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| 绝经后女性骨密度与维生素D和高密度脂蛋白水平相关性研究 |
| Relationship between bone mineral density and vitamin D and high density lipoprotein levels in postmenopausal women |
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| DOI：10.3969/j.issn.1006-7108.2019.02.012 |
| 中文关键词: 骨密度 骨骼状况 高密度脂蛋白 骨质疏松 绝经后妇女 维生素D |
| 英文关键词:bone mineral density bone status high-density lipoprotein osteoporosis postmenopausal women vitamin D |
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| 中文摘要: |
| 目的 探索绝经后妇女血清维生素D水平与高密度脂蛋白(high-density lipoprotein，HDL)和骨密度(bone mineral density，BMD)之间的关系。方法 2015年1月至2018年2月在我院病房及门诊就诊的244名绝经后妇女参加了这项横断面研究，她们都没有服用骨质疏松药物，也没有患任何慢性疾病。采用双能X射线吸收测定法用于评估髋部、股骨颈和腰椎(L1～4)的BMD。每个人根据世界卫生组织骨质疏松症标准在至少一个骨骼区域进行分类。在数据收集结束时，测量所有参与者的血脂谱和维生素D水平。维生素D血清水平低于30 ng/mL被定义为维生素D缺乏或不足。结果 27.9％的参与者表现出骨质疏松症。骨质疏松患者的HDL血清水平更高(P＜0.05)。参与者的低密度脂蛋白、总甘油三酯和总胆固醇水平差异无统计学意义(P＞0.05)。在未调整年龄、绝经年龄、肥胖和使用抗高血脂药物(他汀类药物)后，HDL水平与腰椎(1～4)、髋部和股骨颈的BMD值和T评分呈显著负相关(P＜0.05)。在根据维生素D水平对参与者进行分类以及调整混杂因素之后，仅在维生素D缺乏或不足的参与者中观察到HDL水平与三部位的BMD值以及T评分之间呈显著负相关(P＜0.05)。结论 在维生素D缺乏的绝经后妇女中，血清HDL水平与骨骼状态呈负相关。 |
| 英文摘要: |
| Objective The aim of this study was to investigate the association between high-density lipoprotein (HDL) and bone mineral density (BMD) taking into account serum vitamin D levels in postmenopausal women. Methods From January 2015 to February 2018, a total of 244 postmenopausal women participated in this study; all of them were not taking osteoporosis medication and were not suffering from any chronic disorder. Dual-energy X-ray absorptiometry was used to assess BMD of the total hip, femoral neck and lumbar vertebrae (L1-L4). Each person was categorized based on the World Health Organization osteoporosis criteria in at least one skeletal region. At the end of the data collection, lipid profiles and vitamin D levels were measured for all participants. Serum vitamin D levels less than 30 ng/mL were defined as vitamin D deficiency or insufficiency. Results 27.9% of all participants had osteoporosis. Osteoporotic participants tended to be older with higher HDL serum levels (P<0.05). No significant difference was seen in low-density lipoprotein, total triglyceride and total cholesterol levels among participants (P>0.05). In a univariate model, after adjusting for age, menopausal age, obesity, physical activity, and use of antihyperlipidemic drugs (statins), there were significant negative associations between HDL levels and BMD values and T-score in the three regions (P<0.05). Interestingly, after classification of participants based on vitamin D levels and adjustment for confounding factors, the significant negative associations between HDL levels and BMD values and T-score in the three regions were only observed in participants with vitamin D deficiency or insufficiency (P<0.05). Conclusion Our data show that in postmenopausal women with vitamin D deficiency, serum levels of HDL have negative correlation with bone mass. |
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