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| 载脂蛋白B和绝经后骨质疏松性骨折的相关性分析 |
| Correlation analysis of apolipoprotein B and postmenopausal osteoporotic fractures |
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| DOI：10.3969/j.issn.1006-7108.2024.09.011 |
| 中文关键词: 骨质疏松性骨折 绝经后 血脂谱 载脂蛋白B |
| 英文关键词:osteoporotic fracture postmenopausal lipid profile apolipoprotein B |
| 基金项目:基金项目：江苏省卫生健康委员会老年健康科研项目（LD2022008；LR2022012） |
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| 中文摘要: |
| 目的 探究载脂蛋白B（Apo-B）和绝经后骨质疏松性骨折的相关性。方法 选取2020年11月至2022年7月于常州市第一人民医院就诊的204例绝经后骨质疏松症患者。依据是否发生过脆性骨折将研究对象分为骨折组（n=91）和非骨折组（n=113），其中椎体骨折66例、髋部骨折6例、肋骨及四肢骨折19例。对比两组一般资料、血脂、骨密度T值、甲状旁腺素（PTH）、维生素D、血钙水平及是否患有高血压或糖尿病等差异。采用二元及多元Logistic回归分析载脂蛋白B与骨折风险的相关性。结果 绝经后骨质疏松症患者中，骨折患病率为44.61 %。骨折组的年龄和确诊骨质疏松症年龄均高于非骨折组，而总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B、腰椎、股骨颈和全髋T值水平均低于非骨折组，差异有统计学意义（P＜0.05）。二元Logistic回归分析发现，当调整了年龄(仅限全年龄段组)、血压、腰椎和全髋T值后，载脂蛋白B在全年龄段组和≤65岁组对骨折具有保护作用（OR=0.239, 95% CI：0.079~0.724, P=0.011；OR=0.181, 95% CI：0.032~1.020, P=0.048）。多元Logistic回归分析发现，与无骨折组相比，在椎体骨折组中，当调整了年龄、血压、腰椎和全髋T值后，总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B可能是椎体骨折的保护因素（OR=0.609, 95% CI：0.418~0.888, P=0.010；OR=0.539, 95% CI：0.338~0.860, P=0.010；OR=0.106, 95% CI：0.028~0.408, P=0.001），但在髋部、肋骨及四肢骨折病例中，血脂水平与骨折之间未见明显关联（P＞0.05）；在血脂正常范围内载脂蛋白B对椎体骨折可能具有保护作用（OR=0.048, 95% CI：0.008~0.306, P=0.001），当高脂血症时载脂蛋白B的保护作用消失（P＞0.05）。结论 载脂蛋白B可能是绝经后女性椎体骨质疏松性骨折的保护因素。 |
| 英文摘要: |
| Objective To investigate the correlation between apolipoprotein B (Apo-B) and postmenopausal osteoporotic fractures. Methods A total of 204 patients with postmenopausal osteoporosis who were admitted to Changzhou First People's Hospital from November 2020 to July 2022 were enrolled. According to whether fragility fractures had occurred，the subjects were divided into fracture group (n=91) and non-fracture group (n=113)， including 66 cases in the vertebral fracture group，6 cases in the hip fracture group，and 19 cases in the rib and limb fracture group. The two groups were compared in terms of general data，blood lipid level，bone mineral density T value， parathyroid hormone (PTH)， vitamin D， blood calcium， and whether they had hypertension or diabetes. Binary and multivariate logistic regression were used to analyze the association between apolipoprotein B and fracture risk. Results The prevalence of fractures in postmenopausal patients with osteoporosis was 44.61%. The chronological age and the age of osteoporosis diagnosis of the fracture group were higher than those in the non-fracture group，while the levels of total cholesterol，low-density lipoprotein cholesterol，apolipoprotein B，T values of lumbar spine，femoral neck and total hip were significantly lower than those in the non-fracture group (P<0.05). Binary logistic regression analysis showed that apolipoprotein B had a protective effect on fractures in the whole age group and the ≤65 years old group after adjusting for age (whole age group only)，blood pressure， T values of lumbar spine and total hip (OR=0.239，95% CI：0.079-0.724，P=0.011；OR=0.181，95% CI：0.032-1.020， P=0.048). Multivariate Logistic regression analysis showed that total cholesterol，low-density lipoprotein cholesterol and apolipoprotein B were the protective factors for vertebral fractures in the vertebral fracture group after adjusting for age，blood pressure，T values of lumbar spine and total hip compared with the non-fracture group (OR=0.609，95% CI：0.418-0.888，P=0.010；OR=0.539，95% CI：0.338-0.860，P=0.010；OR=0.106，95% CI：0.028-0.408，P=0.001)，but there was no significant association between lipid level and fracture in the hip，rib and limb fracture group (P>0.05)；apolipoprotein B may have a protective effect on vertebral fractures in the normal range of blood lipids (OR=0.048，95% CI：0.008-0.306，P=0.001)，but the protective effect disappears in hyperlipidemia (P>0.05). Conclusion Apolipoprotein B may be a protective factor for vertebral osteoporotic fractures in postmenopausal women. |
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