Hanley D A, Brown J P, Tenenhouse A, Olszynski W P, Ioannidis G, Berger C, Prior J C, Pickard L, Murray T M, Anastassiades T, Kirkland S, Joyce C, Joseph L, Papaioannou A, Jackson S A, Poliquin S, Adachi J D
Department of Medicine, University of Calgary. Calgary, Alberta, Canada.
J Bone Miner Res. 2003 Apr;18(4):784-90. doi: 10.1359/jbmr.2003.18.4.784.
This cross-sectional cohort study of 5566 women and 2187 men 50 years of age and older in the population-based Canadian Multicentre Osteoporosis Study was conducted to determine whether reported past diseases are associated with bone mineral density or prevalent vertebral deformities. We examined 12 self-reported disease conditions including diabetes mellitus (types 1 or 2), nephrolithiasis, hypertension, heart attack, rheumatoid arthritis, thyroid disease, breast cancer, inflammatory bowel disease, neuromuscular disease, Paget's disease, and chronic obstructive pulmonary disease. Multivariate linear and logistic regression analyses were performed to determine whether there were associations among these disease conditions and bone mineral density of the lumbar spine, femoral neck, and trochanter, as well as prevalent vertebral deformities. Bone mineral density measurements were higher in women and men with type 2 diabetes compared with those without after appropriate adjustments. The differences were most notable at the lumbar spine (+0.053 g/cm2), femoral neck (+0.028 g/cm2), and trochanter (+0.025 g/cm2) in women, and at the femoral neck (+0.025 g/cm2) in men. Hypertension was also associated with higher bone mineral density measurements for both women and men. The differences were most pronounced at the lumbar spine (+0.022 g/cm2) and femoral neck (+0.007 g/cm2) in women and at the lumbar spine (+0.028 g/cm2) in men. Although results were statistically inconclusive, men reporting versus not reporting past nephrolithiasis appeared to have clinically relevant lower bone mineral density values. Bone mineral density differences were -0.022, -0.015, and -0.016 g/cm2 at the lumbar spine, femoral neck, and trochanter, respectively. Disease conditions were not strongly associated with vertebral deformities. In summary, these cross-sectional population-based data show that type 2 diabetes and hypertension are associated with higher bone mineral density in women and men, and nephrolithiasis may be associated with lower bone mineral density in men. The importance of these associations for osteoporosis case finding and management require further and prospective studies.
在基于人群的加拿大多中心骨质疏松症研究中，对5566名50岁及以上女性和2187名50岁及以上男性进行了这项横断面队列研究，以确定报告的既往疾病是否与骨矿物质密度或椎体畸形患病率相关。我们检查了12种自我报告的疾病状况，包括糖尿病（1型或2型）、肾结石、高血压、心脏病发作、类风湿性关节炎、甲状腺疾病、乳腺癌、炎症性肠病、神经肌肉疾病、佩吉特病和慢性阻塞性肺疾病。进行多变量线性和逻辑回归分析，以确定这些疾病状况与腰椎、股骨颈和大转子的骨矿物质密度以及椎体畸形患病率之间是否存在关联。经过适当调整后，2型糖尿病女性和男性的骨矿物质密度测量值高于非2型糖尿病者。这些差异在女性的腰椎（+0.053g/cm²）、股骨颈（+0.028g/cm²）和大转子（+0.025g/cm²）最为显著，在男性的股骨颈（+0.025g/cm²）最为显著。高血压也与女性和男性较高的骨矿物质密度测量值相关。这些差异在女性的腰椎（+0.022g/cm²）和股骨颈（+0.007g/cm²）最为明显，在男性的腰椎（+0.028g/cm²）最为明显。尽管结果在统计学上尚无定论，但报告有既往肾结石与未报告有既往肾结石的男性似乎在临床上具有较低的骨矿物质密度值。腰椎、股骨颈和大转子的骨矿物质密度差异分别为-0.022、-0.015和-0.016g/cm²。疾病状况与椎体畸形的关联并不强烈。总之，这些基于人群的数据表明，2型糖尿病和高血压与女性和男性较高的骨矿物质密度相关，而肾结石可能与男性较低的骨矿物质密度相关。这些关联对骨质疏松症病例发现和管理的重要性需要进一步的前瞻性研究。
