中国骨质疏松杂志

残余胆固醇与老年女性骨质疏松骨折及骨代谢相关性研究

Correlation between residual cholesterol and osteoporosis fractures and bone metabolism in elderly women

DOI：10.3969/j.issn.1006-7108.2024.11.003

英文关键词:bone remodeling balance remnant cholesterol elderly women osteoporosis fracture

基金项目:成都市医学科研课题（2022447）

作者	单位
徐文1 邹明2* 池继敏2	1.成都体育学院附属体育医院, 四川成都 610041 2.四川省骨科医院, 四川成都 610041

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中文摘要:

目的探讨残余胆固醇与老年女性骨质疏松性骨折（osteoporosis fracture，OPF）风险及骨代谢平衡相关性。方法选取2021年1月至2023年12月于成都体育学院附属体育医院就诊的60岁以上女性住院患者共2 447例，分为无骨折组（A组，1 170例）和骨折组（B组，1277例）。检测总胆固醇（Tch）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDLc）、低密度脂蛋白胆固醇（LDLc）、总Ⅰ型胶原氨基端延长肽（tPINP）、Ⅰ型胶原羧基端肽β特殊序列（β-CTX）、25-羟基维生素D[25-（OH）VitD]、总蛋白（TP）、白蛋白（Alb）、钙（Ca）、磷（P）、镁（Mg）、尿素（Urea）、肌酐（Cr）、胱抑素C（Cys-C）、尿酸（UA）、肾小球滤过率（eGFR）、骨形成T值（FT）、骨吸收T值（RT）、骨转换率（TR）及骨重建平衡（BL）。结果（1）骨折组ALB、Ca、P、HDLc、25-OH-VitD、UA 、eGFR、BL含量较无骨折组降低，年龄、Glu、TG、Tch、β-CTX、RT、RC较无骨折组增加，差异有统计学意义(P<0.05)。TP、LDLc、Mg、tPINP、Urea、Cre、Cys-C、FT、TR无统计学意义（P>0.05）;（2）年龄、RC、BL、UA、ALB为老年女性骨质疏松性骨折的风险因素，OR分别为1.07（95% CI：1.05~1.08）、3.21（95% CI：2.43~4.25）、0.84（95% CI：0.80~0.89）、0.996（95% CI：0.995~0.997）、0.96（95% CI：0.94~0.98），P<0.05;（3）RC含量越高，OPF风险越高，最高层RC每增加一单位，OPF风险增加3.14倍，校正OR为3.14 (95% CI：2.38~4.14)。BL与OPF风险呈U型关系，P<0.01，BL截点为– 0.43与2.33；（4）RC与BL呈倒U型关系，P<0.01，RC的截点为1.07 mmol/L。结论 RC、BL是老年女性OPF的危险因素。BL与OPF风险呈U型相关，与RC呈倒U型相关。

英文摘要:

Objective To explore the correlation between remnant cholesterol (RC) and the risk of osteoporosis fracture (OPF) and bone metabolism balance in elderly women. Methods A total of 2 447 female inpatients aged 60 and above were selected from January 2021 to December 2023. There were 1 170 cases in the non-fracture group (Group A) and 1 277 cases in the fracture group (Group B). Total cholesterol (Tch), triglycerides (TG), high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), total procollagen typeⅠamino-terminal propeptide (tPINP), carboxy terminal peptide of type I collagen β Special sequence (β-CTX), 25 hydroxyvitamin D (25- OH VitD), total protein (TP), albumin (Alb), calcium (Ca), phosphorus (P), magnesium (Mg), Urea (Urea), creatinine (Cr), cystatin C (Cys-C), uric acid (UA), glomerular filtration rate (eGFR), bone formation T score (FT) , bone resorption T score (RT), bone turnover rate (TR), and bone remodeling balance (BL) were detected. Results (1) ALB , Ca , P, HDLc , 25-OH VitD , UA , eGFR and BL in fracture group decreased compared to the non-fracture group. Age , Glu , TG, Tch, β-CTX , RT and RC increased compared to the non-fracture group, with a statistically significant difference (P<0.05). TP , LDLc , Mg , tPINP , Urea , Cre , Cys-C , FT and TR showed no statistical significance (P>0.05);⑵Age, RC, BL, UA, and ALB are risk factors for osteoporotic fractures in elderly women, with OR values of 1.07 (95% CI: 1.05-1.08), 3.21 (95% CI: 2.43-4.25), 0.84 (95% CI: 0.80-0.89), 0.996 (95% CI: 0.995-0.997), 0.96 (95% CI: 0.94-0.98), P<0.05; (3) The higher the RC content, the higher the risk of OPF in elderly women. For every unit increase in the highest RC, the risk of OPF increased by 3.14 times, with a adjusted OR of 3.14 (95% CI: 2.38-4.14). There is a U-shaped relationship between BL and OPF risk (P<0.019), with BL cutoff points of – 0.43 and 2.33; (4) RC and BL had an inverted U-shaped relationship (P<0.01), and the cutoff point of RC was 1.07 mmol/L. Conclusion RC and BL are risk factors for OPF in elderly women. BL is associated with an U-shaped risk of OPF and an inverted U-shaped risk of RC.

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