Analysis Of Osteoporosis Associated Risk Factors And TCM Syndrome Types In Older Men

Objective?To detection the GH,IGF-1 and Bone metabolic markers(ipads metabo lic markers,BMMS)levels and Bone mineral density of primary osteoporosi s;?To explore the correlation between the bone mineral density of patien ts with primary osteoporosis?age and the serum GH?IGF-1;?To parallel c omparison and analysis the positive rate and the sensitivity of serum G H?IGF-1 and Bone metabolic markers(BMMS)in the primary osteoporosis;?we explores different syndrome types in the distribution characteristics of primary osteoporosis according to the TCM syndrome differentiation at the same time.Methods(1)According to the criteria for the diagnosis of osteoporosi,186 c ases of patients with osteoporosis and 121 cases selected from 616 cases of patients are divided into group of 52 cases of postmenopausal osteopor osis,older women osteoporosis group 74 cases,osteoporosis in older men,22 cases s(the age of 70 is alzheimer's disease,due to the group of 50-69-year-old male patients with osteoporosis number too little negligib le),Women ? 45 years old,male ? 70 years old,the average age of 73.45 ±9.89 years old;(2)Using Lunar Prodigy dual-energy X-ray(DEXA)bone mineral density instrument measure bone mineral density and By Swiss roche Elecsys2010 t ype automatic electrochemical luminescence immunity analyzer and form a c omplete set of sample kit to detect growth hormone(GH)?insulin-like gro wth factor-1(IGF-1)?N the osteocalcin(BGP)?parathyroid hormone(PTH)?the general type 1 amino terminal propeptide(P1NP)and beta collagen deg radation products(?-CTX);(3)All of the data and serum bone density of the input are summarized by the use of statistical software EpiData 3.1 and checked doublly.Date were analyzed by using SPSS 21.0 and expressed as mean ±standard error t o find the correlation between primary osteoporosis' Bone mineral density?Bone metabolic markers(BMMS)and the GH/IGF-1 axis,tParallel comparison a nd analysis of three groups of GH,IGF-1 and BMMS positive rate and posit ive change(To use P<0.05 show statistically significant difference and use person correlation analysis the relationship between indicators and 1 istcorrelation coefficient r and P.using the regression analysis to list the regression equation);(4)The object of study on the questionnaire included:weight,height,B ody mass index,living habits,Past medical history,history of drug and so on.And according to the correlation of all four examinations of TCM,it ca n be divided into the kidney-Yang deficiency,Liver-Kidney Yin deficiency,spleen-kidney-yang deficiency And Qi Stagnation Blood Stasis.Results(1)The average and comparison results of GH?IGF-1 of three groups s how that GH average high and low for osteoporosis in older men<postmenopa usal osteoporosis group<elderly women osteoporosis group,there was no si gnificant difference three groups(P>0.05),IGF-1 average high and low fo r osteoporosis in older men group<elderly women osteoporosis group<post menopausal osteoporosis group,there was significant difference between e lderly women osteoporosis group and postmenopausal osteoporosis group(P>0.05);(2)The correlation of GH,IGF-1 and BMD,age of Primary osteoporosis patients shows that the GH has a negatively correlation with the BMD of L 1-L4 and femoral neck BMD,it is statistical significance(P<0.05),the cor relation coefficient respectively r=-0.153,r2=-0.168,p1=0.041,p2=0.024,;the IGF-1 has a positively correlation with great trochanter BMD and a ne gatively correlation with age,the correlation coefficient r1=0.161,r2=-0.188,p1=0.032,p2=0.012,the regression equation is:GH=-0.874*L1-L4BMD+l.270,GH=-1.603*femoral neck BMD+1.568,IGF-1=66.872*great trochanter BMD+27.919,IGF-1=-0.805*age+131.242;(3)The correlation of GH,IGF-1 and BMD,age of Postmenopausal osteop orosis group shows that GH and IGF-lhave no correlation with BMD and age;(4)The correlation of GH,IGF-1 and BMD,age of older women osteoporo sis group shows that GH has a negatively correlation with the BMD of L1-L 4 BMD,he correlation coefficient r=-0.208,p=0.046,IGF-1 has a positively correlation with great trochanter BMD,the correlation coefficient of r=0.273,p=0.008,the regression equation is:GH=-1.287*L1-L4 BMD+1.717,IGF-1=87.277*great trochante BMD+13.157;(5)The correlation of GH,IGF-1 and BMD,age of Osteoporosis in olde r men group shows that GH has a negatively correlation with the femoral n eck BMD and big tuberosity BMD,the correlation coefficient respectively r1=-0.638,r2=-0.467,p1=0.000,p2=0.014,the regression equation is:GH=-6.255*femoral neck BMD+4.134,GH=-3.017*great trochante BMD+2.416,IGF-1 ha s no correlation with BMD and age;(6)The compared results of three groups of indicators show that the i ndexes in postmenopausal osteoporosis group size as follows:the proporti on of BGP(40%)?IGF-1(30%)?PINP(20%)??-CTX(17%)?PTH(13%)?GH(0),osteoporosis in older women group each index proportion size:IGF-1(46%)?P1NP(38%)?BGP(30%)??-CTX(30%)?PTH(25%)?GH(0),oste oporosis in older men group each index proportion size:IGF-1(70%)?BGP(52%)?P1NP(26%)??-CTX(19%)?PTH(19%)?GH(7%);(7)Positive predictive value of GH in each group:old male osteoporos is group?postmenopausal osteoporosis?older women osteoporosis group;Positive predictive value of IGF 1 in each group:old male osteoporosis group?postmenopausal osteoporosis?older women osteoporosis group;P ositive predictive value of PTH in each group comparison:older women ost eoporosis group?older men osteoporosis group?postmenopausal osteopor osis group;P1NP in each group of positive comparison:older women osteop orosis group?elderly male osteoporosis group?postmenopausal osteopor osis group;Beta CTX in each group the positive rate of comparison:elder ly male osteoporosis group?older women osteoporosis group?postmenopa usal osteoporosis group;BGP in each group the positive rate of compariso n:elderly male osteoporosis group?postmenopausal osteoporosis group?older women osteoporosis group;(8)0n different parts of the bone density,the comparison results of BM D of L1-L4 is no statistical significance(P>0.05).In the femoral neck B MD,spleen and kidney Yang deficiency group(P<0.05)and liver and kidney Y in deficiency group(P<0.05)compared with qi and blood stasis group were different;about upper femoral neck BMD,liver and kidney Yin deficiency gr oup(P<0.05)compared with qi and blood stasis group is different.Conclusion(1)The GH and IGF-1 have associated with patients with primary osteopo rosis bone density,especially in patients with senile osteoporosis bone mineral density;Artificially adjust or control could affect the level of serum GH,IGF-1,changes of patients with primary osteoporosis bone miner al density,especially the change of the patients with senile osteoporosi s,bone density,can indirectly reflect the status of osteoblast activity,could for the development of a new kind of train of thought and theory b asis for gene therapy method.(2)IGF-1 positive rate of senile osteoporosis diagnosis sensitivity is larger,the diagnosis of osteoporosis in older men,in particular,may b ecome a new kind of auxiliary diagnostic indicators provide train of thou ght and theory;(3)In BMMS,BGP has the highest sensitivity to primary osteoporosis di agnosis,PTH lowest,P1NP and beta-ctx is balance;(4)The patient of the postmenopausal osteoporosis and old male osteop orosis group given priority to the spleen and kidney Yang deficiency synd rome is easy to develop osteoporosis.The older women osteoporosis group is given priority to the liver and kidney Yin deficiency syndrome.The spl een and kidney Yang deficiency and the liver and kidney Yin deficiency h ave a higher percentage in the study.To prevent brittle fracture,we shoul d pay more important attention to the two card type and adopt early inter vention treatment which provides a new thinking for a better prevention a nd treatment of osteoporosis.