Bone density and hemoglobin levels in older persons: results from the InCHIANTI study
Bone density and hemoglobin levels in older persons: results from the InCHIANTI study
复制标题
DOI：
10.1007/s00198-004-1739-6
复制
发表时间：
2005-06-01
影响因子：
4
通讯作者：
Ferrucci, L
中科院分区：
文献类型：
--
作者：
Cesari, M;Pahor, M;Ferrucci, L
低氧血症已被认为是骨质流失的一个危险因素。本研究的目的是调查骨量和骨密度测量与贫血和血红蛋白水平在一个大样本的老年社区居住的人。这项研究是基于950名参加“基安蒂地区衰老”研究的参与者的数据。所有的分析都考虑了持续血红蛋白水平以及二分性贫血变量（根据WHO标准定义为女性血红蛋白< 12 g/dl，男性血红蛋白< 13 g/dl）。对所有参与者进行右小腿外围定量计算机断层扫描（pQCT），以评估总骨密度、小梁骨密度、皮质骨密度以及皮质与总骨面积之比。在调整人口统计学、慢性病、肌肉力量和生物学变量后，采用线性回归分析评估pQCT骨骼测量与贫血和血红蛋白水平的多变量关系。参与者年龄为75.0岁（SD 6.9）。在我们的样本中，101名参与者（10.6%）贫血。在女性中，评估pQCT骨测量值（每SD增加）与血红蛋白水平/贫血之间相关性的校正线性回归分析系数显示，贫血与总骨密度显著相关（β =） 0.335， SE= 0.163；P= 0.04)、皮质骨密度（β =） 0.428， SE= 0.160；P = 0.008)。发现贫血与小梁骨密度和皮质骨面积与总骨面积之比的关系具有临界意义。血红蛋白水平与骨小梁骨密度（beta= 0.112， SE= 0.049， P= 0.02）、总骨密度（beta= 0.101， SE= 0.046， P= 0.03）、皮质骨密度（beta= 0.100， SE= 0.046， P= 0.03）、皮质骨与总面积之比（beta= 0.092， SE= 0.045， P= 0.04）存在显著相关。在男性中，血红蛋白水平与总骨密度（β = 0.076， SE= 0.036， P= 0.03）和皮质骨密度（β = 0.095， SE= 0.41， P= 0.02）存在显著相关性。据报道，贫血与皮质骨密度之间的关系具有临界意义。我们得出的结论是，贫血和低血红蛋白水平与骨量和骨密度呈负相关和独立相关。与血红蛋白水平相关的骨质流失主要发生在皮质骨。血红蛋白水平较低的女性比男性骨质流失更严重。
Hypoxemia has been recognized as a risk factor for bone loss. The aim of the present study is to investigate the relationship of bone mass and density measures with anemia and hemoglobin levels in a large sample of older community-dwelling persons. The study is based on data from 950 participants enrolled in the "Invecchiare in Chianti'' ( Aging in the Chianti area, InCHIANTI) study. All the analyses were performed considering continuous hemoglobin levels as well as the dichotomous anemia variable ( defined according to WHO criteria as hemoglobin < 12 g/dl in women and < 13 g/dl in men). A peripheral quantitative computerized tomography (pQCT) scan of the right calf was performed in all participants to evaluate total bone density, trabecular bone density, cortical bone density, and the ratio between cortical and total bone area. Linear regression analyses were used to assess the multivariate relationship of pQCT bone measures with anemia and hemoglobin levels after adjustment for demographics, chronic conditions, muscle strength and biological variables. Participants were 75.0 (SD 6.9) years old. In our sample, 101 participants (10.6%) were anemic. In women, coefficients from adjusted linear regression analyses evaluating the association between pQCT bone measures ( per SD increase) and hemoglobin levels/anemia showed significant associations of anemia with total bone density ( beta=) 0.335, SE= 0.163; P= 0.04) and cortical bone density (beta=) 0.428, SE= 0.160; P= 0.008). Relationships with borderline significance were found for the associations of anemia with trabecular bone density and the ratio between cortical and total bone area. Significant associations were found between hemoglobin levels and trabecular bone density (beta= 0.112, SE= 0.049; P= 0.02), total bone density (beta= 0.101, SE= 0.046; P= 0.03), cortical bone density (beta= 0.100, SE= 0.046; P= 0.03) and the ratio between cortical bone and total area (beta= 0.092, SE= 0.045; P= 0.04). In men, significant associations were found for hemoglobin levels with total bone density (beta= 0.076, SE= 0.036; P= 0.03) and cortical bone density (beta = 0.095, SE= 0.41; P= 0.02). A borderline significance was reported for the association between anemia and cortical bone density. We concluded that anemia and low hemoglobin levels are negatively and independently associated with bone mass and density. The bone loss associated with hemoglobin levels mainly occurs in the cortical bone. Women with lower hemoglobin levels demonstrate a higher bone loss than male counterparts.