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血浆致动脉粥样硬化指数与绝经后妇女的骨小梁骨评分评估的骨微结构恶化相关:卡马戈队列研究。

The atherogenic index of plasma is related to a degraded bone microarchitecture assessed by the trabecular bone score in postmenopausal women: The Camargo Cohort Study.

机构信息

Bone Metabolic Unit. Department of Internal Medicine, Hospital Marqués de Valdecilla-IDIVAL. University of Cantabria. Santander, Spain.

Bone Metabolic Unit. Department of Internal Medicine, Hospital Marqués de Valdecilla-IDIVAL. University of Cantabria. Santander, Spain.

出版信息

Maturitas. 2021 Jun;148:1-6. doi: 10.1016/j.maturitas.2021.03.008. Epub 2021 Mar 26.

Abstract

OBJECTIVE

To assess the association between the atherogenic index of plasma (AIP) and the trabecular bone score (TBS) in postmenopausal women. Furthermore, to analyze its relationship with bone mineral density (BMD), and serum concentrations of 25OHD, PTH, and bone turnover markers.

STUDY DESIGN

Cross-sectional study nested in a population-based cohort of 1,367 postmenopausal women aged 44-94 years. Participants were classified according to TBS values (<1.230, between 1.230-1.310 and >1.310) and regarding a widely accepted cut-off point of ≥0.11 for AIP. We analyzed TBS, BMD, serum levels of 25OHD, PTH, P1NP, CTX, and clinical covariates. A multivariate analysis was performed to assess the adjusted association between AIP and TBS.

RESULTS

The mean age of participants was 63±10 years. Women with TBS values <1.230 were older, had greater BMI, greater prevalence of fractures after the age of 40 years, more years since menopause, higher values of AIP, and significantly lower levels of HDL-C, serum phosphate, and 25OHD. AIP values ≥0.11 were not associated with the presence of densitometric osteoporosis (OR=0.83, 95%CI 0.58-1.18; p = 0.30) but, in multivariate analysis, AIP values ≥0.11 were related to a degraded microarchitecture after controlling for age, BMI, smoking, diabetes status, ischemic heart disease, statin use, GFR, a fragility fracture at over 40 years of age and lumbar osteoporosis by DXA, with an adjusted OR=1.61 (95%CI 1.06-2.46; p = 0.009).

CONCLUSIONS

AIP is significantly and independently associated with a degraded bone microarchitecture as measured by TBS. In this sense, AIP might be a useful tool in the overall assessment of bone metabolism in postmenopausal women.

摘要

目的

评估血浆致动脉粥样硬化指数(AIP)与绝经后妇女的骨小梁评分(TBS)之间的关系。此外,分析其与骨密度(BMD)、血清 25-羟维生素 D(25OHD)、甲状旁腺激素(PTH)和骨转换标志物浓度的关系。

研究设计

在一项基于人群的 1367 名绝经后年龄在 44-94 岁的妇女队列中进行的横断面研究。根据 TBS 值(<1.230、1.230-1.310 和>1.310)和 AIP 的广泛接受的临界值≥0.11 对参与者进行分类。我们分析了 TBS、BMD、血清 25OHD、PTH、P1NP、CTX 和临床协变量。进行多变量分析以评估 AIP 和 TBS 之间的调整关联。

结果

参与者的平均年龄为 63±10 岁。TBS 值<1.230 的女性年龄较大,BMI 较高,40 岁后骨折发生率较高,绝经后时间较长,AIP 值较高,HDL-C、血清磷酸盐和 25OHD 水平显著较低。AIP 值≥0.11 与骨密度正常的骨质疏松症无关(OR=0.83,95%CI 0.58-1.18;p=0.30),但在多变量分析中,AIP 值≥0.11 与年龄、BMI、吸烟、糖尿病状态、缺血性心脏病、他汀类药物使用、肾小球滤过率、40 岁以上脆性骨折和 DXA 测量的腰椎骨质疏松症校正后的微结构退化有关,调整后的 OR=1.61(95%CI 1.06-2.46;p=0.009)。

结论

AIP 与 TBS 测量的骨微结构退化显著且独立相关。在这个意义上,AIP 可能是绝经后妇女骨代谢整体评估的有用工具。

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