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目的采用骨小梁分数(TBS)这种新型的骨微结构评价指标,探讨他汀类药物对骨小梁微结构的影响。方法回顾南京医科大学第一附属医院老年医学科2014年1月—2016年3月收治的中老年患者253例,根据是否服用他汀类药物分为他汀组(服用他汀类药物1年以上)90例和对照组(从未服用过他汀类药物)163例。观察2组血清三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、碱性磷酸酶、空腹血糖等生化指标及25羟维生素D水平。双能X线骨密度仪(DXA)检测腰椎及股骨颈骨密度,TBS i Nsight?软件分析腰椎DXA图像得出TBS值。结果他汀组的总胆固醇及低密度脂蛋白胆固醇水平低于对照组(P<0.01),而2组其他生化指标差异均无统计学意义(P>0.05)。他汀组较对照组具有更高的腰椎BMD(g/cm2:1.04±0.19 vs.0.96±0.14,P<0.01)及TBS(1.31±0.09 vs.1.26±0.09,P<0.01),但2组股骨颈BMD差异无统计学意义(P>0.05)。结论他汀类药物使用可以提高中老年人群腰椎骨密度,并改善骨小梁微结构。
OBJECTIVE: To evaluate the effect of statins on the microstructure of trabecular bone by using the new bone microstructure evaluation index of trabecular bone fraction (TBS). Methods A retrospective study of 253 cases of middle-aged and elderly patients admitted to the First Affiliated Hospital of Nanjing Medical University from January 2014 to March 2016 was divided into statin group (taking statins more than one year) according to whether they took statins or not And control group (never took statins) 163 cases. Serum triglyceride, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, alkaline phosphatase, fasting blood glucose and other biochemical markers and 25-hydroxy vitamin D were observed in two groups. Dual-energy X-ray absorptiometry (DXA) was used to detect lumbar and femoral neck BMD. TBS i Nsight ™ software was used to analyze lumbar DXA images for TBS. Results The levels of total cholesterol and low density lipoprotein cholesterol in the statin group were lower than those in the control group (P <0.01). There was no significant difference in other biochemical indexes between the two groups (P> 0.05). The statin group had higher lumbar spine BMD (g / cm2: 1.04 ± 0.19 vs.0.96 ± 0.14, P <0.01) and TBS (1.31 ± 0.09 vs.1.26 ± 0.09, P <0.01) Neck BMD difference was not statistically significant (P> 0.05). Conclusion The use of statins can improve lumbar BMD of middle-aged and elderly people and improve the trabecular structure.