■COPD,合并骨质疏松症,具有很高的发病率和潜在的巨大危害。选择最佳的诊断方法来实现骨矿物质密度(BMD)筛查对于COPD患者至关重要。缺乏对COPD患者BMD降低的研究。
■探讨COPD患者骨密度降低和骨质疏松的危险因素。
■我们共纳入81例AECOPD患者,他们于2019年7月1日至2020年1月31日期间入院。将患者分为BMD正常组,BMD降低组和OP组。用ROC曲线下面积探讨CT值在骨异常诊断中的价值,并收集临床指标。
■椎体松质骨的CT值与BMD的T值高度相关(R>5.5,P<0.0001)。采用多元Logistic回归分析,我们发现COPD持续时间,BMI,25-羟维生素D3和长期吸入糖皮质激素是影响COPD患者不同BMD水平的独立因素。各组骨形成指标差异无统计学意义。β-crossL与血清IL-6呈负相关(r=-0.254,P=0.022),ALP与血清TNF-α呈正相关(r=0.284,P=0.023)。
■胸腰段椎体松质骨CT在骨异常诊断中具有潜在价值。COPD持续时间,BMI,25-羟维生素D3和长期吸入糖皮质激素可能有助于COPD患者的BMD降低,血清IL-6和TNF-α调节COPD患者骨代谢。
UNASSIGNED: COPD, combined with Osteoporosis, has a high incidence and potential for great harm. Choosing an optimal diagnostic method to achieve bone mineral density (BMD) screening is crucial for COPD patients. Studies on COPD patients with BMD reduction are lacking.
UNASSIGNED: To identify the risk factors of BMD reduction and osteoporosis in COPD patients.
UNASSIGNED: We included a total of 81 patients with AECOPD, who were admitted to the hospital from July 1, 2019, to January 31, 2020. Patients were grouped into BMD normal group, BMD reduced group and OP group. The areas under ROC curve were used to explore the value of CT values in the diagnosis of bone abnormality, and clinical indicators were collected.
UNASSIGNED: The CT value of the vertebral cancellous bone is highly correlated with the T value of BMD (R > 5.5, P < 0.0001). Using multivariate Logistic regression analysis, we showed that COPD duration, BMI, 25-hydroxyvitamin D3, and long-term inhaled glucocorticoid were independent factors affecting different BMD levels in COPD patients. No significant difference in bone formation indexes between groups. β-crossL was negatively correlated with serum IL-6 (r=-0.254, P=0.022), and ALP was positively correlated with serum TNF-α (r=0.284, P=0.023).
UNASSIGNED: Thoracolumbar vertebral cancellous bone CT has potential value in the diagnosis of bone abnormality. COPD duration, BMI, 25-hydroxyvitamin D3, and long-term inhaled glucocorticoid may contribute to the BMD reduction in COPD patients, and serum IL-6 and TNF-α regulate bone metabolism in COPD patients.