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| 200例正常老年人性别及相关因素对腰椎骨密度的影响 |
| Effects of gender and related factors on lumbar spine bone mineral density in 200 cases of healthy elderly people |
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| DOI：10.3969/j.issn.1006-7108.2017.05.012 |
| 中文关键词: 骨密度；性别；生长激素；类胰岛素样生长因子-1 雌二醇；睾酮 |
| 英文关键词:Bone mineral density (BMD) Gender Growth hormone (GH) Insulin-like growth factor -1 (IGF-1) Estradiol(E2) Testosterone (T) |
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| 中文摘要: |
| 目的 探讨200例不同性别正常老年人群腰椎骨密度（BMD)与性别因素及相关因素的相关性。方法 双能X线吸收 法（DXA)BMD检测仪检测200例60岁及以上年龄的佳木斯地区常住人口中正常老年人群腰椎L2-4骨密度，记录性别、年 龄、体重、身高、BMI。化学发光酶免疫法检测血清生长激素（GH)、类胰岛素样生长因子-l(IGF-l)、雌二醇（E2)、睾酮（T)。 将所有人分为女性组和男性组，每组按5岁一个年龄段进行分组,分为5组,60岁?，65岁~,70岁~,75岁?，≥80岁。分别 进行各变量与腰椎BMD及各变量之间的统计学分析。结果 女性组中IGF-1、E2、GH、T与腰椎L2-4 BMD有明显正相关，相 关性IGF-1 >E2>GH>T;男性组中IGF-1、GH、E2、T与腰椎L2-4BMD有明显正相关，相关性IGF-1 > GH > E2 > T;女性组、男 性组年龄与腰椎L2-4BMD均有明显负相关。所有组中性别因素与腰椎L2-4BMD有明显相关。女性组控制年龄、身高、体重、 BMI后，IGF-1与腰椎L2-4BMD有明显正相关。男性组控制年龄、身高、体重、BMI后，IGF-1与腰椎L2-4BMD有明显正相关； E2与腰椎L2-4BMD有明显正相关，相关性IGF-1 >E2。所有组控制年龄、身高、体重、BMI后，性别因素与腰椎L2-4BMD有明 显相关。控制其他所有变量两变量偏相关及多元线性逐步回归结果，显示IGF-1与L2-4骨密度有明显正相关，性别与IGF-1 有明显负相关,年龄与IGF-1有明显负相关,E2与IGF-1有明显正相关。所有明显相关性,P值均小于0.05。女性组和男性组 身高、GH、IGF-1、E2、T随年龄增长均逐渐下降。结论 性别因素对老年人群L2-4骨密度有影响，而性别因素的差异主要表现 在女性组与男性组之间IGF-1有明显差异，IGF-1与L2-4BMD明显正相关。IGF-1随年龄的下降是老年性骨质疏松症发生的 重要原因，而雌激素能减慢IGF-1下降。老年男女性别差异对L2-4骨密度的影响与两者IGF-1之间的差异有关。 |
| 英文摘要: |
| Objective To investigate the correlation of lumbar spine bone mineral density (BMD) with gender and related factors in 200 cases of healthy elderly people. Methods Dual energy X-ray absorption (DXA) lumbar spine BMD (L2-4) was measured in 200 cases of healthy older residents aged 60 and over in the Jiamusi area. Data on gender, age, weight, height and BMI were collected. Serum growth hormone (GH)，insulin-like growth factor -1 (IGF-1)，estradiol (E2) and testosterone (T) were assess using chemiluminescence enzyme immunoassay (CLEIA). All participants were divided into two groups according to gender, and each gender were grouped into 5 groups according age (60-65, 65-70, 70-75, 75-80，and ≥ 80 years). Statistical analyses were performed on the association of each variable with lumbar spine BMD as well as between each variable. Results In women IGF- 1, E2，GH and T had significant positive correlation with L2-4 BMD, with the correlation coefficients IGF-1 > E2 > GH > T. In men IGF-1, GH, E2 and T had significant positive correlation with L2-4 BMD, with the correlation coefficients IGF-1 > GH > E2 > T. In both genders, age had significant negative correlation with L2-4 BMD. In all age groups, gender had significant correlation with L2-4 BMD. In females, after controlling for age, height, weight and BMI, IGF-1 significantly positively correlated with L2-4 BMD. In males, controlling for age, height, weight and BMI, IGF-1 and E2 had significant positive correlation with L2-4 BMD, with the correlation coefficient IGF-1 > E2. After controlling for age, height, weight and BMI, in the whole sample there was a significant correlation between gender and L2-4 BMD. Controlling for other variables, partial correlation and multiple linear stepwise regression results showed that there was significant positive correlation between IGF-1 and L2-4 BMD, significant negative correlation of gender and age with IGF-1, and significant positive correlation between E2 and IGF-1 ( all P < 0. 05 ). In both genders, height, GH, IGF-1, E2 and T decreased with age. Conclusion Gender influenced BMD of L2-4 in the elderly, and the gender difference was mainly due to the difference in IGF-I between males and females； IGF-1 had positive correlation with L2-4 BMD. Decrease in IGF-1 with age is an important reason for the occurrence of osteoporosis in the elderly, while estrogen can slow down the decline of IGF-1. The effect of gender difference on L2-4 BMD in the elderly was related to the difference in IGF-1 between the two. |
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