50歲以上婦女骨質密度和骨小樑指數與血清鹼性磷酯酶之相關性

Correlation of Bone Mineral Density and Trabecular Bone Score With Serum Alkaline Phosphatase in Women Over 50 Years Old

陳保良(Pao-Liang Chen) ； 王昱豐(Yuh-Feng Wang) ； 蔡依良(Yi-Liang Tsai) ； 廖建國(Jian-Guo Liao) ； 林明賢(Min-Hsien Lin) ； 莊紫翎(Tzyy-Ling Chuang)

《核子醫學暨分子影像雜誌》 35卷1期 (2022/03) Pp. 13-23

https://doi.org/10.6332/ANMMI.202203_35(1).0002

摘要

背景：本研究目的為骨質密度和骨小樑指數（trabecular bone score, TBS）是否與50歲以上女性的血清鹼性磷酸酶（alkaline phosphatase, ALP）數值相關。方法：本篇為回溯性研究，收集2014年11月至2021年7月於臺灣南部某教學醫院預防醫學中心接受健康檢查之女性。排除標準：包括年齡＜50歲、尚未停經、癌症、人體測量或實驗室數據不完整、骨質密度數據不完整。最終收集7,188位停經後婦女。數據分析，參與者根據骨密度分為三組：正常骨密度883位（12.1%）；低骨質密度3,687位（51.3%）；骨質疏鬆症2,618位（36.4%）。結果：本篇研究平均年齡為61.27±6.97歲（範圍51－88歲）。整體平均身體質量指數為23.72±3.33 kg/m^2，平均ALP為80.59±23.34 IU/L，平均TBS為1.301±0.095。數據分析顯示，低骨質密度組ALP數值為正常組的1.289倍（p＜0.001*），而骨質疏鬆組是正常組的1.599倍（p＜0.001*）。在TBS低骨密度組為正常組的0.313倍（p＜0.001*），而骨鬆組為正常組的0.111倍（p＜0.001*）。多元線性回歸逐步分析顯示，TBS和ALP具有顯著的反比關係。結論：在50歲以上女性中，我們觀察到ALP數值越高，TBS和骨質密度越低。

關鍵字

鹼性磷酯酶 ； 骨質密度 ； 骨小樑指數 ； 50歲以上婦女

並列摘要

Background: This study aims to determine whether bone mineral density and trabecular bone score (TBS) are related to serum alkaline phosphatase (ALP) levels in women over 50 years old. Methods: Women who received health examinations at a regional teaching hospital preventive medicine center in southern Taiwan were retrospectively recruited from November 2014 to July 2021. Exclusion criteria included age ＜ 50 years, premenopause, cancer, incomplete anthropometric or laboratory data, and lack of bone mineral density assessment. The final cohort included 7,188 postmenopausal women. For data analysis, the participants were divided into subgroups based on bone density: normal bone density, 883 (12.1%); low bone density, 3,687 (51.3%); osteoporosis, 2,618 (36.4%). Results: The mean age of the cohort was 61.27 ± 6.97 years (range, 51-88 years). The total cohort had a mean body mass index of 23.72 ± 3.33 kg/m^2, mean ALP 80.59 ± 23.34 IU/L, and mean TBS 1.301 ± 0.095. Data analysis revealed that participants with low bone density had ALP levels 1.289 times that of the normal group (p ＜ 0.001*), and osteoporosis group had ALP levels 1.599 times that of the normal group (p ＜ 0.001*). In TBS, the low bone density group was 0.313 times that of the normal group; while the osteoporosis group was 0.111 times that of the normal group. Multiple linear regression stepwise analysis showed that TBS and ALP had a significant inverse relationship. Conclusions: Among women over 50 years old, we observed that the higher the ALP level, the lower the TBS and bone density.

並列關鍵字

alkaline phosphatase ； bone mineral density ； trabecular bone score ； women over 50 years old