Study On The Relationship Between Syndrome Types Of Kidney Deficiency And Hip Geometry In Postmenopausal Women

Objective:To explore the relationship between syndrome types of kidney deficiency and hip geometry in postmenopausal women,so as to provide reference for further improving the ability to predict and evaluate the risk of fragile fracture of hip in postmenopausal women and to prevent and treat osteoporosis more efficiently.Methods:From September 2017 to December 2018,a total of 685 postmenopausal women who volunteered to participate in the study in the Department of Osteoporosis Gene Syndrome,Fujian Institute of traditional Chinese Medicine were randomly selected for questionnaire survey and bone mineral density(BMD).100 subjects who did not meet the selection criteria were excluded from the research items such as hip geometric parameters detection and TCM syndrome differentiation.A total of 585 subjects were selected,aged between 41 and 90 years old,with an average age of 61.99±7.53 years.Divided into kidney yin Deficiency of kidney-yang,deficiency of both yin and yang of kidney,deficiency of kidney(other syndromes)and no deficiency of kidney were divided into three groups: normal bone mass,decrease of bone mass and osteoporosis.The bone mass loss and the distribution of each syndrome type in postmenopausal women,the correlation between hip geometric structure parameters and general data of BMD,and the comparison of BMD and hip geometric structure parameters in each syndrome group were analyzed statistically by SPSS20.0.Results:1.Correlation distribution:(1)Loss of bone mass(n%)in postmenopausal women: normal group(105/17.9%),bone mass reduction group(316/54.0%),osteoporosis group(164/28.0%).(2)Distribution of various syndrome types(n%): Kidney yin and yang deficiency group(150/25.6%),kidney yin deficiency group(137/23.4%),kidney deficiency(other syndromes)group(115/19.7%),no kidney deficiency group(93/15.9%),kidney yang deficiency group(90/15.4%).(3)The distribution of bone mass loss in each syndrome group: the normal bone mass in the non-kidney deficiency group was 38.7%,which was higher than that in the kidney deficiency syndrome group,and the osteoporosis rate was 8.6%,which was lower than that in the kidney deficiency syndrome group.2.Correlation analysis of general data with BMD and hip geometric parameters in postmenopausal women: age,menopausal years were negatively correlated with BMD and hip geometric parameters:cross-sectional area(CSA),cross-sectional moment of inertia,(CSMI),section modulus(Z),cortical thickness(Cort)(P<0.001);and positively correlated with buckling ratio(BR)(P<0.001).There was a negative correlation between menarche age and BMD(P<0.05);height and weight and body mass index(BMI)were positively correlated with BMD and hip geometric parameters CSA,CSMI,Z,Cort(P<0.001),and negatively correlated with BR(P<0.001).3.Comparison of bone mineral density and geometric parameters of hip:(1)BMD in postmenopausal women with kidney deficiency groups(kidney yin deficiency group,kidney yang deficiency group,kidney yin yang deficiency group and kidney deficiency other syndrome groups)were significantly lower than that without kidney deficiency group(P<0.001);The levels of CSA,Z and Cort in each kidney deficiency syndrome group were significantly lower than those in the group without kidney deficiency(P<0.05),and the levels of BR in the groups with kidney deficiency were significantly higher than those in the group without kidney deficiency(P<0.05),and the difference in CSA was the most significant(P<0.05).However,there were no significant difference in bone mineral density and geometric structure parameters of hip among different syndrome types of kidney deficiency(P>0.05);(2)There were no significant difference in bone mineral density and geometric structure parameters of postmenopausal women in the kidney deficiency syndrome groups in postmenopausal women without osteoporosis.BMD was significantly lower than that in the non-kidney deficiency group,hip geometric parameters CSA,CSMI,Z,Cort,were significantly lower in the kidney deficiency syndrome groups than in the non-kidney deficiency group;BR,kidney deficiency syndrome groups were significantly higher than that in the non-kidney deficiency group,and the hip geometric parameters in the kidney deficiency syndrome group were significantly lower than those in the non-kidney deficiency group.There was no significant difference in geometric parameters between BMD and hip between different syndromes groups of kidney deficiency(P>0.05);(3)There were no significant difference in BMD and geometric structure parameters of hip among postmenopausal women with osteoporosis.Conclusion:1.In postmenopausal women,the number of kidney deficiency accounted for the vast majority.Kidney yin deficiency syndrome and kidney yin yang deficiency syndrome were the most common,kidney deficiency(other syndrome types)was the second,kidney yang deficiency syndrome was relatively few,kidney deficiency was closely related to the incidence of osteoporosis.2.The increase of age and menopausal years is a risk factor for the decrease of BMD and hip bone strength in postmenopausal women,while the higher BMI is the protective factor to enhance BMD and hip bone strength.3.In postmenopausal women,kidney deficiency was the risk factor for the decrease of hip bone strength and fragile fracture of hip.There was no significant difference in hip bone strength among the syndrome types of kidney deficiency(kidney yin deficiency,kidney yang deficiency,kidney yin yang deficiency and kidney deficiency other syndromes).