| ObjectiveQuantitative computed tomography(QCT)was used to detect lumbar spine volumetric bone mineral density(vBMD)and visceral adipose tissue(VAT)area in postmenopausal women,and to observe the relationship between lumbar spine vBMD and Omentin-1 level and VAT.To investigate the relationship between abdominal fat distribution and lumbar spine vBMD and the risk factors of PMOP in postmenopausal women.MethodsA total of 206 postmenopausal women aged 50～70 years were selected from June to December 2022 for physical examination in the health management center of our hospital.On the basis of 64-slice spiral CT scanning,the lumbar spine(L1～L2)vBMD was measured by QCT,and its average value was taken.At the same time,the abdominal VAT area and abdominal subcutaneous adipose tissue(SAT)area were measured,and the VAT/SAT ratio was calculated.According to the mean value of lumbar spine vBMD,the subjects were divided into three groups: 66 patients in the normal bone mass group,91 patients in the osteopenia group,and 49 patients in the osteoporosis group.Subjects’ names,sex,age,menopause years,past medical history,drug use,smoking,alcohol consumption,systolic blood pressure(SBP),diastolic blood pressure(DBP),height,weight,and body mass index(BMI)were recorded.5ml fasting venous blood was extracted from all subjects and sent to the laboratory of our hospital for the determination of fasting blood glucose(FPG),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),alkaline phosphatase(ALP),serum uric acid(UA),aspartate aminotransferase(AST),and alanine aminotransferase(ALT),γ-glutamyl transpeptidase(GGT),blood calcium(Ca),blood phosphorus(P)levels.3ml of serum samples were reserved and stored in the-80° refrigerator for later use.2ml serum samples were collected and sent to the isotope room of our hospital for detection of parathyroid hormone(PTH),25-hydroxyvitamin D [25(OH)D],serum procollage 1N-terminal peptide(P1NP),serum β-isomer of Cterminal telopeptide of type 1 collagen(β-CTX)and fasting insulin(FIns)levels.Homeostasis model insulin resistance index(HOMA-IR)was calculated.Another 1ml serum sample was taken to detect Omentin-1 by enzyme linked immunosorbent assay(ELISA).The general data and clinical indicators of the three groups were compared;The correlation between lumbar spine vBMD and serum Omentin-1,VAT area,VAT/SAT,clinical data and indicators was analyzed,and the correlation between serum Omentin-1,VAT/SAT and clinical data,clinical indicators was analyzed,and the influencing factors of vBMD were analyzed by multiple linear regression.The clinical value of serum Omentin-1 and VAT/SAT in predicting postmenopausal osteoporosis was analyzed using subject performance characteristic curve(ROC).Results1 Comparison of general data and clinical indicators among the three groups1.1 There were no significant differences in BMI,SAT area,TC,TG,HDL-C,LDL-C,FPG,PTH,UA,AST,ALT,ALP,GGT,SBP,DBP,Ca and P in the normal bone mass group,osteopenia group and osteoporosis groups(all P > 0.05).1.2 The age,menopause years,VAT area,VAT/SAT,HOMA-IR,FIns,P1 NP and β-CTX in osteoporosis group and osteopenia group were higher than those in normal bone mass group,while those in osteoporosis group were higher than those in osteopenia group,the difference was statistically significant(all P < 0.05).1.3 The vBMD,Omentin-1 and 25(OH)D in osteoporosis group and osteopenia group were lower than those in normal bone mass group,while those in osteoporosis group were lower than those in osteopenia group,with statistical significance(all P < 0.05).2 Spearman correlation analysis and multiple linear regression analysis2.1 Correlation of Lumbar spine vBMD with serum Omentin-1,VAT area,VAT/SAT,clinical data,and clinical indicatorsLumbar spine vBMD was positively correlated with serum Omentin-1 and 25(OH)D(r =0.386,0.540,all P < 0.05).Lumbar spine vBMD was negatively correlated with age,menopausal years,HOMA-IR,VAT area,VAT/SAT,P1 NP and β-CTX(r =-0.410,-0.443,-0.569,-0.219,-0.370,-0.533,-0.664,all P < 0.05).2.2 Correlation of serum Omentin-1 with VAT area,VAT/SAT,clinical data,and clinical indicatorsSerum Omentin-1 level was positively correlated with 25(OH)D level(r =0.166,P < 0.05).Serum Omentin-1 was negatively correlated with BMI,HOMA-IR,VAT area,VAT/SAT,P1 NP and β-CTX(r=-0.183,-0.275,-0.433,-0.392,-0.203,-0.350,all P < 0.05).2.3 Correlation between VAT/SAT and clinical data and clinical indicatorsVAT/SAT was positively correlated with menopausal years,BMI,HOMA-IR,P1 NP and β-CTX(r=0.208,0.209,0.342,0.149,0.171,all P < 0.05).VAT/SAT was negatively correlated with 25(OH)D(r=-0.204,P < 0.05).2.4 Multiple linear regression analysis was used to analyze the influencing factors of lumbar spine vBMDThe years of menopause,VAT/SAT,HOMA-IR,P1 NP,β-CTX and 25(OH)D were independent influencing factors for vBMD(β’ =-0.205,-0.132,-0.245,-0.191,-0.298,0.157,all P < 0.05).3 Clinical value of serum Omentin-1 and VAT/SAT in predicting postmenopausal osteoporosis3.1 Clinical value of serum Omentin-1 in predicting postmenopausal osteoporosis: The area under the ROC curve(AUC)was 0.744,the standard error(SE)was 0.38,the sensitivity was 76.4%,the specificity was 68.2%,the Youden index was 0.446,the best cut-off value was 37.03ng/mL,95%CI was 0.669～0.819,P < 0.001.3.2 Clinical value of VAT/SAT in predicting postmenopausal osteoporosis: The area under the ROC curve(AUC)was 0.657,the standard error(SE)was 0.039,the sensitivity was 62.1%,the specificity was63.6%,the Youden index was 0.258,and the best cut-off value was 1.241,95%CI was 0.580～0.734,P <0.001.Conclusions1.Serum Omentin-1 level is decreased and VAT/SAT ratio is increased in postmenopausal women with osteoporosis.2.VAT/SAT is a negative influence factor on lumbar spine vBMD,and the effect of adipose tissue on lumbar spine vBMD in postmenopausal women may depend on the type of abdominal fat distribution.3.The decrease of serum Omentin-1 level is a good predictor of PMOP. |
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