帕金森病患者髋部骨密度、25-羟维生素D3与髋部骨折的相关性分析

摘要

目的 探讨帕金森病(parkinson's disease,PD)患者髋部骨密度(bone mineral density,BMD)、25-羟维生素D3与髋部骨折的相关性.方法 以61例年龄在51 ～68岁的帕金森病患者为PD组,以64名年龄和性别匹配的健康人群作为对照组,采用双能X射线骨密度仪测定骨密度,采用电化学发光法检测25-羟维生素D3水平.对两组受试者跟踪随访3年,记录随访期间髋部骨折的发生情况并进行对比.结果 PD组髋部总骨密度、股骨颈骨密度、转子间骨密度、股骨干骨密度均低于对照组,差异具有统计学意义(t值分别为-3.747、-4.256、-4.706、-4.274,P均＜0.001).PD组25-羟维生素D3水平明显低于对照组,差异具有统计学意义(f=-4.500,P＜0.001).PD组中髋部总骨密度与25-羟维生素D3具有相关性(r=0.510,P=0.047).PD组髋部骨折发生率高于对照组,差异有统计学意义(x2=4.04,P=0.04).结论 PD患者髋部骨折发生率较同年龄、同性别健康人群高,髋部骨折发生与髋部骨密度和25-羟维生素D3水平有关.%Objective To investigate the correlation among hip bone mineral density (BMD),25-hydroxyl vitamin D3,and hip fracture in patients with Parkinson's disease (PD).Methods Sixty-one 51-68 years old patients with Parkinson's disease were in Parkinson group (PD group) and 64 sex and age-matched healthy people were in control group.BMD was assessed with dualenergy X-ray absorptiometry (DXA).25-Hydroxyl vitamin D3 levels were detected using electrochemical luminescence method.Incidence of hip fractures in the two groups during the 3-year follow-up period was studied and compared.Results The result indicated that PD patients had lower total hip BMD,femoral neck BMD,intertrochanteric BMD,and femoral shaft BMD than healthy controls,and the difference was statistically significant (t =-3.747,-4.256,-4.706,-4.274,respectively,P ＜0.001).PD patients had lower 25-hydroxyl vitamin D3 levels than controls (t =-4.500,P ＜ 0.001).25-hydroxyl vitamin D3 was significantly correlated with BMD of the hip in PD patients (r =0.510,P =0.047).The incidence of hip fracture in PD patients was higher than that in controls,and the difference was statistically significant (x2 =4.04,P =0.04).Conclusion PD patients have a higher risk of hip fracture than sex and age-matched controls.Hip BMD and 25-hydroxyl vitamin D3 are correlated with hip fracture.