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老年女性左心室功能与骨密度的关联:一项基于人群的研究。

Association of left ventricular function with bone mineral density in older women: a population-based study.

作者信息

Laudisio Alice, Marzetti Emanuele, Antonica Livia, Cocchi Alberto, Bernabei Roberto, Zuccalà Giuseppe

机构信息

Department of Gerontology and Geriatrics, Catholic University of Medicine, L.go F. Vito, 1-00168, Rome, Italy.

出版信息

Calcif Tissue Int. 2008 Jan;82(1):27-33. doi: 10.1007/s00223-007-9094-1. Epub 2008 Jan 4.

Abstract

Due to the increasing mortality and disability rates associated with hip and vertebral fractures in older age, research is currently focusing on "new" determinants of osteoporosis in elderly subjects. Most recently, low bone mineral density (BMD) has been repeatedly reported in patients with end-stage heart failure. We assessed the association, if any, of BMD with left ventricular ejection fraction (LVEF) in a general older population. We assessed the association of LVEF with T score, Z score, and stiffness index in all 312 subjects aged 75 and over living in Tuscania, Italy. Among women, LVEF was associated with T score (beta = 0.02, 95% CI 0.01-0.05; P = 0.033), Z score (beta = 0.02, 95% CI 0.01-0.04; P = 0.038), and stiffness index (beta = 0.25, 95% CI 0.02-0.48; P = 0.036) in multivariable linear regression analysis, after adjusting for lifestyle habits, demographic variables, comorbid conditions, polypharmacy, and objective measurements. No significant associations were observed in men. In linear discriminant analysis, the LVEF cutoff level that best predicted osteoporosis was < or =49%. Left ventricular function is directly and independently associated with all of the ultrasonographic BMD parameters in older women. As left ventricular dysfunction, often asymptomatic, is a prevalent finding in older women, this association and its potential therapeutic implications should be assessed in dedicated studies.

摘要

由于老年髋部和椎体骨折相关的死亡率和残疾率不断上升,目前的研究聚焦于老年受试者骨质疏松症的“新”决定因素。最近,终末期心力衰竭患者中反复报告有低骨密度(BMD)情况。我们在普通老年人群中评估了BMD与左心室射血分数(LVEF)之间是否存在关联。我们评估了意大利图斯卡尼亚地区312名75岁及以上受试者的LVEF与T值、Z值及硬度指数之间的关联。在女性中,经过对生活习惯、人口统计学变量、合并症、多种药物治疗及客观测量指标进行校正后,多变量线性回归分析显示LVEF与T值(β = 0.02,95%可信区间0.01 - 0.05;P = 0.033)、Z值(β = 0.02,95%可信区间0.01 - 0.04;P = 0.038)及硬度指数(β = 0.25,95%可信区间0.02 - 0.48;P = 0.036)相关。在男性中未观察到显著关联。在线性判别分析中,最能预测骨质疏松症的LVEF临界值为≤49%。老年女性的左心室功能与所有超声骨密度参数直接且独立相关。由于左心室功能障碍在老年女性中普遍存在且常无症状,这种关联及其潜在的治疗意义应在专门研究中进行评估。

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