摘要目的 探讨主动脉钙化与绝经后妇女椎骨骨折发生风险的关系. 方法 选择561例≥60岁绝经后妇女,进行前瞻性研究,随访3年.根据主动脉钙化评分(ACS)分为四组:A组(ACS=0分)、B组(ACS=1～2分)、C组(ACS =3 ～6分)、D组(ACS＞6分).腰椎侧位X线片观察主动脉钙化及椎骨骨折发生情况.利用双能X线骨密度仪评估骨密度(BMD).根据ACS分为主动脉钙化组和无主动脉钙化组.采用Cox比例风险模型评估主动脉钙化与椎骨骨折风险的关系. 结果 主动脉钙化组椎骨骨折的发生率明显高于无主动脉钙化组(P＜0.01).当ACS增高时,椎骨骨折的发生率增加.在调整年龄、体重指数、BMD、吸烟、饮酒、高血压、糖尿病、总胆固醇、心肌梗死、卒中和25-羟基维生素后,D组(HR 3.03,95％ CI 1.42 ～6.24)、BMD(HR 2.82,95％ CI 1.75～5.68)、年龄(HR 1.96,95％ CI 1.38 ～ 4.52)、两次以上跌伤史(HR 1.45,95％ CI1.24 ～2.79)和脂联素水平(HR1.07,95％ CI1.22～2.31)与椎骨骨折的发生相关. 结论 严重主动脉钙化与绝经后妇女椎骨骨折的发生密切相关.

abstractsObjective To investigate the association between aortic calcification and risk of vertebral fracture in Chinese postmenopausal women.Methods This study recruited 561 postmenopausal women aged 60 or older who were prospectively followed for 3 years.Based on the ACS,the patients were divided into aortic calcification group (n =236) and non-aortic calcification group (n =325).Extent of aortic calcification and incidence of vertebral fracture were quantified on the baseline lateral radiographs of lumbar spine.Dual energy x-ray absorptiometry was utilized to evaluate the bone mineral density (BMD).Cox proportional hazards models were used to assess the associations between aortic calcification and risk of vertebral fracture.Results In aortic calcification group incidence of vertebral fracture was significantly higher than that in non-aortic calcification group (P ＜ 0.01).Moreover vertebral fracture presented an increased incidence while the ACS was higher.After the adjustment of age,body mass index,BMD,current smoking,current drinking,hypertension,diabetes,total cholesterol,myocardial infarction,stroke and 25-hydroxy vitamin D,aortic calcification with ACS ＞ 6(HR =3.03,95％CI 1.42-6.24),BMD (HR =2.82,95％ CI 1.75-5.68),age (HR =1.96,95％ CI 1.38-4.52),history of two or more falls (HR =1.45,95％ CI 1.24-2.79) and adiponectin (HR =1.07,95％ CI 1.22-2.31) were associated with increased risk of vertebral fracture.Conclusion Severe aortic calcification is closely associated with vertebral fracture for postmenopausal women.