Department of Gastroenterology, University of Juntendo, School of Medicine, Tokyo, Japan.
Ther Clin Risk Manag. 2015 Mar 6;11:381-91. doi: 10.2147/TCRM.S80647. eCollection 2015.
A number of diseases and drugs may influence bone mineral density; however, there are few reports concerning the relationship between lifestyle-related diseases and osteoporosis in Japan as determined by multivariate analysis. The aim of this study was to investigate the risk factors for osteoporosis and whether infection by or eradication of Helicobacter pylori is associated with osteoporosis.
Between February 2008 and November 2014, using a cross-sectional study design, we investigated patient profile (age, sex, BMI, alcohol, smoking), H. pylori infection status, comorbidities, internal medicine therapeutic agents (calcium channel blocker, HMG-CoA reductase inhibitors, proton pump inhibitor), serum parameters (Hb, calcium, γGTP), bone turn over markers (bone-specific alkaline phosphatase (BAP) and collagen type I cross-linked N telopeptide (NTX), findings on dual-energy x-ray absorptiometry (DEXA) and upper gastrointestinal endoscopy, and Frequency Scale for the Symptoms of GERD score in consecutive outpatients aged ≥50 years at our hospital. We divided the subjects into an osteoporosis group and a non-osteoporosis group and investigated risk factors for osteoporosis between the two groups by bivariate and multivariate analyses.
Of the 255 eligible study subjects, 43 (16.9%) had osteoporosis. Bivariate analysis showed that advanced age, female sex, lower body mass index, lower cumulative alcohol intake, lower Brinkman index, H. pylori positivity, lower hemoglobin, bone-specific alkaline phosphatase, lower prevalence of hiatal hernia, and endoscopic gastric mucosal atrophy were related to osteoporosis. Multivariate analysis showed that advanced age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.07-1.19, P<0.001), female sex (OR 6.27, 95% CI 2.26-17.39, P<0.001), low BMI (OR 0.82, 95% CI 0.72-0.94, P=0.005), H. pylori positivity (OR 3.00, 95% CI 1.31-6.88, P=0.009), and BAP (OR 1.07, 95% CI 1.01-1.14, P=0.035) were related to osteoporosis.
Advanced age, low BMI, BAP, and H. pylori positivity were risk factors for osteoporosis; however, the success of H. pylori eradication was not a risk factor for osteoporosis in Japan.
许多疾病和药物可能会影响骨密度; 然而，由于多元分析，关于日本与生活方式相关疾病和骨质疏松症之间关系的报告很少。本研究的目的是调查骨质疏松症的危险因素，以及是否感染或根除幽门螺杆菌与骨质疏松症有关。
2008 年 2 月至 2014 年 11 月，我们采用横断面研究设计，调查了患者特征（年龄、性别、BMI、酒精、吸烟）、幽门螺杆菌感染状况、合并症、内科治疗药物（钙通道阻滞剂、HMG-CoA 还原酶抑制剂、质子泵抑制剂）、血清参数（Hb、钙、γGTP）、骨转换标志物（骨碱性磷酸酶（BAP）和 I 型胶原交联 N 端肽（NTX））、双能 X 射线吸收仪（DEXA）和上消化道内镜检查结果以及胃食管反流病症状频率量表（GERD）评分，对我院连续就诊的≥50 岁的门诊患者进行了研究。我们将受试者分为骨质疏松组和非骨质疏松组，并通过双变量和多变量分析调查两组之间骨质疏松症的危险因素。
在 255 名符合条件的研究对象中，43 名（16.9%）患有骨质疏松症。单变量分析表明，年龄较大、女性、较低的体重指数、较低的累计饮酒量、较低的布赖恩指数、幽门螺杆菌阳性、较低的血红蛋白、骨碱性磷酸酶、较高的食管裂孔疝患病率和内镜胃黏膜萎缩与骨质疏松症有关。多变量分析显示，年龄较大（比值比[OR]1.13，95%置信区间[CI]1.07-1.19，P<0.001）、女性（OR 6.27，95%CI 2.26-17.39，P<0.001）、较低的 BMI（OR 0.82，95%CI 0.72-0.94，P=0.005）、幽门螺杆菌阳性（OR 3.00，95%CI 1.31-6.88，P=0.009）和 BAP（OR 1.07，95%CI 1.01-1.14，P=0.035）与骨质疏松症有关。
年龄较大、BMI 较低、BAP 和幽门螺杆菌阳性是骨质疏松症的危险因素；然而，在日本，幽门螺杆菌根除的成功不是骨质疏松症的危险因素。
