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目的探讨江苏正常男性人群血清维生素D水平与骨密度、骨微结构的相关性。方法收集自2013年至2015年在南京医科大学第一附属医院老年医学科住院体检的234例男性患者资料,患者平均年龄为58岁。对其进行双能X线吸收仪(dual energy X-ray absorptiometry,DXA)扫描,采用TBS Insight软件进行骨小梁分数(trabecular bone score,TBS)计算,测定血清25-羟维生素D(25-hydroxy vitamin D,25OHD)、空腹血糖、三酰甘油、胆固醇、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)等临床指标。结果 234例男性受试者血清25OHD的平均水平是(46.19±19.41)nmol/L,25OHD与腰椎骨密度(bone mineral density,BMD)无明显相关性(r=0.060,P=0.390),而与骨微结构(trabecular bone score,TBS)呈正相关(r=0.140,P=0.030)。将研究对象按年龄分成2组:≤55岁组(n=108),>55岁组(n=126),对比≤55岁组,>55岁组TBS数值随年龄降低(P<0.05),而BMD、25OHD随年龄无明显变化;同时发现,年龄与TBS呈负相关(r=-0.230,P=0.001),但与BMD无相关性(r=-0.080,P=0.260)。多元回归分析在校正了年龄、腰围、臀围、血糖、HDL-C这些影响骨代谢的因素之后,25OHD(nmo/L)与TBS依然存在相关性(β=0.001,P=0.010)。结论血清25OHD水平在江苏正常男性人群可能与骨微结构相关,TBS较BMD更为灵敏。
Objective To investigate the relationship between serum vitamin D levels and bone mineral density and bone microstructure in normal male subjects in Jiangsu Province. Methods The data of 234 male patients who were hospitalized in the Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University from 2013 to 2015 were collected. The average age of the patients was 58 years. The rats were subjected to dual energy X-ray absorptiometry (DXA) scans, and TBS Insight software was used to calculate the trabecular bone score (TBS). Serum 25-hydroxyvitamin D (25- fasting blood glucose, triglyceride, cholesterol, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) Clinical indicators. Results The mean 25OHD level of 234 male subjects was (46.19 ± 19.41) nmol / L, while there was no significant correlation between 25OHD and BMD (r = 0.060, P = 0.390) The bone micro-structure (TBS) was positively correlated (r = 0.140, P = 0.030). The subjects were divided into two groups by age: ≤55 years old (n = 108),> 55 years old (n = 126) However, BMD and 25OHD had no significant change with age. At the same time, age was negatively correlated with TBS (r = -0.230, P = 0.001), but not with BMD (r = -0.080, P = 0.260). Multivariate regression analysis Correlated 25OHD (nmo / L) with TBS (β = 0.001, P = 0.010) after adjusting for factors affecting bone metabolism such as age, waist circumference, hip circumference, glucose and HDL-C. Conclusion Serum 25OHD level in Jiangsu normal male population may be related to the microstructure of bone, TBS is more sensitive than BMD.