绝经后活动性类风湿性关节炎患者低骨密度的相关危险因素分析
Analysis of risk factors associated with low bone mineral density in postmenopausal women with active rheumatoid arthritis
  
DOI:10.3969/j.issn.1006-7108.2019.06.015
中文关键词:  骨密度  骨桥蛋白  抵抗素  体质量指数  类风湿性关节炎
英文关键词:bone mineral density  osteopontin  resistin  body mass index  rheumatoid arthritis
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作者单位
方梓青* 舒高 广州中医药大学第三临床医学院,广东 广州 510006 
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中文摘要:
      目的 分析绝经后活动性类风湿性关节炎(rheumatoid arthritis,RA)患者出现低骨密度相关的危险因素。方法 研究对象为106例患有活动性RA的绝经后妇女,患者按体质量指数(BMI)分组:I组消瘦(18.5~24.9 kg/m2,n=36),II组超重(25.0~29.9 kg/m2,n=35),III组肥胖(>30.0 kg/m2,n=35)。检测这些患者的股骨BMD和血清BTM水平:骨钙素(OC)和I型胶原交联C-端肽片段(CTX)和骨桥蛋白(OPN)、抵抗素、高敏C反应蛋白、白细胞介素-6、肿瘤坏死因子(TNF)-a。结果 与较瘦的女性相比,肥胖女性的总股骨BMD和总T评分显然更高(P<0.05);发现BMD和CTX水平与体重存在显著相关性(P<0.05)。调整股骨颈BMD后,BMI与TNF-α水平呈负相关(P<0.05)。骨钙素水平与抵抗素呈负相关(P<0.05),CTX水平与OPN呈正相关(P<0.05);并发现BTM和BMD与其他炎症指标之间的关联。观察到OPN水平与体重、腰围和绝经后时间之间呈负相关性(P<0.05)。结论 本研究结果表明,体重和OPN、抵抗素和TNF-α在绝经后活动性RA患者的骨密度降低中起重要作用。
英文摘要:
      Objective To analyze the risk factors associated with low bone mineral density in postmenopausal patients with active rheumatoid arthritis (RA). Methods A total of 106 postmenopausal women with active RA were studied. Patients were grouped by body mass index (BMI): group I was lean (18.5-24.9 kg/m2,n=36), group II was overweight (25.0-29.9 kg/m2, n=35), group III was obese (>30.0 kg/m2, n=35). The femoral BMD and serum levels of BTMs: osteocalcin (OC), collagen type I cross-linked C-telopeptide fragments (CTX), osteopontin (OPN), resistin, high sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-a (TNF-a)were measured in these patients. Results Femoral BMD and total T-score were significantly higher in obese women than in lean subjects (P<0.05). BMD and CTX levels were significantly associated with body mass parameters (P<0.05, respectively). After adjusting femoral neck BMD, BMI was negatively associated with the TNF-a levels (P<0.05). Osteocalcin level was negatively correlated with resistin (P<0.05). CTX level was positively correlated with OPN (P<0.05). There were associations between BTM and BMD and other inflammatory indices. OPN was negatively correlated with body weight (P<0.05), waist circumference(P<0.05), and duration of postmenopausal period (P<0.05). Conclusion The present study suggests that body weight, OPN, resistin, and TNF-a play an important role in lowering BMD in postmenopausal women with active RA.
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