Jeong S-H, Choi S H, Kim J-Y, Koo J-W, Kim H J, Kim J S
Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Korea.
Neurology. 2009 Mar 24;72(12):1069-76. doi: 10.1212/01.wnl.0000345016.33983.e0.
Causes of benign positional vertigo (BPV) are mostly unknown. The aim of this study was to elucidate an association of osteoporosis with idiopathic BPV.
Two hundred nine consecutive patients with a confirmed diagnosis of idiopathic BPV underwent bone mineral densitometry of anterior-posterior lumbar spine and femur. The T scores were compared with those of 202 controls without a history of dizziness. Recurrence was defined when the patients reported two or more previous episodes of positional vertigo similar to those experienced at the time of diagnosis.
In both women and men, the lowest T scores were decreased in patients with BPV compared with those in controls. Furthermore, the prevalences of osteopenia (-2.5 < T score < -1.0) and osteoporosis (T score < or =-2.5) were higher in both women and men with BPV than in controls. Multiple logistic regression analyses adjusted for age, sex, alcohol, smoking, and hyperphosphatemia showed that only the existence of osteopenia/osteoporosis was associated with an increased risk of BPV (adjusted odds ratio of osteopenia = 2.0, 95% confidence interval 1.2-3.4, p = 0.011; adjusted odds ratio of osteoporosis = 3.1, 95% confidence interval 1.4-7.2, p = 0.007). In women aged > or =45 years, the lowest T scores were also decreased in the recurrent group, compared with those in the de novo group.
Osteopenia/osteoporosis may be associated with idiopathic benign positional vertigo (BPV). The effectiveness of measuring bone mineral densitometry and restoring normal calcium metabolism for preventing recurrences of BPV requires further validation.
良性阵发性位置性眩晕(BPV)的病因大多不明。本研究旨在阐明骨质疏松症与特发性BPV之间的关联。
对209例确诊为特发性BPV的连续患者进行腰椎前后位和股骨的骨密度测量。将T值与202例无头晕病史的对照组进行比较。当患者报告有两次或更多次先前的位置性眩晕发作,且与诊断时经历的发作相似时,定义为复发。
在女性和男性中,与对照组相比,BPV患者的最低T值均降低。此外,BPV的女性和男性中骨量减少(-2.5 < T值 < -1.0)和骨质疏松症(T值≤-2.5)的患病率均高于对照组。对年龄、性别、酒精、吸烟和高磷血症进行校正的多因素逻辑回归分析显示,只有骨量减少/骨质疏松症的存在与BPV风险增加相关(骨量减少的校正比值比 = 2.0,95%置信区间1.2 - 3.4,p = 0.011;骨质疏松症的校正比值比 = 3.1,95%置信区间1.4 - 7.2,p = 0.007)。在年龄≥45岁的女性中,复发组的最低T值也低于初发组。
骨量减少/骨质疏松症可能与特发性良性阵发性位置性眩晕(BPV)有关。测量骨密度和恢复正常钙代谢对预防BPV复发的有效性需要进一步验证。