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慢性阻塞性肺疾病合并骨质疏松症时胸部CT值与骨密度T值的潜在预测因素

Potential Predictive of Thoracic CT Value and Bone Mineral Density T-Value in COPD Complicated with Osteoporosis.

作者信息

Hu Tinghua, Dai Shanshan, Yang Lan, Zhu Bo

机构信息

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710000, People's Republic of China.

Department of Respiratory and Critical Care Medicine, Xi'an No. 9 Hospital, Xi'an, Shaanxi, People's Republic of China.

出版信息

Int J Gen Med. 2024 Jul 10;17:3027-3038. doi: 10.2147/IJGM.S466292. eCollection 2024.

Abstract

BACKGROUND

COPD, combined with Osteoporosis, has a high incidence and potential for great harm. Choosing an optimal diagnostic method to achieve bone mineral density (BMD) screening is crucial for COPD patients. Studies on COPD patients with BMD reduction are lacking.

PURPOSE

To identify the risk factors of BMD reduction and osteoporosis in COPD patients.

PATIENTS AND METHODS

We included a total of 81 patients with AECOPD, who were admitted to the hospital from July 1, 2019, to January 31, 2020. Patients were grouped into BMD normal group, BMD reduced group and OP group. The areas under ROC curve were used to explore the value of CT values in the diagnosis of bone abnormality, and clinical indicators were collected.

RESULTS

The CT value of the vertebral cancellous bone is highly correlated with the T value of BMD (R > 5.5, P < 0.0001). Using multivariate Logistic regression analysis, we showed that COPD duration, BMI, 25-hydroxyvitamin D3, and long-term inhaled glucocorticoid were independent factors affecting different BMD levels in COPD patients. No significant difference in bone formation indexes between groups. β-crossL was negatively correlated with serum IL-6 (r=-0.254, P=0.022), and ALP was positively correlated with serum TNF-α (r=0.284, P=0.023).

CONCLUSION

Thoracolumbar vertebral cancellous bone CT has potential value in the diagnosis of bone abnormality. COPD duration, BMI, 25-hydroxyvitamin D3, and long-term inhaled glucocorticoid may contribute to the BMD reduction in COPD patients, and serum IL-6 and TNF-α regulate bone metabolism in COPD patients.

摘要

背景

慢性阻塞性肺疾病(COPD)合并骨质疏松症的发病率高,危害大。选择最佳诊断方法以实现骨密度(BMD)筛查对COPD患者至关重要。目前缺乏关于COPD患者骨密度降低的研究。

目的

确定COPD患者骨密度降低和骨质疏松症的危险因素。

患者与方法

我们纳入了2019年7月1日至2020年1月31日期间入院的81例慢性阻塞性肺疾病急性加重期(AECOPD)患者。将患者分为骨密度正常组、骨密度降低组和骨质疏松组。采用ROC曲线下面积探讨CT值在诊断骨异常中的价值,并收集临床指标。

结果

椎体松质骨的CT值与骨密度T值高度相关(R>5.5,P<0.0001)。通过多因素Logistic回归分析,我们发现COPD病程、体重指数(BMI)、25-羟维生素D3和长期吸入糖皮质激素是影响COPD患者不同骨密度水平的独立因素。各组间骨形成指标无显著差异。β-交联羧基末端肽(β-crossL)与血清白细胞介素-6(IL-6)呈负相关(r=-0.254,P=0.022),碱性磷酸酶(ALP)与血清肿瘤坏死因子-α(TNF-α)呈正相关(r=0.284,P=0.023)。

结论

胸腰椎椎体松质骨CT在诊断骨异常方面具有潜在价值。COPD病程、BMI、25-羟维生素D3和长期吸入糖皮质激素可能导致COPD患者骨密度降低,血清IL-6和TNF-α调节COPD患者的骨代谢。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/268a/11246664/e7690dc7e7e5/IJGM-17-3027-g0001.jpg

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