Servicio de Medicina Interna, Hospital Universitario de Canarias, Universidad de La Laguna, Tenerife, Canary Islands, 38320, Spain.
Servicio de Medicina Interna, Hospital Universitario de Canarias, Universidad de La Laguna, Tenerife, Canary Islands, 38320, Spain.
Clin Nutr. 2018 Dec;37(6 Pt A):2137-2143. doi: 10.1016/j.clnu.2017.10.008. Epub 2017 Oct 16.
BACKGROUND & AIMS: Some studies have illustrated the association between serum lipid profile and bone mineral density (BMD) or fractures. None of these studies was performed among alcoholics, despite the fact that alcoholism may affect both bone mass and lipid metabolism. We here analyse the relationship of serum lipid profile with bone mass among a population of 280 heavy alcoholics (29 women).
patients underwent a densitometric assessment of BMD and determination of a serum lipid panel. Castelli index (Total cholesterol/HDL cholesterol) and the LDL/HDL cholesterol index were calculated.
There was a direct correlation between both total cholesterol and LDL-cholesterol and femoral neck (r = 0.17 and r = 0.20, respectively) and lumbar spine (r = 0.16 and r = 0.20) T score, total BMD (r = 0.14 and r = 0.18) or pelvis BMD (r = 0.16 and r = 0.23; p < 0.025 in all cases). HDL-cholesterol showed no relationship with BMD. Serum triglycerides were also directly related to T score at the lumbar spine (ρ = 0.13; p = 0.032) and pelvis BMD (ρ = 0.13; p = 0.037). Pelvis BMD was significantly related to Castelli index (ρ = 0.15) and LDL/HDL index (ρ = 0.18; p < 0.015 in both cases). Multivariate analysis showed that the association between the serum lipid panel and BMD was independent of liver function and body mass index.
Therefore, BMD was directly related to total cholesterol and LDL cholesterol in heavy alcoholism. This counter intuitive observation adds to others derived from several similar studies conducted in different population groups but not in alcoholics as of yet. The mechanisms that explain the association between serum lipids and bone metabolism need further investigation.
一些研究表明血清脂质谱与骨密度（BMD）或骨折之间存在关联。然而，这些研究都没有在酗酒者中进行，尽管酒精中毒可能会影响骨量和脂质代谢。我们在此分析了 280 名重度酗酒者（29 名女性）的血清脂质谱与骨量之间的关系。
患者接受 BMD 密度测定和血清脂质谱测定。计算 Castelli 指数（总胆固醇/高密度脂蛋白胆固醇）和 LDL/HDL 胆固醇指数。
总胆固醇和 LDL 胆固醇与股骨颈（r=0.17 和 r=0.20）和腰椎（r=0.16 和 r=0.20）T 评分、总 BMD（r=0.14 和 r=0.18）或骨盆 BMD（r=0.16 和 r=0.23）呈直接正相关（p<0.025）。HDL 胆固醇与 BMD 无关。血清甘油三酯与腰椎（ρ=0.13；p=0.032）和骨盆 BMD（ρ=0.13；p=0.037）的 T 评分也呈直接相关。骨盆 BMD 与 Castelli 指数（ρ=0.15）和 LDL/HDL 指数（ρ=0.18；p<0.015）显著相关。多元分析表明，血清脂质谱与 BMD 的相关性独立于肝功能和体重指数。
因此，在重度酗酒者中，BMD 与总胆固醇和 LDL 胆固醇直接相关。这种与直觉相反的观察结果与其他几项在不同人群中进行的类似研究结果一致，但尚未在酗酒者中进行。解释血清脂质与骨代谢之间关联的机制需要进一步研究。
