中国骨质疏松杂志

从脂代谢指标探究骨质疏松症和骨质疏松性骨折的风险因素

Research on the risk factors of osteoporosis and osteoporotic fractures based on lipid metabolism indexes

DOI：10.3969/j.issn.1006-7108.2023.12.013

英文关键词:osteoporosis osteoporotic fracture lipid metabolism bone mineral density

基金项目:国家自然科学基金（82274542，82274615，82205137，82205230）；广东省教育厅创新团队项目（2021KCXTD017）；广东省自然科学基金（2022A1515012062）；中国医药教育协会项目（药教协项联字[2022]第067号）；广州市科技计划（202201011169，202201011761）；广州市青年科技人才托举项目（QT20220101302）；广东省基础与应用基础研究基金（2020A1515110322）

作者	单位
秦威城1，2 何博文1，2 尚奇1，2 周泽霖1，2 招文华1，2 李兵1，2 陈桂锋1，2 余富勇1，2 周本根2，3 沈耿杨2，3 江晓兵2，3* 任辉2，3*	1.广州中医药大学第一临床医学院，广东广州 510405 2.广州中医药大学岭南医学研究中心，广东广州 510405 3.广州中医药大学第一附属医院脊柱骨科，广东广州 510405

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中文摘要:

目的通过分析骨质疏松症（osteoporosis，OP）与骨质疏松性骨折（osteoporotic fracture，OPF）中骨密度（bone mineral density，BMD）与脂代谢指标的关系，探讨并对比影响OP与OPF发生的相关因素。方法回顾性收集475例患者的临床资料、BMD及脂代谢指标，根据BMD进行分组，比较临床资料并通过多元逐步回归分析相关的风险因素。结果体质量指数（body mass index，BMI）与BMD呈正相关（P＜0.05），高密度脂蛋白胆固醇（HDL-C）和载脂蛋白A1（ApoA1）与BMD呈负相关（P＜0.05）。通过多元逐步回归分析表明高BMI、HDL-C及载脂蛋白B（Apo-B）是OP和OPF发生的保护因素；Apo-A1是OPF发生的独立危险因素。基于OP和OPF相关的因素进行ROC曲线分析，得AUC面积分别为0.742、0.710。结论脂代谢指标（BMI、HDL-C、Apo-A1、Apo-B）与OP和OPF有一定的相关性，能为OP和OPF的预防及治疗提供一定的临床监测依据。

英文摘要:

Objective To analyze the relationship between bone mineral density (BMD) and lipid metabolism in osteoporosis (OP) and osteoporotic fractures (OPF), and to explore and compare the related factors affecting the occurrence of OP and OPF. Methods The clinical data, BMD, and lipid metabolism indexes of 475 patients were retrospectively collected and divided into groups according to BMD. The clinical data were compared and the related risk factors were analyzed with multiple stepwise regression. Results Body mass index (BMI) was positively correlated with BMD, while high density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (ApoA1) were negatively correlated with BMD. Multiple stepwise regression analysis showed that high BMI, HDL-C, and apolipoprotein B (Apo-B) were protective factors for OP and OPF. Apo-A1 was an independent risk factor for OPF. Based on the factors related to OP and OPF, the ROC curve analysis showed that the AUC area was 0.742 and 0.710, respectively. Conclusion There is a certain correlation between lipid metabolism indexes (BMI, HDL-C, Apo-A1, Apo-B) and OP and OPF. This may provide some clinical monitoring basis for the prevention and treatment of OP and OPF.

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