Correlation Between 25-hydroxyvitamin D3 With Bone Mineral Density And FRAX Score In Elderly Patients

Objective To investigate the relationship between 25-hydroxyvitamin D3 levels in elderly patients and fracture risk calculated by the Fracture Risk Assessment(FRAX).Methods 1.Select patients aged 60 years or older who were hospitalized in the Department of Internal Medicine,Affiliated Hospital of Qingdao University from September 2016 to September 2017.Average age: 70.85 years,male: 141 cases,female: 165 cases,according to inclusion criteria And exclusion criteria determine the study subject.2.Collection of relevant clinical data Refer to the medical records of all included subjects and record the femoral neck,lumbar 2-4(L2-4)and hip bone mineral density and serum 25(OH)D3 and other biochemical indicators,and record all 25(OH)D3 concentration tertiles were divided into T1,T2 and T3.3.Use the computer to calculate the FRAX fracture risk for 10 years based on the clinical data and bone density of the standardized fracture risk assessment sheet.4.Analyze the relationship between different 25(OH)D3 levels and bone mineral density and FRAX 10-year fracture risk.5.All data were analyzed using statistical software SPSS 21.0.Quantitative data were described in the form of mean±standard deviation().Single-factor tests were performed using the ANOVA,t-test,or ?2 test for hypothesis testing;the bivariate correlations were described using Spearman rank correlation coefficients.When multivariate analysis was performed,a multiple regression equation model was established.All test levels were bilateral ?=0.05.Results 1.Compared with the general situation of male and female,in 306 cases,BUN,UA,Scr,e GFR and 25(OH)D3 were significantly higher in males than females(P<0.05),and LDL and HDL in females.ALP and P were significantly higher than those of men(P<0.05).2.Male and female BMD-L1,BMD-L2,BMD-L3,BMD-L4,BMD-neck,BMD-wards triangle,BMD-larger trochanter,BMD-femoral shaft,T-femoral neck,T-wards triangle,The t-vernacle,T-L1,T-L2,T-L3,and T-L4 showed that the male group was significantly higher than the female group by two independent sample t-test results,and the differences were statistically significant(all P<0.05).The two groups of PMOF female were significantly higher than the male,the difference was statistically significant(P<0.05);the PHF female was significantly lower than the male,the difference was also statistically significant(P<0.05).Osteoporosis in men ratio of 20.57%,a decrease of bone mass 53.9%,the proportion of osteoporosis was 44.85%,the ratio of female osteopenia 43.03%,significantly higher than men(P<0.05).3.All subjects were sx ?divided into three groups according to the 25(OH)D3 tertile,which were T1,T2,and T3.The e GFR of each group was analyzed by one-way ANOVA.The overall difference was statistically significant(P<0.05).Further using the LSD method to compare the results between groups showed that the e GFR in the T2 group was significantly higher than that in the T1 group and the T3 group(P<0.05);there was no significant difference between the T1 group and the T3 group(P>0.05).The analysis of alanine aminotransferase in female groups by one-way ANOVA showed that the overall difference was statistically significant(P<0.05).4.Stepwise regression analysis showed that there was a correlation between 25(OH)D3 and BMD and T values of all sites after adjustment for various related confounding factors(all P<0.05).The non-standardized coefficients of all models were greater than 1,indicating a positive correlation;25(OH)D3 was negatively correlated with PMOF and PHF,and the non-standardized coefficients were all less than 1(all P<0.05).Conclusions 1.The level of 25(OH)D3 in elderly patients is low,and the level of 25(OH)D3 in older men is higher than that in women.Women are more prone to osteoporosis than men.2.There was a positive correlation between bone mineral density and 25(OH)D3 in elderly patients,and there was a negative correlation between the probability of fractures(PMOF)at the main site in 10 years and the probability of hip fracture(PHF)at 10 years and 25(OH)D3,so 25(OH)D3 may be a protective factor for bone density and FRAX score.