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肥胖对接受吸入皮质类固醇治疗的绝经后哮喘患者骨密度的影响。

Influence of obesity on bone mineral density in postmenopausal asthma patients undergoing treatment with inhaled corticosteroids.

机构信息

Department of Physical Therapy and Rehabilitation, Fatih University Faculty of Medicine, Ankara, Turkey.

出版信息

Clinics (Sao Paulo). 2009;64(4):313-8. doi: 10.1590/s1807-59322009000400008.

Abstract

OBJECTIVES

The etiology of osteoporosis in asthma is complex as various factors contribute to its pathogenesis. The purpose of our study was to investigate the effects of obesity and inhaled steroids, as well as the severity and duration of asthma, on osteoporosis in postmenopausal asthma patients as compared to healthy controls.

METHODS

A total of 46 patients with asthma and 60 healthy female controls, all postmenopausal, were enrolled in our study. Bone mineral density was assessed at the lumbar spine and hip using a Lunar DPX-L densitometer.

RESULTS

Bone mineral density (BMD) scores were comparable between the asthmatic and control groups, with average scores of 0.95 +/- 0.29 and 0.88 +/- 0.14 g/cm(2), respectively. Likewise, osteoporosis was diagnosed in a similar percentage of patients in the asthmatic (39.1%) and control (43.3%) groups. Bone fracture was identified in four patients with asthma (8.6%) and in six patients from the control group (10%). We could not detect any relationship between BMD and duration of asthma, asthma severity, inhaled steroids or body mass index (BMI). There was no difference between the two groups with respect to age or years since menopause. Although asthma patients were more likely to be overweight and presented higher BMD scores on average than the control subjects, these differences were not statistically significant.

CONCLUSIONS

There is a slight positive protective effect of high BMI against osteoporosis in asthma patients, but this effect is overcome by time and menopause status. Therefore, the protective effect of obesity against osteoporosis in asthma patients seems to not be significant.

摘要

目的

哮喘患者骨质疏松的病因复杂,多种因素共同导致其发病机制。本研究旨在探讨肥胖和吸入性类固醇、哮喘严重程度和持续时间对绝经后哮喘患者骨质疏松的影响,并与健康对照组进行比较。

方法

共纳入 46 例哮喘患者和 60 例健康女性对照组,均为绝经后女性。采用 Lunar DPX-L 骨密度仪检测腰椎和髋部的骨密度。

结果

哮喘组和对照组的骨密度(BMD)评分相似,平均评分分别为 0.95±0.29 和 0.88±0.14 g/cm²。同样,哮喘组和对照组中诊断为骨质疏松的患者比例相似(分别为 39.1%和 43.3%)。哮喘组有 4 例(8.6%)和对照组有 6 例(10%)发生骨折。我们未发现 BMD 与哮喘持续时间、哮喘严重程度、吸入性类固醇或体重指数(BMI)之间存在任何关系。两组在年龄或绝经后时间方面无差异。尽管哮喘患者更可能超重,且平均 BMD 评分较高,但这些差异无统计学意义。

结论

高 BMI 对哮喘患者骨质疏松有轻微的正向保护作用,但这种作用被时间和绝经状态所抵消。因此,肥胖对哮喘患者骨质疏松的保护作用似乎并不显著。

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