慢性血液透析患者骨质疏松症的风险因素

M. Errihani, A. Sobhi, K. Hassani, S. Benbria, D. Kabbaj
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摘要

导读:血液透析患者。与慢性肾病相关的骨质疏松症是一种复杂的疾病,其发病率和死亡率与骨折风险有关。骨质疏松症的发病率很高,但临床和生物学因素的归因却不甚明了。我们的研究旨在确定骨质疏松症的患病率和相关因素。研究方法横断面研究纳入了 40 名至少接受过 6 个月血液透析的慢性病患者。所有受试者均接受了腰椎(LS)和股骨颈(FN)的双能 X 射线吸收测量法(DXA)骨质密度(BMD)检测。数据通过描述性分析进行统计分析。根据 T 评分将患者分为两组,即骨质疏松组(T 评分≤-2.5)和非骨质疏松组(T 评分>-2.5)。所研究的风险因素[年龄、血液透析持续时间、甲状旁腺激素(PTH)、碱性磷酸酶(ALP)和腹主动脉钙化(AAC)]已通过逻辑回归进行了搜索。结果显示平均年龄为 59 ± 16 岁,47% 为女性,血液透析时间的中位数为 54 个月。腰椎骨质疏松症患病率为 27.5%,股骨颈骨质疏松症患病率为 32.5%。关于危险因素,在单变量分析中,与腰椎骨质疏松症相关的因素有年龄(P=0.034)、PTH(P=0.024)、AAC(P=0.024)、ALP(P=0.027),而在多变量分析中,只有PTH与骨质疏松症显著相关(P=0.019)。在 FN,单变量分析中与骨质疏松症相关的因素有年龄(p=0.03)、AAC(p=0.01)、ALP(p=0.04),多变量分析中与 APL 相关(p=0.035)。结论骨质疏松症与骨转换异常有关。我们建议使用 DXA 定期筛查骨折风险,并及早纠正失调。
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Risk Factors for Osteoporosis in Chronic Hemodialysis Patients
Introduction: in hemodialysis patients. Osteoporosis associated with kidney disease chronic is a complex entity with significant morbidity and mortality relative to risk of fracture. Its prevalence is high, but the incrimination of clinical and biological factors remains poorly identified. The purpose of our study is to determine the prevalence and factors associated with osteoporosis. Methods: A cross-sectional study included 40 chronic hemodialysis patients for at least 6 months. All subjects underwent a bone mineral density (BMD) assay with dual-energy x-rays absorptiometry (DXA) at the lumbar spine (LS) and femoral neck (FN). Data were statistically analyzed by means of descriptive analysis. Patients were divided into 2 groups based on the T-score to define the osteoporotic (t score≤-2.5) and the no-osteoporotic (t score>-2.5). The search for the risk factors studied [age, duration of hemodialysis, parathyroid hormone (PTH), alkaline phosphatases (ALP), and calcification of the abdominal aorta (AAC)] has been carried out by logistic regression. Results: The average age was 59 ± 16 years, 47% were women, and the median of hemodialysis duration was 54 months. The prevalence of osteoporosis at the lumbar spine was 27.5% and at the femoral neck was 32.5%. Regarding risk factors, at the LS, the factors associated with osteoporosis retained in the univariate analysis were age (p=0.034), PTH (p=0.024), AAC (p=0.024), ALP (p=0.027) and in the multivariate analysis, only PTH was significantly associated (p=0.019). At the FN; The factors associated with osteoporosis retained in analysis univariate were age (p = 0.03), AAC (p = 0.01), ALP (p=0.04) and in analysis multivariate was the APL (p= 0.035). Conclusion: Osteoporosis is associated with turnover abnormalities. We suggest that regular screening for fracture risk using DXA and early correction of the disorders.
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