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老年人血清骨保护素与骨密度的关系

     

摘要

Objective To determine the difference of serum level of osteoprotegerin ( OPG ) between Uyghur and Han elder people in Xinjiang, and to explore the correlation between serum OPG and bone mineral density-T ( BMD-T ) of the lumbar vertebrae and the left proximal femur.Methods Three hundred and twelve elder people ( over 60 years old) in the First Affiliated Hospital of Xinjiang Medical University from October 2011 to December 2013 were selected.BMD of the lumbar vertebrae and the left proximal femur was detected using dual energy X-ray absorptiometry ( DXA) .Serum level of OPG was detected using ELISA method.Results (1) The serum level of OPG in abnormal bone mass group 1.588 (1.559) was lower than that in the normal bone mass group 2.062 (1.606) (Z=1.531, P=0.018).(2) The serum level of OPG in Uyghur group 1.503 (1.033) was lower than that in the Han group 1.971 (1.805) (Z=1.834, P=0.002).When stratified by gender, the serum level of OPG in Uyghur males 1.474 (0.729) was lower than that in Han males 2.062 (1.712) (Z=2.215, P=0.000).There was no significant difference in women between the two people ( P >0.05 ) .By case control stratification, the serum level of OPG in Uyghur population 1.772 (1.044) of normal bone mass was lower than that in Han with normal bone mass 2.303 (2.031) (Z=1.404, P=0.039), while there was no significant difference in low bone mass group between the two ethnics (P>0.05).(3) Spearman partial correlation analysis showed that the serum level of OPG was negatively correlated with BMD-T of L2, L3, L4, L total, Neck, G.T, InterTro, and the hip location in female Han (r=-0.333-0.235, P=0.02-0.032).The serum level of OPG was positively correlated with BMD-T of G.T (r=0.174, P=0.026) in male Han.There was no correlation between OPG and BMD-T of any location in Uyghur people.After control of age and BMI, the serum level of OPG was still positively correlated with T value of L2, L3, L total, InterTro, and the hip in female Han.(4) Binary linear regression showed that serum OPG was a negative determinant of L1-T, L2-T, L3, L total-T, and Inter Tro-T, which could explain the 0.8%-10%variation of the T value.(5) Fitting curve showed that OPG and BMD-T of L1, L2, L3, L total, and InterTro was linearly fit in Han females.Best quadratic polynomial fit was found between serum level of OPG and T value of GT and Hip.There was no fit between serum level of OPG and L4-T and Neck T.Conclusion The serum level of OPG in Uyghur elderly is lower than that in Han population, and especially it is lower in Uygur men.The serum level of OPG could be an influence factor to the variation of BMD-T value in Han female elderly.%目的:明确血清骨保护素(osteoprotegerin,OPG)在维吾尔族、汉族老年人是否存在差异性,探讨其与腰椎、左股骨近端骨密度T值( BMD-T)的关系。方法选择2011年10月至2013年12月在新疆医科大学第一附属医院住院患者312例(年龄≥60岁),采用双能X线吸收法(DXA)测量腰椎(L)、左股骨近端BMD-T值,采用酶联免疫吸附法(ELISA)检测血OPG的浓度,进行统计学分析。结果(1)血OPG浓度在低骨量组1.588(1.559)较骨量正常组2.062(1.606)降低(Z=1.531,P=0.018)。(2)血OPG浓度在维吾尔族组1.503(1.033)较汉族组1.971(1.805)偏低(Z=1.834,P=0.002);按性别分层:维吾尔族男性血OPG浓度1.474(0.729)较汉族男性2.062(1.712)明显偏低(Z=2.215,P=0.000),而在女性间两民族血OPG浓度则无统计学差异;按病例-对照分层:维吾尔族骨量正常者血 OPG 浓度1.772(1.044)明显较汉族骨量正常者2.303(2.031)低(Z=1.404,P=0.039),而在低骨量者两民族血OPG浓度则无统计学差异。(3)Spearman相关性分析结果显示:汉族女性L2、L3、L4、L总(LZ)、股骨颈(Neck)、大粗隆(G.T)、粗隆间(InterTro)、髋关节(Hip)部位血OPG浓度与BMD-T值呈负相关(r=-0.333~-0.235,P=0.02~0.032),汉族男性G.T-T与血OPG浓度呈正相关(r=0.174,P=0.026),维吾尔族无论男性、女性血OPG浓度与各骨骼部位BMD-T值无明显相关性( P>0.05),经控制BMI、年龄后汉族女性血OPG浓度与L2、L3、L总、InterTro、Hip部位BMD-T值的相关性仍有统计学意义;(4)二元线性回归分析结果提示:汉族女性血OPG浓度对L1、L2、L3、L总、InterTro部位T值是负性决定因素,可以解释T值变异的0.8%~10%。(5)拟合曲线提示:汉族女性血OPG浓度与L1、L2、L3、L总、InterTro部位T值以线性拟合最优,与G.T、Hip部位T值以二次多项式拟合最优,与L4、Neck部位T值无最优拟合曲线。结论维吾尔族老年人血OPG浓度较汉族老年人偏低,尤其维吾尔族男性低于汉族男性;血OPG浓度变化可能是汉族老年女性骨密度T值变化的影响因素。

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