摘要目的 研究甘油三酯(triglyceride,TG)、总胆固醇(totalcholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterin,LDL-C)及高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)与老年女性骨密度(bone densitometry,BMD)及骨质疏松(osteoporosis,OP)性骨折之间的关系。方法 回顾性分析2018年 9月至2020年3月门诊体检或住院的女性OP患者110例,年龄55~83岁,平均年龄(68.26±6.28)岁。按照是否发生骨质疏松性骨折分为骨折组52例,年龄56~83岁,平均年龄(69.04±6.30)岁;非骨折组58例,年龄55~80岁,平均年龄(67.57±6.24)岁。所有患者均进行BMD测定及空腹血脂测定,记录年龄、身体质量指数(body mass index,BMI)等一般资料。骨折组BMD与年龄、BMI、TG、TC、LDL-C及HDL-C的关系采用Pearson相关分析,相关系数r>0表示正相关,r<0表示负相关;以TC、TG、LDL-C、HDL-C为自变量,采用Logistic回归分析探寻老年女性OP性骨折的危险因素,均以P<0.05为差异有统计学意义。结果 老年OP性骨折女性年龄与L1~4、股骨颈、Ward三角区、大转子、转子间、总髋部BMD负相关(r<0,P<0.05);BMI与L1~4和髋部各部位BMD正相关(r>0,P<0.05);TC、TG与L1~4和髋部各部位BMD负相关(r<0,P<0.05);HDL-C与L1~4和髋部各部位BMD无相关性(r<0,P>0.05);LDL-C与Ward三角区、大转子、转子间、总髋部BMD负相关(r<0,P<0.05)。TC为老年女性OP性骨折的独立危险因素,HDL-C为老年女性OP性骨折的保护因素(P<0.05)。结论 血脂中TC、TG、LDL-C与老年OP性骨折女性不同部位BMD相关性不同,HDL-C与不同部位骨密度无相关性。TC为老年女性OP性骨折危险因素,HDL-C可能为老年女性OP性骨折保护性因素。
Abstract:Objective To investigate the relationship between triglyceride (TG),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) with bone density (BMD) and osteoporotic fractures in elderly women.Methods Retrospective analysis was performed on 110 female osteoporotic patients who underwent outpatient physical examination or were hospitalized from September 2018 to March 2020.The age range ranged from 55~83 years,with an average age of (68.26±6.28)years.According to whether or not osteoporotic fracture occurred,52 cases with an average age of(69.04±6.30)years old(range:56~83 year)were included in fracture group and 58 caseswith an average ago of (67.57±6.24)years old(range:55~80 year) were includedin non-fracture group.Bone mineral density (BMD) and fasting lipid profile were measured in all patients,and general information such as age and body mass index (BMI) were recorded.The relationship between BMD and age,BMI,TG,TC,LDL-C and HDL-C in fracture group was analyzed by Pearson correlation analysis.Correlation coefficient r greater than zero indicated positive correlation,and r less than zero indicated negative correlation.With TC,TG,LDL-C and HDL-C as independent variables,Logistic regression analysis was used to explore the risk factors of osteoporotic fractures in elderly women,P<0.05 was considered statistically significant.Results In elderly women with osteoporotic fractures,age was negatively correlated with BMD of L1~4,femoral neck,Ward triangle,greater trochanter,intertrochanteric,and total hip (r<0,P<0.05),BMI was positively correlated with BMD in L1~4 and hip regions(r>0,P<0.05),TC and TG were negatively correlated with BMD in L1~4 and hip regions (r<0,P<0.05),HDLC had no correlation with BMD in L1~4 and hip regions (r<0,P>0.05),LDL-C was negatively correlated with BMD of Ward triangle,greater trochanter,intertrochanteric and total hip (r<0,P<0.05).In elderly women,TC was an independent risk factor for osteoporotic fracture,and HDL-C was a protective factor for osteoporotic fracture (P<0.05).Conclusion In elderly women with osteoporotic fractures,the correlation of TC,TG and LDL-C in blood lipids with BMD at different sites was different,while HDL-C had no correlation with BMD at different sites.In elderly women,TC is a risk factor for osteoporotic fracture,and HDL-C may be a protective factor for osteoporotic fracture.
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