The Change Of Serum High Density Lipoprotein Cholesterol In Chronic Obstructive Pulmonary Disease Patients With Osteoporosis

Objective: Study the relationship between high density lipoprotein cholesterol （HDL-c） andosteoporosis （OP） in Chronic Obstructive Pulmonary Disease（COPD）by observing changesof bone mineral density （BMD），HDL-c，interleukin-6 （IL-6） , tumor necrosis factor- alpha（TNF-α），body mass index（BMI） etc in COPD patients.Methods: 60 stable COPD patients were chosen as COPD group. And equal number of healthypeople matching the COPD group in age and gender made up of the control group. We collectedthe basic document of all objects including age、sex、smoking index and so on, by the form ofquestionnaire. BMD in lumbar vertebrae (L_1-4) and femoral neck were measured by dual energyX-ray, according to which the COPD group was divided into COPD-OP group andCOPD-NONE-OP group. Serum HDL-c was detected by an automatic biochemical analyzerusing immunodepression direct method, serum IL-6 and TNF-αby Enzyme-linkedimmunosorbent assay. Besides, we also tested COPD patients’ lung function and arterial partialpressure oxygen（PaO2）.Results:1. The level of BMI（23.21±3.20）kg/cm₂was obviously lower, and the rates of lowBMD（55/60，91.67%） or osteoporosis （26/60，43.33%） were significantly higher in COPD group,compared with those of the control group [（24.97±3.03）kg/cm₂,（25/60，41.67%）, （5/60，8.33%）, all P<0.05].2. Levels of HDL-c [（1.29±0.32） mmol/L, IL-6（18.82±12.87） pg/ml，TNF-α（123.01 109.55）pg/ml] in COPD group were higher than corresponding values from the control group[（1.13±0.22）mmol/L, （12.62±3.96） pg/ml，（66.08±47.16） pg/ml, all P<0.05)].3.The forced expiratory volume in one second （FEV1） percentage predicted（51.18±15.25 ）% and FEV1／forced vital capacity （ FVC） ratio （40.77±8.72）% were obviouslylower than those in COPD-NONE-OP group [ （62.15±20.12）%, （47.91±11.29 ）% , allP<0.05]．The level of BMI（22.07±3.12）kg/cm₂was obviously lower than in COPD-NONE-OPgroup（24.08±3.29）kg/cm₂. There was no significant difference in age, smoking index, IL-6 andPaO2levels between the two groups.4. COPD-OP group had much higher HDL-c and TNF-αlevels[（1.45±0.34） mmol/L,（158 .97±116.84） pg/ml] than COPD-NONE-OP group [ （1.17±0.24） mmol/L,（96.09±94.26）pg/ml, all P<0.05].5. The BMD of the left and right femoral neck in COPD patients had significantly negative correlation with HDL-c（r=-0.313,-0.350，all P<0.05） , and positive correlation with FEV1／FVC％or BMI （r=0.333,0.363,0.395,0.392, all P <0.05）．6. HDL-c had significantly negative correlation with FEV1% predicted, FEV1／FVC％andBMI （r=-0.368,-0.397,-0.361, all P<0.05）.7.The multivariate logistic analysis showed that HDL-c（P=0.026,OR=0.053）and BMI （P=0.032，OR=1.324） had significant impact on OP.Conclusion: COPD patients have significantly low BMD and higher serum HDL-c level, COPDcombined OP patients have much higher HDL-c. HDL-c has negative correlation with BMD andworse lung function.