Correlation Between Body Mass Index And Vitamin D And Tcm Syndrome Type Of 0steoporosis In Postmenopausal Women

Purpose:To investigate the correlation between Body Mass Index(BMI)and serum vitamin D levels in postmenopausal women and TCM syndrome types of postmenopausal osteoporosis(PMOP).The aim is to provide new ideas for better guidance of TCM syndrome differentiation and TCM prevention and treatment of PMOP.Methods:According to the inclusion criteria,253 postmenopausal women were enrolled in the osteoporosis clinic of Jinan community and the Affiliated Hospital of Shandong University of Traditional Chinese Medicine.Among them,147 were non-osteoporosis patients and 106 were osteoporosis patients.253 postmenopausal women were divided into four groups according to BMI:BMI<18.5kg/m~2was considered as lean group,18.5kg/m~2≤BMI<24kg/m~2was considered as normal group,24kg/m~2≤BMI<28kg/m~2was considered as hyperrecombinationgroup,and≥28kg/m~2was considered as obesity group.General information was collected and height and weight were measured.Bone mineral density(BMD),serum 25 hydroxyvitamin D(25(OH)D)and serum Parathyroid hormone(PTH)were determined.The correlation between BMI and serum 25(OH)D and bone density was analyzed.According to TCM syndrome differentiation,106 cases of osteoporosis women were divided into three types:liver-kidney Yindeficiency,spleen-kidney Yang deficiency and kidney blood stasis.The correlation between BMI and TCM syndrome types of postmenopausal osteoporosis was studied,and spss25.0 software was used forstatistical analysis.Results:1.General information results show:There were no statistically significant differences in age,height and serum PTH among lean group,normal group,superstructure group and obesity group(P>0.05).The difference in body weight was statistically significant(P<0.05),and pairwisecomparison between groups was statistically significant(P<0.05).2.The correlation between different BMI groups and serum 25(OH)D was shown:There was no correlation between BMI of lean group,normal group and excess recombinant BMI and serum 25(OH)(P>0.05),while BMIof obesity group was negatively correlated with serum 25(OH)D,with statistical significance(P<0.05).Obesity was divided into moderate obesity(28kg/m~2≤BMI≤30kg/m~2),moderate obesity(30kg/m~2<BMI≤35kg/m~2)and excessive obesity(BMI>35kg/m~2).There was no statistical significance in serum25(OH)D between the three groups with different degrees of obesity(P>0.05).There was no correlation between BMI and serum PTH in lean group,normal group,superrecombinant group and obese group,and the difference was not statistically significant(P>0.05).3.The correlation between different BMI groups and bone density was shown:BMI of lean group and superrecombinant group was positively correlated with BMD of forearm,L1-4BMD of lumbar spine and total BMD ofhip,with statistical difference(P<0.05).There was no correlation between BMI and forearm BMD,lumbar L1-4BMD and hip BMD inthe normal group,with no statistical significance(P>0.05)(which may be related to the small sample size).BMI in obesity group wasnegatively correlated with forearm BMD,lumbar L1-4BMD and hip BMD,and the difference was statistically significant(P<0.05).Obesity was divided into moderate obesity,moderate obesity and excessive obesity.Lumbar L1-4BMD and hip BMD in moderate obesity group werehigher than those in moderate obesity and excessive obesitygroup,the difference was statistically significant(P<0.05),while there was no statistically significant difference among other groups(P>0.05).4.The correlation between BMI and PMOP TCM syndrome type showed that:The BMI difference of liver-kidney Yin deficiency group,spleen-kidney Yang deficiency group and kidney deficiency blood stasis group was statistically significant(P<0.05),and the BMI of spleen-kidney Yang deficiency type was greater than that of the other two groups,the difference was statistically significant(P<0.05).There were differences in the distributionof TCM syndrome types of PMOP among different BMI groups(P<0.05).The proportion of PMOP with spleen-kidney Yang deficiency type in the excessive obesity group was large,and the difference was statistically significant(P<0.05),while there was no statistical significance in the distribution of TCM syndrome types of PMOP among the other groups(P>0.05).Conclusion:1.Increased body weight has a protective effect on bones,but when BMI exceeds a certain range,that is,BMI>30kg/m~2,bone density tends to decrease.2.The serum 25(OH)D level is generally low in postmenopausal obese women,and obesity is easy to cause low serum 25(OH)D level,which may be unfavorable to the prevention of PMOP.3.Excessive obesity(BMI>35kg/m~2)is a risk factor for postmenopausal osteoporosis of spleen-kidney Yang deficiency type.