Correlation Studies Of The Relationship Between Bone Mineral Density Reducing And Senile Coronary Heart Disease And Its Risk Factors

Objective To investigate the correlation between Bone Mineral Density(BMD)decrease and the incidence of senile coronary heart disease(CHD)in the elderly,to promulgate the close relationship between BMD decreases and the onset of CHD risk factors.To provide a relative and complete basic clinical evidence for further clinical research of the osteoporosis(Osteoporosis,OP)and CHD risk factors.To explore the new ideas for the clinical comprehensive prevention and the control of CHD and OP.Methods 1.Selected 152 elderly patients of the Geriatric medicine in the first affiliated hospital of Anhui University in July 2013 to August 2015.74 cases of male and 78 cases of female were included,age of 65~90 years old(76.5±7.93),all patients were performed to done dual-energy X-ray absorptiometry(DEXA)to determinated the BMD values;According to the measured BMD level,all finalists were divided into three groups which concluded about bone mass normal group(n=39,age75.2±5.35)and low BMD group(n=50,age76.3±5.78)and the OP group(n=63,age77.6±5.91).According to the diagnosed of coronary heart disease standard the three groups were further divided into CHD group(n=83,age77.2±5.39)and NCHD group(n=79,age76.7±5.78),and according to the gender whichwer further divided into male and female,total of 12 subgroups.2.Recorded the 24 hours average systolic blood pressure(24h SBP)and diastolic blood pressure(24h DBP)of all selected finalists,collected the weight and height,the smoking history,family history of coronary heart disease,history of whether had taken drugs which will affected bone density(such as calcium supplements,steroid hormones and double phosphonic acid salts)by asked,further calculated the body mass index(BMI),collected all finalists' serum total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-c),high density lipoprotein cholesterol(HDL-c),uric acid(UA),serum calcium(Ca)and phosphorus(P)concentrations.3.Analyzed and compared the differences between kind of gender and degree BMD level groups incidence of coronary heart disease(CHD);analyzed the basic data to compare the differences of levels of CHD and biochemical indexes and traditional risk factors among BMD groups;analyzed the correlation between BMD decrease and reduce CHD risk factors as well.To provide prevented and monited clinical references value of the OP and CHD early patients.Results 1.There was no statistically significant difference between low BMD groups and normal bone mass incidence of the elderly male CHD patients,(P>0.05);there was statistically significant difference between OP groups and normal bone mass between the elderly male CHD patients,(P>0.05);there were statistically significant difference between low BMD groups and OP groups and normal bone mass of the elderly female CHD patients,(P>0.05);the elderly female with low BMD group had relatively significant difference between bone mass normal group and OP group in coronary heart disease(CHD)(P<0.05);2.The comparison of kind BMD levels in the related risk factors and biochemical indexes of CHD: there had no statistically significant differences among groups of age,BMI,and serum Ca,P,BGP,TC,Hcy,2h PG and DBP level comparative(P>0.05);the level of SBP and LDL were gradually reduced in low BMD and OP group compared to bone mass normal group,the proportion of patients with smoking,and the TG,FPG,UA level were increased in OP group compared to bone mass normal group,while had a lower level HDL-c and E2 level,the difference was statistically significant(all P<0.05);3.The incidences of CHD risk factors comparison among different BMD level: the BMD and OP groups had higher prevalence in blood pressure,diabetes,hyperlipidemia than the normal bone mass group,with statistically significant difference(P<0.05);4.A multiariable Logistic regression analysis had showed low BMD and OP had a higher relative risk than the tradition of CHD risk factors with coronary heart disease(CHD)as the dependent variablly(age,smoking,SBP,BMI,TG,LDL-c,UA were included),(P=0.026,OR=0.026,95% CI=0.373~0.987);With reduced BMD(conclude OP)as dependent variable,the regression analysis of the gender,smoking,hypertension and CHD,hyperlipidemia,diabetes and other factors had showed that smoking,hypertension,CHD,hyperlipidemia were the major risk factors for BMD decrease.Conclusion 1.The incidence of low BMD patients with coronary heart disease in the eldly male have no obvious correlation between CHD patients or not,and the incidence of CHD are significantly increased between OP and BMD groups in the eldly;2.The eldly with OP is a systemic disease,the reduction of BMD level is closely relate to the risk factors of CHD such as hypertension,hyperlipidemia,which will affecte each other on the well,and promote the progress of elderly patients with CHD and OP jointly.3.Compared with traditional risk factors(age,smoking,SBP,BMI,TG,LDL-c,DM,etc.),BMD level reduction played a crucial role in the onset of senile CHD,on the other hand,these factors would affected the change of bone mass,CHD and OP should give a more comprehensive treatment and prevention in the process of the clinical.