实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (8): 847-850.doi: 10.3969/j.issn.1003-9198.2025.08.019

• 临床研究 • 上一篇    下一篇

老年女性心脏X综合征与骨代谢标志物的关联研究

王宇, 贺勤, 戴玉玲, 包志娟, 黄菁菁, 张琼   

  1. 210031 江苏省南京市,南京医科大学第四附属医院老年医学科(王宇,黄菁菁,张琼);
    210031 江苏省南京市, 南京普斯康健养老服务中心(贺勤,戴玉玲);
    210032 江苏省南京市,南京市江北新区泰山街道桥荫路社区卫生服务站(包志娟)
  • 收稿日期:2024-12-24 出版日期:2025-08-20 发布日期:2025-08-19
  • 通讯作者: 张琼,Email:1067020228@qq.com
  • 基金资助:
    江苏省妇幼健康研究会 2023 年度委托研究课题(JSFY202306)

Association study of biomarkers of bone metabolism and risk of cardiac syndrome X in elderly women

WANG Yu, HE Qin, DAI Yuling, BAO Zhijuan, HUANG Jingjing, ZHANG Qiong   

  1. Department of Geriatrics, the Fourth Affiliated Hospital of Nanjing Medical University, Nanjing 210031, China (WANG Yu, HUANG Jingjing, ZHANG Qiong);
    Nanjing Pusikangjian Elderly Service Center, Nanjing 210031, China (HE Qin, DAI Yuling);
    Qiaoyin Road Community Health Service Station, Taishan Subdistrict, Jiangbei New Area, Nanjing 210032, China (BAO Zhijuan)
  • Received:2024-12-24 Online:2025-08-20 Published:2025-08-19
  • Contact: ZHANG Qiong, Email: 1067020228@qq.com

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摘要： 目的 探究老年女性心脏X综合征(CSX)的相关危险因素,重点关注骨密度及骨代谢标志物对CSX的影响。 方法 选取2021—2024年于南京医科大学第四附属医院老年医学科住院治疗的256例老年女性病人,分为CSX组(126例)和对照组(非CSX病人,130例),比较2组一般临床资料、骨密度及骨代谢相关指标,采用logistic回归分析老年女性CSX的影响因素。 结果 CSX组酗酒、吸烟、高血压、骨质疏松比例,LDL-C、心电图ST段压低水平均高于对照组(P＜0.05),HDL-C、雌二醇水平、腰椎/股骨颈骨密度、25羟维生素D水平低于对照组(P＜0.05);CSX组骨碱性磷酸酶(BALP)、骨钙素(BGP)、Ⅰ型前胶原N端前肽(P1NP)水平高于对照组(P＜0.05);Logistic回归分析提示,股骨颈骨密度降低、雌二醇水平下降、LDL-C水平升高,及P1NP、BALP、BGP水平升高是老年女性CSX的独立危险因素。 结论 低骨密度、低雌二醇水平、高LDL-C水平及高骨转换标志物共同驱动老年女性CSX发生,临床防治需协同优化骨代谢与心血管风险干预策略。

关键词: 老年女性, 心脏X综合征, 骨密度, 骨代谢

Abstract: Objective To investigate the risk factors associated with cardiac syndrome X (CSX) in the elderly women, with a particular focus on the impact of bone mineral density (BMD) and bone metabolism markers. Methods A total of 256 elderly women admitted to the Fourth Affiliated Hospital of Nanjing Medical University from 2021 to 2024 were divided into the CSX group (n=126) and the control group (n=130). The general clinical data, bone mineral density (BMD) and bone turnover markers were compared between the two groups, and the influencing factors of CSX in the elderly women were analyzed by logistic regression analysis. Results The CSX group showed higher proportion of alcohol abuse, smoking, hypertension and osteoporosis, along with elevated levels of low-density lipoprotein cholesterol (LDL-C) and electrocardiograph ST-segment depression, compared with the control group (P<0.05). Conversely, the levels of high-density lipoprotein cholesterol (HDL-C) and estradiol were significantly lower in the CSX group (P<0.05). The BMD of lumbar spine and femoral neck, and the level of 25-hydroxyvitamin D were significantly lower (P<0.05), and the levels of bone alkaline phosphatase (BALP), osteocalcin (BGP), and procollagen Ⅰ N-terminal propeptide (P1NP) were significantly higher in the CSX group than those in the control group (P<0.05). Logistic regression analysis revealed that decreased femoral neck BMD, reduced estradiol level, elevated LDL-C, and increased levels of P1NP, BALP, and BGP were independent risk factors for CSX in the elderly women. Conclusions Reduced BMD, hypoestrogenism, dyslipidemia, and increased bone turnover jointly drive the incidence of CSX in the elderly women. Integrated management should target both bone metabolism and cardiovascular risk.

Key words: elderly women, cardiac syndrome X, bone mineral density, bone metabolism

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