Effects of total bilirubin on the prevalence of osteoporosis in postmenopausal women without potential liver disease
Effects of total bilirubin on the prevalence of osteoporosis in postmenopausal women without potential liver disease
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DOI：
10.1007/s00774-013-0452-y
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发表时间：
2013-11-01
影响因子：
3.3
通讯作者：
Choi, Yoon-Ho
中科院分区：
文献类型：
--
作者：
Bian, Lu-Qin;Li, Rong-Zhen;Choi, Yoon-Ho
总胆红素本身是否是绝经后妇女骨质疏松症的危险因素仍不确定，迄今为止还没有研究探讨这一重要问题。本研究旨在评估总胆红素对无潜在肝病的绝经后妇女骨质疏松症患病率的绝对影响。在本研究中，入组了接受骨密度测量的无潜在肝病的绝经后女性受试者（n = 918）。采用相关分析和Logistic回归分析总胆红素与其他变量的关系。因此，骨质疏松症患者的总胆红素水平显著降低（P = 0.005）。校正多个变量后，总胆红素升高0.1 mg/dl与骨质疏松风险的比值比降低38%相关[OR 0.62（95%CI 0.52-0.88），P = 0.012]。总胆红素与BMD独立相关[腰椎系数= 0.41，95%CI（0.35-0.47），P < 0.001;股骨颈系数= 0.44，95%CI（0.36-0.48），P < 0.001]。腰椎和股骨颈的z评分与总胆红素呈正相关（r = 0.33，P < 0.001; r = 0.37，P < 0.001），血钙与总胆红素呈正相关（r = 0.13，P < 0.001）。因此，这项研究表明，总胆红素和无潜在肝病的绝经后妇女骨质疏松症的患病率之间存在独立的负相关关系。总胆红素可作为这类人群骨质疏松症的临时性新危险因素。
It is still uncertain whether total bilirubin per se is a risk factor for osteoporosis in postmenopausal women and no study has so far examined this important issue. This study was designed to assess the sheer effects of total bilirubin on the prevalence of osteoporosis in postmenopausal women without potential liver disease. In the present study, postmenopausal female subjects without potential liver disease (n = 918) who underwent measurement of bone mineral density were enrolled. Correlation and logistic regression analysis were used to assess the relationship between total bilirubin and other variables. As a result, subjects with osteoporosis had a significantly lower total bilirubin level (P = 0.005). A 0.1 mg/dl increase in total bilirubin was associated with reduced odds ratio of the risk by 38 % for osteoporosis [OR 0.62 (95 % CI 0.52-0.88), P = 0.012] after adjustment for several variables. Total bilirubin was independently associated with BMD [coefficient = 0.41, 95 % CI (0.35-0.47), P < 0.001 for lumbar spine and coefficient = 0.44, 95 % CI (0.36-0.48), P < 0.001 for femur neck]. A positive correlation could be observed with significant difference between total bilirubin and z-score (r = 0.33, P < 0.001 for lumbar spine and r = 0.37, P < 0.001 for femur neck) and total bilirubin was positively correlated with serum calcium (r = 0.13, P < 0.001) as well. Therefore, this study demonstrates an independent inverse association between total bilirubin and the prevalence of osteoporosis in postmenopausal women without potential liver disease. Total bilirubin would be useful as a provisional new risk factor of osteoporosis in such a population.