中国骨质疏松杂志

体检人群血脂水平及血脂异常分型与骨密度的相关性研究

Study on the correlation between blood lipid indices, abnormal blood lipid typing and bone mineral density in population on physical examination

DOI：10.3969/j.issn.1006-7108.2021.07.007

中文关键词: 骨密度骨质疏松血脂异常

英文关键词:bone mineral density osteoporosis dyslipidemia

基金项目:国家重点研发计划子课题（2017YFC0113901）；四川省干保委课题（川干研 2017-205）

作者	单位
谢雪张婷*	四川省医学科学院·四川省人民医院健康管理中心，四川成都 610072

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中文摘要:

目的探讨基于体检人群血脂各项指标及不同血脂异常分型与骨密度的关系。方法收集2018年1月至2019年6月在四川省人民医院健康管理中心进行健康体检，骨密度和血脂相关指标完整且年龄＞18周岁的体检者28174例，收集体检者的基本信息、各项血脂指标及平均骨密度与T值等资料，按照血脂异常分型进一步将患者分为高胆固醇血症组、高三酰甘油血症组、混合型高脂血症组和血脂正常组，比较各组间骨密度的差异，采用多元线性回归模型分析各血脂指标对骨密度的影响。结果 28174例体检者中，高胆固醇血症914例(3.2%)、高三酰甘油血症2266例(8.0%)、混合型高脂血症819例(2.9%)、血脂正常24175例(85.8%)；骨密度正常16594例(58.9%)、骨量减少或骨质流失8511例(30.2%)、骨质疏松3069例(10.9%)。不同血脂异常分型体检者的性别构成、平均年龄、BMI水平、TC、TG、LDL-C、HDL-C水平之间存在差异(P均＜0.05)。不同血脂异常分型体检者的骨量异常者构成、骨密度和T值的平均水平之间存在差异(P均＜0.05)，高胆固醇血症组和混合型高脂血症组的骨密度水平明显低于对照组及高三酰甘油血症组(P均＜0.05)，而骨量异常者的占比为高胆固醇血症组和混合型高脂血症组的构成比高于对照组及高三酰甘油血症组(P均＜0.05)。结论加强体检人群高胆固醇血症和混合型高脂血症的骨密度筛查，骨量异常患者应重视血脂水平的监测。

英文摘要:

Objective To explore the relationship between bone mineral density (BMD) and blood lipid indices and different types of dyslipidemia in a physical examination population. Methods A total of 28174 health examinee with complete bone mineral density and lipid-related indicator records and over 18 years of age in Health Management Center of Sichuan People's Hospital from January 2018 to June 2019 were collected. Data of the basic information, blood lipid indices, average bone mineral density and T value of the physical examinee were collected. The patients were further divided into hypercholesterolemia and hypertriglyceride group, hypercholesterolemia group, hypertriglyceride group, and normal blood lipid group according to the abnormal blood lipid classification. The differences of bone mineral density among the groups were compared. The effect of each blood lipid index on bone mineral density was analyzed with multiple linear regression model. Results Of the 28174 physical examination people, 914 (3.2%) had hypercholesterolemia, 2266 (8.0%) had hypertriglyceridemia, 819 (2.9%) had mixed hyperlipidemia, 24175 (85.8%) had normal blood lipid, 16594 (58.9%) had normal bone density, 8511 (30.2%) had osteopenia, and 3069 (10.9%) had osteoporosis. There were differences in gender composition, average age, BM level, TC, TG, LDL-C and HDL-C levels among different types of dyslipidemia (all P<0.05). There were differences in the composition, BMD and T value of the patients with abnormal bone mass among different types of dyslipidemia (all P<0.05). The BMD levels in the hypercholesterolemia group and the mixed hyperlipidemia group were significantly lower than those in the control group and the hypertriglyceridemia group (all P<0.05), while the proportion of the patients with abnormal bone mass was hypercholesterolemia. The composition ratio in group A and mixed hyperlipidemia group was higher than that in control group and hypertriglyceridemia group (P<0.05). Conclusion BMD screening for hypercholesterolemia and mixed hyperlipidemia in physical examination population should be strengthened. Patients with abnormal bone mass should pay attention to monitoring the blood lipid level.

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