40岁以上人群骨密度与血清钙磷代谢、维生素D及骨代谢的相关性研究-东南大学学报医学版

40岁以上人群骨密度与血清钙磷代谢、维生素D及骨代谢的相关性研究

作者：杨梅¹ 2 沈红宇¹ 沈建新¹ 许锬² 薛爱龙¹ 沈红梅¹ 张荣艳¹ 姚小燕¹ 俞哲宇¹ 沈霞¹

单位：1. 吴江区疾病预防控制中心, 江苏苏州 215200;
2. 苏州大学医学部公共卫生学院/江苏省老年病预防与转化医学重点实验室, 江苏苏州 215123

分类号：R195;R336

出版年·卷·期（页码）：2021·40·第一期（22-26）

摘要：

目的：研究苏州市吴江区40岁以上人群骨密度（bone mineral density，BMD）与血清钙（Ca）磷（P）代谢、维生素D及骨代谢间相关性。方法：采用多阶段分层随机抽样方法，选取2018年3—7月吴江区社区40岁以上人群骨质疏松症调查数据。采取双能X线吸收法（DXA）骨密度仪进行腰椎正位（L_1-4和L_2-4）和股骨近端（股骨颈、大转子和全髋骨）BMD的测定。结果：本调查对象217例中男82例，女135例;平均年龄（57.03±10.43）岁。各部位BMD水平男女间差异均具有统计学意义（P<0.01）。单因素分析显示，性别、年龄、体质量指数（BMI）、P、碱性磷酸酶（ALP）、β-胶原降解产物（β-CTX）、总Ⅰ型胶原氨基端前肽（PINP）在各部位BMD差异均有统计学意义（P<0.01），25羟基维生素D[25（OH）D₃]仅在大转子BMD、全髋BMD差异有统计学意义（P<0.05）。在控制性别、年龄、BMI后，Ca、25（OH）D₃在各部位BMD差异均无统计学意义，而血清P与 L_1-4、L_2-4 BMD仅在0.05水平上相关，差异具有统计学意义。多元逐步回归分析结果显示，高龄、女性是BMD的危险因素，BMI与各部位BMD呈正相关（均β>0，P<0.05），P与股骨颈（β=-0.158）、大转子（β=-0.158）、全髋（β=-0.158）BMD呈负相关（P<0.05）。结论：吴江区40岁以上人群BMD与相关血生化、骨代谢指标具有显著相关性，血清P与股骨颈、大转子、全髋BMD呈负相关，PINP与各部位BMD值均呈负相关。

Objective: To study the correlation between bone mineral density (BMD) and serum calcium (Ca) phosphorus (P), vitamin D and bone metabolism index(BMI) in people over 40 years old in Wujiang District, Suzhou, Jiangsu. Methods: Multi-stage stratified random sampling method was used to select osteoporosis from March 2018 to July 2018 in Wujiang community. The BMD of lumbar spine (L_1-4 and L_2-4) and proximal femur (femoral neck, trochanter and total hip) were measured by dual energy X-ray absorptiometry (DXA). Results: The 217 subjects consisted of 82 males and 135 females, with an average age of (57.03 ±10.43) years. The difference of BMD level in different parts was statistically significant (P<0.01). Univariate analysis showed that sex, age, BMI, P, ALP, β-CTX, PINP were significantly correlated with BMD of all parts (P<0.01), 25 (OH) D₃ was only significantly correlated with BMD of trochanter and total hip (P<0.05). After controlling gender, age and BMI, there was no significant correlation between Ca, 25 (OH) D₃ and BMD of all parts, while serum P was only correlated with L1-4 and L2-4 at 0.05 level, the results showed statistically significant. The results of multiple stepwise regression analysis showed that being old and female were risk factors of BMD, BMI and BMD of all parts were positively correlated(all β>0,P<0.05). P was negatively correlated with BMD of femoral neck (β=-0.158), trochanter (β=-0.158) and total hip (β=-0.158), and all the results were statistically significant (P<0.05). Conclusion: The correlation among BMD, serology and bone metabolism indexes is statistically significant. Serum P was negatively correlated with BMD of Femoral neck, Trochanter and Total hip, and there was a negative correlation between PINP and BMD.

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