Objective To investigate the relationship among age,menopausal status,serum 25 (OH)VD and skeletal metabolism index as PTH (Parathyroid Hormone),CA(Calcium),P (Phosphorus) and boned mineral density (BMD) of climacteric female in Xi'an.Methods 352 cases of healthy women at the age of 40～60 were collected who did routine examination in outpatient building of the First Affiliated Hospital of Xi'an Jiaotong University from January 2016 to April 2016.According to the results of skeletal density test,all subjects were divided into 3 groups as the normal group (T＞-1),the reduction group (-2.5＜T＜-1),the osteoporosis group (T＜-2.5).Electrochemiluminescent immunoassay (ECLIA) was used to detect levels of serum 25 (OH)VD,PTH,CA and P.Kruskal-Wallis test and chi-square test were used to analyze differences of age,serum 25(OH)VD,PTH,CA and P in different levels of bone mineral density groups.Results Compared with bone density normal group 2.24(2.18～2.29)mmol/L,serum CA levels of bone mineral density reduction group 2.27 (2.20 ～ 2.32)mmol/L and osteoporosis group 2.27(2.23～2.33)mmol/L were significantly higher (Z=9.669,P＜0.01).Serum P levels of bone mineral density reduction group 1.15 (1.09～ 1.23)mmol/L and osteoporosis group 1.18 (1.09～ 1.25)mmol/L were obviously higher than bone density normal group,1.11 (0.99 ～ 1.23) mmol/L (Z =13.64,P＜ 0.01).Ages of osteoporosis group 54(50～57) years and bone mineral density reduction group 51 (47～ 54) years were significantly older than Bone density normal group 47(43～50) years (Z=73.08,P＜0.01).The rate of menopause in osteoporosis group and bone mineral density reduction group were significantly higher than in bone density normal group (x2 =13.81,P＜ 0.01).There was no statistical difference in serum 25(OH)VD and PTH between groups.Conclusion This study found boned density of climacteric women is more likely correlated with age,menopause status and levels of serum CA and P.There was not enough evidence to prove that 25 (OH)VD and PTH have effect on skeletal density.Therefore,to monitor and detect the menopause status and levels of serum CA and P of climacteric female is critical for the prevention and treatment on osteoporosis of women.%目的 探讨西安地区更年期女性的血清维生素D[25 (OH) VD]以及骨代谢常用指标甲状旁腺激素(parathyroid hormone,PTH)、血钙(calcium,CA)和血磷(phosphorus,P)与骨密度分级之间的关系.方法 于2016年1月～4月期间收集交通大学第一附属医院门诊常规体检年龄分布于40～60岁更年期健康女性352例,根据骨密度检测结果分为骨密度正常组(T＞-1)、骨密度减少组(-2.5＜T＜-1)和骨密度疏松组(T＜-2.5).采用电化学发光免疫分析法检测入组样本血清中25(OH)VD及PTH,CA和P的水平.采用Kruskal-Wallis检验和卡方检验分析不同骨密度水平组中年龄、血清25(OH)VD,PTH,CA和P的差异.结果 统计分析发现骨密度减少组[2.27(2.20～2.32)mmol/L]和骨密度疏松组[2.27(2.23～2.33)mmol/L]中受试者的血CA显著高于骨密度正常组[2.24(2.18～2.29)mmol/L,Z=9.669,P＜0.01];骨密度减少组[1.15(1.09～1.23)mmol/L]和骨密度疏松组[1.18(1.09～1.25)mmol/L]中受试者的血P浓度明显高于骨密度正常组[1.11(0.99～1.23)mmol/L),Z=13.64,P＜0.01];骨密度疏松组受试者的年龄54(50～57)岁,明显高于骨密度减少组51(47～54)岁和骨密度正常组[47(43～50)岁,Z=73.08,P＜0.01];骨密度疏松组和骨密度减少组的绝经率显著高于骨密度正常组,差异有统计学意义(x2=13.81,P＜0.01);组间25 (OH) VD的水平和PTH水平比较,差异无统计学意义.结论 更年期女性骨密度水平受年龄、绝经与否及血清CA和P水平等因素的影响较大,但没有足够的证据证明血25(OH)VD和PTH的水平影响骨密度水平,因此监测更年期女性的绝经情况、CA和P水平对女性骨质疏松发生的预防和治疗至关重要.
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