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葡萄糖、胰岛素和体脂在评估功能性下丘脑性闭经女性骨密度和小梁骨评分中的作用

The Role of Glucose, Insulin and Body Fat in Assessment of Bone Mineral Density and Trabecular Bone Score in Women with Functional Hypothalamic Amenorrhea.

作者信息

Sowińska-Przepiera Elżbieta, Krzyścin Mariola, Syrenicz Igor, Orlińska Adrianna, Ćwiertnia Adrianna, Przepiera Adam, Jezierska Karolina, Cymbaluk-Płoska Aneta, Bumbulienė Žana, Syrenicz Anheli

机构信息

Pediatric, Adolescent Gynecology Clinic, Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland.

Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland.

出版信息

J Clin Med. 2024 Jul 26;13(15):4388. doi: 10.3390/jcm13154388.

Abstract

For years, bone mineral density (BMD) has played a key role in assessing bone health, but the trabecular bone score (TBS) is emerging as an equivalent measure. However, BMD alone may not fully measure bone quality or predict osteoporosis risk. To evaluate the usefulness of TBS and BMD in estimating the risk of bone fracture in young women with FHA, this study examined the association between metabolic parameters and bone quality, which was measured using TBS and BMD. We analyzed the association of metabolic factors with tests assessing bone quality-TBS and BMD. Patients were checked for BMI, measured body fat, and determined serum glucose levels and insulin levels in a 75g glucose load test. Spearman correlation analysis was used. Significant positive correlations were found between BMD and age ( < 0.001) and body fat ( < 0.001), as well as between TBS values and BMI ( < 0.001) and TBS and percent body fat ( < 0.001). Of the variables analyzed in the multivariate analysis, the only independent predictor of higher bone mineral density in the lumbar spine was found to be higher values of the trabecular bone index in the same segment ( < 0.001). The use of TBS provides a simple tool for estimating the risk of bone damage. Ultimately, early screening, diagnosis and treatment of patients with FHA may help prevent osteoporosis and fragility fractures in the long term.

摘要

多年来,骨矿物质密度(BMD)在评估骨骼健康方面发挥了关键作用,但小梁骨评分(TBS)正逐渐成为一种等效的测量方法。然而,仅BMD可能无法完全衡量骨质或预测骨质疏松症风险。为了评估TBS和BMD在估计患有功能性下丘脑性闭经(FHA)的年轻女性骨折风险中的作用,本研究检测了代谢参数与使用TBS和BMD测量的骨质之间的关联。我们分析了代谢因素与评估骨质的检测指标——TBS和BMD之间的关联。对患者进行了体重指数(BMI)检查、测量了体脂,并在75克葡萄糖负荷试验中测定了血清葡萄糖水平和胰岛素水平。采用Spearman相关性分析。发现BMD与年龄(<0.001)和体脂(<0.001)之间存在显著正相关,TBS值与BMI(<0.001)以及TBS与体脂百分比(<0.001)之间也存在显著正相关。在多变量分析中所分析的变量中,发现腰椎较高骨矿物质密度的唯一独立预测因素是同一节段较高的小梁骨指数值(<0.001)。TBS的使用为估计骨损伤风险提供了一个简单的工具。最终,对FHA患者进行早期筛查、诊断和治疗可能有助于长期预防骨质疏松症和脆性骨折。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ea4/11312711/f2402f9d8958/jcm-13-04388-g001.jpg

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