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中国全科医学 ›› 2016, Vol. 19 ›› Issue (25): 3046-3050.DOI: 10.3969/j.issn.1007-9572.2016.25.010

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老年骨质疏松症患者血清1，25-二羟维生素D3与骨骼肌减少症的相关性研究

张黎，李燕   

  1. 650032 云南省昆明市，云南省第一人民医院干部保健科

  • 出版日期:2016-09-02 发布日期:2016-09-02
  • 通讯作者: 李燕，650032 云南省昆明市，云南省第一人民医院干部保健科；E-mail：2689963575@qq.com
  • 基金资助:

    云南省应用基础研究面上项目（2013FZ183）；云南省老年病防治研究中心基金项目（2014NS240）；云南省第一人民医院王陇德院士工作站基金项目（2013年）

Correlation Analysis between Serum 1,25-Dihydroxyvitamin D3 of Patients with Senile Osteoporosis and Sarcopenia

  • Published:2016-09-02 Online:2016-09-02

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摘要：  目的  探讨老年骨质疏松症（osteoporosis，OP）患者血清1，25-二羟维生素D3〔1，25-（OH）2D3〕与骨骼肌减少症（sarcopenia，SAR）的相关性。 方法  选取2013年10月—2015年4月到云南省第一人民医院就诊的老年OP患者390例。根据是否合并SAR，将纳入患者分为合并SAR组（n=286）和未合并SAR组（n=104）。患者均进行体格检查、骨密度和身体组织成分检测及实验室检查，并分析血清1，25-（OH）2D3与SAR评价指标和影响因素的相关性。 结果  两组患者性别、年龄及BMI比较，差异无统计学意义（P＞0.05）。未合并SAR组患者血清1，25-（OH）2D3高于合并SAR组，差异有统计学意义（P＜0.05）。Spearman秩相关分析结果显示，男性/女性OP患者血清1，25-（OH）2D3与步速、握力呈正相关（P＜0.05），而与四肢骨骼肌量指数（ASMI）不相关（P＞0.05）；血清1，25-（OH）2D3与雌二醇（E2）、睾酮（T）、胰岛素样生长因子-1（IGF-1）、白介素10（IL-10）呈正相关（P＜0.05），与活性氧（ROS）、全段甲状旁腺激素（iPTH）、肿瘤坏死因子α（TNF-α）、白介素6（IL-6）呈负相关（P＜0.05），而与BMI、胰岛素抵抗指数（HOMA-IR）、超敏C反应蛋白（hs-CRP）不相关（P＞0.05）。 结论  OP患者血清1，25-（OH)2D3水平与部分SAR评价指标和影响因素相关，可能是早期预测和评估SAR的指标之一。

关键词:

font-family: 宋体, mso-spacerun: 'yes', mso-font-kerning: 1.0000pt">骨质疏松, 肌减少症, 骨化三醇, 相关性分析

Abstract:

 Objective  To explore the correlation between serum 1,25-dihydroxyvitamin D3〔1,25-(OH)2D3〕 of patients with senile osteoporosis(osteoporosis,OP) and sarcopenia(sarcopenia,SAR).
 Methods  390 patients with senile OP,who received treatment in First People′s Hospital of Yunnan Province from October 2013 to April 2015 were selected.Depending on whether merging SAR,they were assigned to group combined with SAR(n=286) and group combined without SAR(n=104).All the patients received physical examination,bone density and body tissue composition testing and laboratory examination to analyze the correlation between serum 1,25-(OH)2D3 level and the evaluation indexes and influencing factors of SAR.
 Results  Gender,age and BMI of the two groups were not significantly different(P＞0.05).Serum 1,25-(OH)2D3 of group combined with SAR was significantly higher than that in group without SAR(P＜0.05).Spearman rank correlation analysis showed that male/female OP patients′ serum OP 1,25-(OH)2D3 was positively correlated with walking speed,grip strength(P＜0.05),and not correlated with arms and legs skeletal muscle mass index(ASMI);serum 1,25-(OH)2D3 presented positive correlation with estradiol(E2),testosterone(T),insulin-like growth factor-1(IGF-1)，interleukin-10(IL-10,P＜0.05),while negatively correlated with reactive oxygen species(ROS),intact parathyroid hormone(iPTH),tumor necrosis factor α(TNF-α),interleukin-6(IL-6,P＜0.05),and not correlated with BMI,homeostasis model assessment of insulin resistance(HOMA-IR),high-sensitivity C-reactive protein(hs-CRP,P＞0.05).
 Conclusion  Serum 1,25-(OH)2D3 level of OP patients is correlated with some of the evaluation indexes and influencing factors,and may be one of the indicators of early prediction.

Key words:

font-family: 宋体, mso-spacerun: 'yes', mso-font-kerning: 1.0000pt">Osteoporosis;Sarcopenia;Calcitriol;Correlation analysis

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