【摘要】 目的探讨河南郑州社区40岁以上中老年人群冠状动脉粥样硬化性心脏病(coronary heart disease,CHD,以下简称冠心病)与骨质疏松性骨折的相关性。方法 2012年12月至2014年12月对郑州市6个社区9 783名40岁以上常住居民(居住年限≥5年)进行横断面现场调查。受试者平均年龄(57.9±9.7)岁。结果总骨质疏松性骨折发生率为1.9%,女性显著高于男性(2.3%vs.1.1%,χ~2=14.973,P<0.001)。并发CHD的女性骨质疏松性骨折发生率更高(3.8%vs.2.1%,χ~2=6.753,P=0.009);男性中差异无统计学意义(2.0%vs.1.1%,χ~2=1.669,P=0.196)。CHD可能是女性骨质疏松性骨折的风险因素(OR=2.271,95%CI:1.305～3.943,P<0.001);男性中未见相关性(OR=1.610,95%CI:0.478～5.432,P=0.444)。校正了年龄、婚姻、教育程度、工作、吸烟、饮酒、饮茶、打鼾状况、业余时间体能活动、肾小球滤过率、体质量指数、腰臀比、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、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)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、谷氨酰转肽酶(γ-glutamyl transpeptidase,GGT)、空腹血糖(fasting plasma glucose,FBG)、服糖后2 h血糖(2 h plasma glucose after glucose load,2hPG)、糖化血红蛋白(glycosylated hemoglobin A1c,Hb A1c)、收缩压、舒张压、脉压差,以及绝经与否等因素之后,CHD与骨质疏松性骨折的显著相关性在女性中仍然存在(OR=1.949,95%CI:1.102～3.500,P=0.023)。结论 40岁以上女性冠心病与近期骨质疏松性骨折发生显著相关。更多还原

【Abstract】 Objective To investigate the association between coronary heart disease(CHD) and osteoporotic fracture in middle-aged and elderly residents over 40 years old in community health centers in Zhengzhou of Henan province.Methods A cross-sectional study was conducted on 9 783 residents aged 40 years or older in six communities in Zhengzhou of Henan(residence years ≥5 years) from December 2012 to December 2014.The average age of the subjects was(57.9 ± 9.7) years.Results The overall incidence of osteoporotic fracture was 1.9%,and it was significantly higher in women than in men(2.3% vs.1.1%,χ~2= 14.973,P<0.001).Among women,the incidence of osteoporotic fracture was significantly higher in those with CHD(3.8% vs.2.1%,χ~2= 6.753,P = 0.009),while no difference was found in men(2.0% vs.1.1%,χ~2= 1.669,P = 0.196).Women with CHD had a higher incidence of osteoporotic fractures(OR = 2.271,95% CI: 1.305-3.943,P < 0.001),while not in men(OR = 1.610,95% CI: 0.478-5.432,P = 0.444).After fully adjusting for potential confounders including age,marriage,education,work,smoking,drinking,drinking tea,snoring status,physical activity,the glomerular filtration rate(e GFR),body mass index,waist hip ratio,triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C), alanine aminotransferase(ALT), aspartate aminotransferase(AST), γ-glutamyl transpeptidase(GGT),fasting blood glucose(FBG),2 h plasma glucose after glucose load(2hPG),glycosylated hemoglobin A1c(HbA1c),systolic blood pressure,diastolic blood pressure,pulse pressure,and memopause,the significances still existed in women(OR = 1.949,95% CI: 1.102-3.500,P = 0.023).Conclusion The presence of CHD is significantly associated with a recent history of osteoporotic fracture in middle-aged and elderly women in Henan province.更多还原