摘要
目的骨质疏松症是中老年人群常见且重要的健康问题,肺功能受损可能对骨骼健康产生潜在影响。本研究基于2007-2010年NHANES数据,系统探讨肺功能指标、骨密度(bone mineral density,BMD)与骨质疏松症之间的关系。方法本研究为横断面研究,纳入3547名50岁及以上成年人。通过FEV1、FVC及FEV1/FVC评估肺功能,BMD测量部位为股骨颈,骨质疏松症的诊断依据世界卫生组织标准。采用多变量逻辑回归模型分析肺功能与骨质疏松症的关联,并调整年龄、性别、种族、吸烟、饮酒、BMI及共病情况等混杂因素。通过Hexbin图展示肺功能与BMD的联合分布,并采用限制立方样条(RCS)模型评估肺功能与骨质疏松症之间的非线性关系。进一步进行亚组分析,并使用森林图展示FEV1/FVC与不同人群骨质疏松风险之间的关联特征。结果较低的肺功能显著增加骨质疏松症的风险。在FEV1/FVC最高四分位数人群中,骨质疏松症的比值比(OR)为0.50(95%CI:0.29~0.85,P=0.015)。基础数据分析显示,骨质疏松症患者的FEV1/FVC值(0.71±0.10)显著低于无骨质疏松症者(0.75±0.09,P<0.001)。RCS分析揭示FEV1/FVC(P=0.014)和FVC(P=0.239)与骨质疏松症之间存在显著的非线性关系,而FEV1的非线性关联较弱(P=0.195)。亚组分析结果在各人群中一致,进一步支持该关联的稳健性。结论中老年人群中,肺功能下降(如FEV1、FVC及FEV1/FVC降低)与骨质疏松症风险增加密切相关。该研究提示,常规监测肺功能有望成为骨质疏松症早期预防和干预的重要策略。
Objective Osteoporosis is a common and significant health concern among middle-aged and older adults.Impaired lung function may have a potential impact on bone health.This study aimed to systematically explore the relationship among lung function parameters,bone mineral density(BMD),and osteoporosis based on data from the 2007–2010 National Health and Nutrition Examination Survey(NHANES).Methods This cross-sectional study included 3,547 adults aged 50 years and older.Lung function was assessed using forced expiratory volume in one second(FEV1),forced vital capacity(FVC),and the FEV1/FVC ratio.BMD was measured at the femoral neck.Osteoporosis was diagnosed according to the World Health Organization(WHO)criteria.Multivariable logistic regression models were used to analyze the association between lung function and osteoporosis,adjusting for potential confounders such as age,sex,race,smoking,alcohol consumption,body mass index(BMI),and comorbidities.A hexbin plot was used to illustrate the joint distribution of lung function and BMD.A restricted cubic spline(RCS)model was applied to assess nonlinear relationships between lung function and osteoporosis.Subgroup analyses were performed.A forest plot was used to display the association between FEV1/FVC and osteoporosis risk across different population subgroups.Results Lower lung function was significantly associated with an increased risk of osteoporosis.Participants in the highest quartile of FEV1/FVC had a 50%lower risk of osteoporosis(OR=0.50,95%CI:0.29-0.85,P=0.015).Baseline analysis showed that osteoporosis patients had a significantly lower FEV1/FVC value(0.71±0.10)than those without osteoporosis(0.75±0.09,P<0.001).RCS analysis revealed significant nonlinear relationships between FEV1/FVC(P=0.014)and FVC(P=0.239)with osteoporosis risk,while the nonlinear association for FEV1 was weaker(P=0.195).Subgroup analysis result were consistent across various populations,supporting the robustness of the association.Conclusion Among middle-aged and older adults,reduced lung function(as indicated by lower FEV1,FVC,and FEV1/FVC)is closely associated with an increased risk of osteoporosis.These findings suggest that routine lung function monitoring may serve as an important strategy for the early prevention and intervention of osteoporosis.
作者
曲振
陈思曌
程春丽
刘志文
李泽鹏
孙志佳
李俊杰
黄宏兴
QU Zhen;CHEN Sizhao;CHENG Chunli;LIU Zhiwen;LI Zepeng;SUN Zhijia;LI Junjie;HUANG Hongxing(The Third Clinical Medical College of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405;Shandong the Second Rehabilitation Hospital,Taian 271000,Shandong;The Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510378,China)
出处
《中国骨质疏松杂志》
北大核心
2026年第1期54-60,共7页
Chinese Journal of Osteoporosis
基金
山东省中医药科技项目(M20242901)。
