[1]钟巍,梁晓敏,黄佳纯,等.血小板计数与血清高密度脂蛋白胆固醇含量比值与腰椎骨密度的关系研究[J].中医正骨,2026,38(01):17-22.
　ZHONG Wei,LIANG Xiaomin,HUANG Jiachun,et al.Association of platelet to high-density lipoprotein cholesterol ratio with lumbar spine bone mineral density[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2026,38(01):17-22.
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血小板计数与血清高密度脂蛋白胆固醇含量比值与腰椎骨密度的关系研究()

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第38卷
期数:
2026年01期
页码:
17-22
栏目:
骨质疏松症
出版日期:
2026-01-20

文章信息/Info

Title:
Association of platelet to high-density lipoprotein cholesterol ratio with lumbar spine bone mineral density
作者:
钟巍1; 梁晓敏1; 黄佳纯2; 黄宏兴2; 万雷2; 张志海2
1.广州中医药大学第三临床医学院,广东 广州 510006; 2.广州中医药大学第三附属医院,广东 广州 510378
Author(s):
ZHONG Wei1; LIANG Xiaomin1; HUANG Jiachun2; HUANG Hongxing2; WAN Lei2; ZHANG Zhihai2
1.The Third Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong,China; 2.The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510378,Guangdong,China
关键词:
骨质疏松;  骨密度;  腰椎;  血小板计数;  胆固醇; HDL;  回归分析
Keywords:
osteoporosis;  bone density;  lumbar vertebrae;  platelet count;  cholesterol; HDL;  regression analysis
摘要:
目的:探讨血小板计数与血清高密度脂蛋白胆固醇含量比值(platelet to high-density lipoprotein cholesterol ratio,PHR)与腰椎骨密度的关系。方法:纳入美国国家健康与营养调查数据库中2011—2018年的11 005名参与者。计算参与者的PHR,根据PHR的四分位数将参与者分为4组,比较4组参与者的人群特征。采用回归分析分析PHR与腰椎骨密度的关系,并按照性别、年龄、是否合并高血压、是否合并糖尿病、体质量指数(body mass index,BMI)5个因素分别进行亚组分析,对于亚组分析中与PHR存在交互作用的因素,进一步进行非线性关系验证。结果:①分组结果。参与者PHR的四分位数分别为3.690、4.750、6.080,Q1组(PHR≤3.690)参与者2751名,Q2组(3.690<PHR≤4.750)参与者4500名,Q3组(4.750<PHR≤6.080)参与者2500名,Q4组(PHR>6.080)参与者1254名。②不同PHR参与者的人群特征分析结果。4组参与者的年龄、性别、教育程度、收入与贫困基线比值、吸烟、合并高血压、合并糖尿病、BMI、腰椎骨密度及血清糖化血红蛋白、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、尿素氮、尿酸含量的组间差异均有统计学意义(H=13.453,P=0.025; χ2=12.081,P=0.042; χ2=17.181,P=0.001; H=2.741,P=0.000; χ2=16.246,P=0.002; χ2=17.181,P=0.000; χ2=15.245,P=0.001; F=2.471,P=0.001; F=0.627,P=0.000; H=6.245,P=0.020; F=14.588,P=0.030; F=17.245,P=0.001; F=12.235,P=0.000; H=4.257,P=0.040; F=4.256,P=0.023)。③PHR与腰椎骨密度的关系分析结果。线性回归及Logistic回归分析结果均显示,PHR与腰椎骨密度呈负向非线性关系。亚组分析结果显示,在男性、女性、20岁≤年龄<29岁、29岁≤年龄<39岁、49岁≤年龄<59岁、不合并高血压、不合并糖尿病及18.5 kg·m-2≤BMI<25 kg·m-2、25 kg·m-2≤BMI<30 kg·m-2亚组中,PHR与腰椎骨密度均呈负向关系; PHR与性别、年龄、是否合并高血压、是否合并糖尿病不存在交互作用(P=0.505,P=0.103,P=0.437,P=0.337),与BMI存在交互作用(P=0.049)。分段线性回归分析结果显示,在BMI≥30 kg·m-2亚组中,PHR与腰椎骨密度的关系存在拐点(PHR=5.806); 当PHR≤5.806时,PHR与腰椎骨密度呈负向线性关系[β=-0.009,95%CI(-0.014,-0.004),P=0.000]; 当PHR>5.806时,PHR与腰椎骨密度的关系无统计学意义[β=0.003,95%CI(-0.001,0.005),P=0.230]。结论:PHR与腰椎骨密度整体上呈负向非线性关系,但在肥胖人群中二者的关系存在拐点,当PHR≤5.806时二者呈负向线性关系,当PHR>5.806时二者之间没有关系。
Abstract:
Objective:To investigate the relationship of platelet to high-density lipoprotein cholesterol ratio(PHR)with lumbar spine bone mineral density(BMD).Methods:Eleven thousand and five participants from National Health and Nutrition Examination Survey(NHANES)database between 2011 and 2018 were included in the study.The PHR of the participants was calculated,and then the included participants were categorized into 4 groups according to the quartiles of PHR,the population characteristics of the 4 groups were compared.After that,the association between PHR and lumbar spine BMD were examined by regression analyses,and the subgroup analyses were conducted,respectively,based on gender,age,whether combined with hypertension,whether combined with diabetes mellitus,and body mass index(BMI).For factors showing significant interaction effects with PHR in the subgroup analyses,the non-linear relationships were further explored.Results:①Grouping.The participants' PHR quartile thresholds were 3.690,4.750,and 6.080,respectively.The 11 005 participants were categorized into Q1 group,Q2 group,Q3 group,and Q4 group,with 2751 ones in Q1 group(PHR≤3.690),4500 ones in Q2 group(3.690<PHR≤4.750),2500 ones in Q3 group(4.750<PHR≤6.080),and 1254 ones in Q4 group(PHR>6.080).②Population characteristics among participants with different PHR.Significant differences were observed among the 4 groups in age,gender,education level,family income-to-poverty ratio,smoking,combined with hypertension,combined with diabetes mellitus,BMI,and lumbar spine BMD,as well as serum levels of glycated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),blood urea nitrogen(BUN),and uric acid(H=13.453,P=0.025; χ2=12.081,P=0.042; χ2=17.181,P=0.001; H=2.741,P=0.000; χ2=16.246,P=0.002; χ2=17.181,P=0.000; χ2=15.245,P=0.001; F=2.471,P=0.001; F=0.627,P=0.000; H=6.245,P=0.020; F=14.588,P=0.030; F=17.245,P=0.001; F=12.235,P=0.000; H=4.257,P=0.040; F=4.256,P=0.023).③Association between PHR and lumbar spine BMD.Both linear and logistic regression analyses revealed a significant inverse nonlinear relationship between PHR and lumbar BMD,and this inverse relationship between PHR and lumbar BMD was observed in the subgroups including male,female,participants aged 20 to <29 years,29 to <39 years,49 to <59 years,those without hypertension or diabetes mellitus,and those with BMI 18.5 to <25 kg/m(2)or 25 to <30 kg/m(2).Moreover,the PHR showed no significant interaction effects with the factors such as gender,age,whether combined with hypertension,or whether combined with diabetes mellitus(P=0.505,P=0.103,P=0.437,P=0.337),but a significant interaction effect with BMI(P=0.049).Furthermore,the piecewise linear regression analysis identified a threshold point in the relationship between PHR and lumbar BMD in the subgroup of participants with a BMI≥30 kg/m(2)(PHR=5.806).When the PHR was≤5.806,a significant inverse linear association was observed between PHR and lumbar BMD(β=-0.009,95%CI(-0.014,-0.004),P=0.000); in contrast,when the PHR was>5.806,the association between PHR and lumbar BMD was not statistically significant(β=0.003,95%CI(-0.001,0.005),P=0.230).Conclusion:PHR exhibits an inverse nonlinear association with lumbar BMD,however,this association exhibits a threshold effect among the obese individuals:at PHR≤5.806,the PHR demonstrates an inverse linear relationship with lumbar BMD; while,at PHR>5.806,no significant association exists between the both.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(82274551); 广东省科技计划项目(2024A1111120018); 广州市荔湾区科技计划项目(20240612)
通信作者:张志海 E-mail:13725295793@139.com
(收稿日期:2025-02-22 本文编辑:吕宁)
更新日期/Last Update: 2026-01-20