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[绝经后女性脂蛋白与骨量的相关性]

[Associations of lipoproteins with bone mass in postmenopausal women].

作者信息

Skripnikova I A, Abirova E S, Alyasova P A, Alikhanova N A, Khudyakov M B, Vygodin V A

机构信息

National Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia.

出版信息

Ter Arkh. 2016;88(1):82-88. doi: 10.17116/terarkh201688182-88.

Abstract

AIM

To study an association between blood lipid composition and bone mass in Russian postmenopausal women.

SUBJECTS AND METHODS

The cross-sectional study included 373 postmenopausal women aged 45-80 years who were examined to diagnose osteoporosis in outpatient settings. Height, body weight, and waist and hip circumferences (WC and HC) were measured before densitometry. Quetelet's index was calculated as a ratio of weight (kg) to height (m2). The concentration of lipids and apolipoproteins (apo) AІ and B were measured by enzyme immunoassay. Bone mineral density (BMD) in the spine and proximal femur (PF) was estimated by dual-energy X-ray absorptiometry.

RESULTS

According to bone mass, the patients were divided into three groups: 1) osteoporosis (OP); 2) osteopenia; 3) normal BMD. The levels of total cholesterol and high-density lipoprotein (HDL) cholesterol were significantly higher in the postmenopausal women with OP than in those with normal bone mass. There was a negative correlation of cholesterol and HDL cholesterol levels with lumbar spine BMD and that of HDL levels with BMD in the femoral neck (FN) and entire PF. The level of lipoprotein (a) (LPa) was significantly lower in the group of patients with OP and positively correlated with BMD in FN and entire PF. After adjustment for age, the duration of menopause, Quetelet's index, and WC/HC association remained only between LPa and FN BMD.

CONCLUSION

Multivariate regression analysis failed to confirm a trend towards decreased BMD and increased HDL cholesterol. This suggests that the association of HDL cholesterol with bone mass is apparently mediated by other factors and, above all, with age, postmenopausal hormonal status and body weight.

摘要

目的

研究俄罗斯绝经后女性血脂成分与骨量之间的关联。

对象与方法

这项横断面研究纳入了373名年龄在45 - 80岁的绝经后女性,她们在门诊接受骨质疏松诊断检查。在进行骨密度测量前测量身高、体重、腰围和臀围(WC和HC)。计算体重指数(Quetelet指数),即体重(kg)与身高(m²)之比。采用酶免疫法测定血脂及载脂蛋白(apo)AⅠ和B的浓度。通过双能X线吸收法评估脊柱和股骨近端(PF)的骨密度(BMD)。

结果

根据骨量,将患者分为三组:1)骨质疏松症(OP);2)骨量减少;3)骨密度正常。绝经后骨质疏松症女性的总胆固醇和高密度脂蛋白(HDL)胆固醇水平显著高于骨量正常的女性。胆固醇和HDL胆固醇水平与腰椎骨密度呈负相关,HDL水平与股骨颈(FN)和整个PF的骨密度呈负相关。骨质疏松症患者组的脂蛋白(a)[LPa]水平显著较低,且与FN和整个PF的骨密度呈正相关。在调整年龄、绝经持续时间、体重指数和WC/HC后,仅LPa与FN骨密度之间仍存在关联。

结论

多变量回归分析未能证实骨密度降低和HDL胆固醇升高的趋势。这表明HDL胆固醇与骨量之间的关联显然由其他因素介导,尤其是年龄、绝经后激素状态和体重。

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