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目的探讨慢性阻塞性肺疾病(COPD)患者血清瘦素与骨密度相关关系。方法采用横断面研究纳入本组的COPD患者26例,健康对照组25例,应用放射免疫检测方法检测血清瘦素,双能x线吸收测定仪行腰椎(L2-4)、股骨颈(Neck)、股骨三角(W ard’s)及股骨大转子(Troch)骨密度检测。结果(1)COPD患者血清瘦素较健康对照组低(P<0.001);(2)COPD组,病程>10年或有过呼吸衰竭患者的血清瘦素高于病程<10年或无呼吸衰竭的患者(P均=0.006);COPD患者血清瘦素与L2-4(r=-0.56,P=0.003)、Neck(r=-0.55,P=0.004)、W ard’s(r=-0.48,P=0.013)及Troch(r=-0.45,P=0.022)骨密度存在明显负相关。结论瘦素可能参与COPD骨矿含量丢失机制发生,且血清瘦素水平可作为COPD骨量丢失的预测因子。
Objective To investigate the relationship between serum leptin and bone mineral density in patients with chronic obstructive pulmonary disease (COPD). Methods Twenty-six patients with COPD and 25 healthy controls were enrolled in this study. Serum leptin levels were measured by radioimmunoassay. Dual-energy x-ray absorptiometry was performed on lumbar spine (L2-4), neck of femur , Femoral triangle (W ard’s) and femoral trochanter (Troch) bone mineral density test. Results (1) Serum leptin in patients with COPD was lower than that in healthy controls (P <0.001). (2) Serum leptin levels in patients with COPD, patients with over 10 years of history or those with respiratory failure were higher than those with less than 10 years of disease or no respiratory failure (R = -0.56, P = 0.004), W ard’s (r = -0.48, P = 0.013) and Troch (r = -0.45, P = 0.022). Conclusion Leptin may be involved in the mechanism of bone mineral loss in COPD, and serum leptin level may be used as a predictor of bone loss in COPD.