本文選題：老年 + 骨保護(hù)素　； 參考：《新疆醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：明確老年人血清骨保護(hù)素(OPG)在骨量異常組與對(duì)照組、維吾爾族與漢族、不同性別、不同年齡間是否存在差異性,探討其與骨量異常的相關(guān)性。方法選擇2011年10月至2013年12月在新疆醫(yī)科大學(xué)第一附屬醫(yī)院干部病房住院的患者312例(年齡≥60歲),采用雙能X線(xiàn)吸收法(DEXA)測(cè)量腰椎、左股骨近端骨密度(BMD),按WHO標(biāo)準(zhǔn)將入選患者分為骨量異常組(骨量減少+骨質(zhì)疏松)199例,對(duì)照組(骨量正常)113例。采用酶聯(lián)免疫吸附法(ELISA)檢測(cè)血清OPG濃度。結(jié)果(1)骨量異常組血清OPG濃度1.588(1.559)ng/ml較對(duì)照組2.062(1.606)ng/ml減低(Z=1.531,P=0.018)；按民族分層：兩組間的比較無(wú)論在維吾爾族還是在漢族,未發(fā)現(xiàn)統(tǒng)計(jì)學(xué)差異(P0.05)；按性別分層：骨量異常的男性血清OPG濃度1.481(1.410) ng/ml較對(duì)照組男性2.062(1.606)ng/mI (Z=1.732,P=0.005)減低,而在女性?xún)山M間未發(fā)現(xiàn)此差異(P0.05)。(2)維吾爾族血清OPG濃度1.503 (1.033) ng/ml較漢族1.971 (1.805) ng/ml明顯偏低(Z=1.834,P=0.002)；按性別分層：維吾爾族男性血清OPG濃度1.474(0.729)ng/ml較漢族男性2.062(1.712)ng/ml低(Z=2.215,P=0.000),兩民族在女性間的比較未發(fā)現(xiàn)統(tǒng)計(jì)學(xué)差異(P0.05)；按病例-對(duì)照分層：骨量異常的維吾爾族與漢族間血清OPG濃度的比較,未發(fā)現(xiàn)統(tǒng)計(jì)學(xué)差異(P0.05),骨量正常者中維吾爾族血清OPG濃度1.772(1.044)ng/ml較漢族2.303(2.031)ng/ml低(Z=1.404,P=0.039)。(3)血清OPG濃度在60-70歲與70歲組間整體比較及按民族、性別、骨量分層后比較,均未發(fā)現(xiàn)統(tǒng)計(jì)學(xué)差異(P0.05)；(4) Spearman相關(guān)性分析顯示：漢族女性血清OPG濃度與腰2-腰4、腰總、股骨頸、大粗隆、粗隆間、髖關(guān)節(jié)部位骨密度呈負(fù)相關(guān)(r=-0.235～-0.333,P=0.02～0.032),經(jīng)控制BMI、年齡后相關(guān)性仍有統(tǒng)計(jì)學(xué)意義(r=-0.126～-0.277,P=0.012～0.028)；漢族男性血清OPG濃度與G.T部位骨密度呈正相關(guān)(r=0.174,P=0.026),經(jīng)控制BMI、年齡后未發(fā)現(xiàn)統(tǒng)計(jì)學(xué)意義(P0.05)；維吾爾族無(wú)論男性還是女性血清OPG濃度與各骨骼部位的骨密度均未發(fā)現(xiàn)相關(guān)性有統(tǒng)計(jì)學(xué)意義(P0.05)。(5)線(xiàn)性回歸分析結(jié)果提示：漢族女性血清OPG濃度對(duì)L1、L2、L3、L總、InterTro部位骨密度是負(fù)性決定因素,可以解釋骨密度變異的0.8%-10%。(6)擬合漢族女性血清OPG濃度與骨密度變化的最優(yōu)曲線(xiàn)提示：血清OPG濃度與L1、L2、L3、L總、InterTro部位骨密度以線(xiàn)性擬合最優(yōu),與G.T、Hip部位骨密度以二次多項(xiàng)式擬合最優(yōu),與L4、Neck部位骨密度未發(fā)現(xiàn)最優(yōu)擬合曲線(xiàn)。(7) Logistic回歸分析顯示：血清OPG濃度為影響骨量異常的保護(hù)因素(OR=0.761,95%CI:0.591～0.979,P=0.034),而女性(OR=14.934,95%CI:6.971～31.991,P=0.000)、年齡(OR=2.131,95%CI:1.366～ 3.323,P=0.001)、飲酒(OR=2.891,95%CI:1.849～4.521,P=0.000)為骨量異常的危險(xiǎn)因素,可能增加骨質(zhì)疏松的患病風(fēng)險(xiǎn)。結(jié)論維吾爾族老年人血清OPG濃度較漢族老年人低,尤其維吾爾族男性低于漢族男性；女性、高齡、飲酒可能增加老年人骨量異常的危險(xiǎn)性；血清OPG可能與老年人骨量異常相關(guān),是老年人骨量異常的保護(hù)性因素。
[Abstract]:Objective : To investigate the correlation between bone mineral density ( OPG ) and bone mass abnormalities in elderly patients with abnormal bone volume ( BMD ) of lumbar spine and left femur by using double - energy X - ray absorpting ( DEXA ) .
There was no statistical difference between the two groups ( P0.05 ) .
The serum OPG concentrations were 1.481 ( 1.410 ) ng / ml and 2.062 ( 1.606 ) ng / ml ( Z = 1.732 , P = 0.005 ) in the control group .
The serum OPG concentration of Uygur male was 1.474 ( 0.729 ) ng / ml and 2.062 ( 1.712 ) ng / ml ( Z = 2.215 , P = 0.000 ) , but no statistical difference was found between the two groups ( P0.05 ) .
There was no statistical difference between the serum OPG concentrations in the Uygur and Han nationalities ( P0.05 ) . The serum OPG concentrations in the normal subjects were 1.772 ( 1.044 ) ng / ml and 2.303 ( 2.031 ) ng / ml in the Han population ( Z = 1.404 , P = 0.039 ) .
( 4 ) The correlation analysis showed that the serum OPG concentration in Han women was negatively correlated with waist 2 - waist 4 , waist total , femoral neck , big bolone , trochanter , and hip part bone density ( r = - 0.235 - 0.333 , P = 0.02 - 0.032 ) . After control of BMI , the correlation of age - related remained statistically significant ( r = - 0.126 ~ - 0.277 , P = 0.012 ~ 0.028 ) ;
The serum OPG concentrations were positively correlated with bone mineral density ( r = 0.174 , P = 0.026 ) in Han men ( r = 0.174 , P = 0.026 ) .
( 7 ) Logistic regression analysis showed that the concentration of OPG in serum of Han women was the best factor affecting bone mineral density ( OR = 0.761 , 95 % CI : 6.971 锝，

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