05）。L2-4骨密度与 BMI（B ＝0.013，P ＝0.001）、HDL-C（B ＝0.110，P＝0.011）、E2（B＝0.001，P﹤0.001）、Ca（B＝0.202，P＝0.014）、P（B＝0.191，P ＝0.040）呈线性正相关，而与绝经年限（B＝-0.004，P＝0.002）、LDL-C（B＝-0.026，P＝0.041）、ALP（B＝-0.003，P﹤0.001）呈线性负相关。结论绝经后女性骨密度与BMI、绝经年限、HDL-C、LDL-C、E2、ALP、Ca、P有关。及时调整血脂代谢异常、适当补钙及采取激素替代治疗、维持合适的体质量均能在一定程度上避免骨质疏松症的发生。