血脂及血清维生素D水平预测老年女性髋部骨质疏松骨折可行性分析

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Abstract Objective To study the correlation between hip osteoporosis fractures in elderly women and lipid and other nutrient metabolites，and to explore the feasibility of vitamin D，blood lipid，uric acid and other nutrient metabolites in predicting hip osteoporosis fractures in elderly women.Methods A retrospective study was conducted to collect 194 elderly women with osteoporosis and elderly women with osteoporosis fractures of the hip who visited the hospital between 2014 and 2015，which were divided into simple osteoporosis group (108 cases) and osteoporosis fractures of the hip group (86 cases).We compared two groups of patients in general，each part of the hip bone mineral density，blood total cholesterol(TC)，serum triglyceride(TG)，serum high density lipoprotein cholesterol(HDL-C)，serum low density lipoprotein cholesterol(LDL-C)，serum uric acid(UA)，25-OH-VitD(25OH-VD) and diabetes prevalence data.Univariate analysis and screening were conducted on the related factors of hip fracture in patients with osteoporosis，and Logistic multivariate regression analysis was performed to screen out the independent risk factors.Independent and joint prediction probability analysis was carried out for the screened risks，and ROC curves of independent and joint prediction were drawn.The area under the curve and pairwise area comparison were calculated using MedCalc 18.5 software.Results There were statistically significant differences in femoral neck BMD，intertrochanteric BMD，greater trochanter BMD，Vit D，TC，TG，LDL-C and UA (P＜0.05).The results of Logistics regression analysis showed that the decrease of Vit D was an independent risk factor for fracture，while the increase of TC was a protective factor for fracture，and the P values were <0.001 and 0.003，respectively.The ROC curve was plotted and the area under the curve was calculated.The AUC of Vit D，TG and joint prediction was 0.804，0.734 and 0.849.The cutoff point of Vit D was 23.955 ng/mL and the cutoff point of TG was 4.950 mmol/L.Comparison between groups showed that the AUC area of the combined prediction was greater than that of the single strand prediction of Vit D and TG (P＜0.05)，while there was no statistical difference between the single strand prediction of Vit D and TG (P＞0.05).Conclusion The feasibility of vitamin D and serum total cholesterol in the prediction of hip fracture in elderly women with osteoporosis is proved，but more prospective study is still needed.

Key words： osteoporotic fracture hip fracture uric acid lipids metabolism

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