中老年女性腰椎、髋部、前臂骨密度和骨质疏松检出率的对比分析

目的 探讨中老年女性在应用双能X线骨密度仪检测不同部位骨密度时应关注检测的部位。 方法 选取2012年9月至2014年4月在我院行双能骨密度检测的中老年女性,比较腰椎、髋部、前臂桡骨下1/3的骨密度（BMD）和T值。结果 中老年女性腰椎、髋部、前臂桡骨下1/3 3个部位的BMD和T评分比较,P<0.001有显著差异。随着年龄逐渐增大,腰椎、髋部和前臂BMD逐渐降低,但70岁以后腰椎BMD趋于平稳。腰椎T评分在40岁和50岁年龄段下降幅度较快,60岁以后下降有所减缓,70岁以后趋于平稳。髋部T评分在各年龄段呈匀速下降。前臂T评分随着年龄的增大下降幅度明显大于腰椎和髋部。骨质疏松检出率也随年增加而增加,重度骨质疏松检出率也以前臂为最高。结论 应用双能X线骨密度仪检测腰椎、髋部、前臂3个部位,经比较发现老年女性前臂骨密度和T评分明显低于腰椎和髋部,提示对老年女性骨质疏松诊断应同时检测前臂骨密度,以免出现骨质疏松的漏诊。     

男性骨密度测量中不同部位骨质疏松检出率差异的比较

目的探讨中国男性腰椎与左右侧股骨不同部位骨质疏松检出率的差异。方法选取246例50~65岁健康男性,双能X线吸收法测量其腰椎、左右两侧股骨(包括股骨颈、粗隆、全髋)的骨密度,根据不同部位的T值得出相应的骨质疏松检出率,比较分析各部位检出率的差异。结果不同部位骨质疏松检出率分别为腰椎16.3%、左侧股骨颈32.1%、右侧股骨颈30.9%、左侧粗隆13.4%、右侧粗隆16.7%、左侧全髋16.7%、右侧全髋15.0%,约30%的男性股骨存在左右侧相差0.5个T值以上。综合选取上述最低T值得出的检出率为41.1%,明显高于选取单一部位T值得出的骨质疏松检出率(P=0.000)。结论综合选取多部位中最低的T值作为判断标准,能够提高中国男性骨质疏松的检出率,减少漏诊率。     

双能X线骨密度测定腰椎和股骨颈对诊断骨质疏松检出率的比较

目的探讨双能X线吸收法测量腰椎及股骨颈两个不同部位骨密度对骨质疏松诊断的检出率,寻找灵敏度高、更经济实用的筛查骨质疏松的有效方法方法 2011年1月至2012年12月在我院妇科及老年病科住院的女性患者共732人,分别测量腰椎及股骨颈的骨密度T值,进行SPSS统计研究。结果对同一人群通过股骨颈和腰椎不同部位检测发现骨质疏松的检出率分别为25.4%,32.0%;严重骨质疏松的检出率分别为9.0%,27.9%;两者之间差异有统计学意义(P=0.001),腰椎骨密度测量对骨质疏松诊断检出率明显优于股骨颈。根据4个年龄组的股骨颈和腰椎的骨密度T值比较差异均有统计学意义(P均0.01)。结论采用双能X线骨密度测定对诊断骨质疏松腰椎明显优于股骨颈。     

腰椎骨质增生患者不同部位骨密度检查的临床分析

目的探讨骨质增生对不同部位骨密度测定的影响。方法以本院就诊有明确骨质增生的患者为研究对象(试验组),将无骨质增生患者作对照(对照组)。首先比较两组年龄、性别构成、髋部和腰椎骨密度T值、骨量分布情况的差别,然后将两组腰椎T值和髋部T值进行组内相关性分析。结果①试验组腰椎T值显著高于髋部T值,差异有统计学意义(P<0.01);对照组腰椎T值与髋部T值比较,差异无统计学意义(P>0.05)。②试验组髋部骨量与腰椎骨量差异显著,差异有统计学意义(P<0.05);对照组髋部骨量与腰椎骨量比较,差异无统计学意义(P>0.05)。③试验组腰椎正位T值与髋部T值存在正相关(r=0.657,P<0.01);对照组腰椎正位T值与髋部T值也存在正相关(r=0.968,P<0.01)。结论髋部骨密度检查可提高腰椎骨质增生患者骨质疏松的检出率。     

青年人群骨密度及标准差对骨质疏松检出率的影响研究

目的 探讨青年人腰椎BMD和SD正常参考值影响骨质疏松症(OP)检出率的程度.方法 用GE-Lunar 公司的DXA仪测量骨密度,调查全国6个中心11418例腰椎PA和髋部BMD,建立了骨密度参考数据库.6个中心的仪器内部精度0.3%～0.7%,仪器间的精度1.1%.从T-score=(受试者BMD-青年人平均BMD)÷青年人骨密度SD值公式中可知,OP检出率与青年人平均BMD呈正比与SD值呈反比.结果 用6个中心及总体各自的青年人平均BMD和SD值为参考标准.对同一人群计算T-score和获得的OP检出率则不相同;发现青年人平均BMD每变化0.01g/cm2,则OP检出率变化1.6%(呈正相关),其SD值每变化0.01 g/cm2,则OP检出率变化4%(呈负相关).结论 青年人平均BMD和SD值不同引起OP检出率也不相同.为了让不同中心的OP检出率有可比性,建议同一个类型的BMD仪,同一个种族,同一个地区用一个设计较完善大样本的参考数据库,以其青年人正常参考值计算T-score.     

北京市老年人腰椎与前臂骨密度的调查及相关分析

采用DEXA检查了北京市三个地区共625例60岁以上老年人腰椎与前臂的bone muneral densiny BMD)及骨质疏松患病率的情况．其中腰椎588例、前臂472例。女性腰椎BMD随年龄增高而逐渐递减(P＞0.05)；男性BMD与年龄无显相关(P＜0.05)。接年龄组比较，男性69岁。女性79岁“前．L1-4的BMD均由城区大于山区及平原。男性的骨质疏松患病率在各地区间无显性差异．女性则为城区小于平原及山区前臂BMD可不论男、女均与年龄呈负相关(P＜0.01)；60岁以后男性及女性BMD下降率最快的部位均为10%处。地区间同一年龄组BMD的比较：男性以10％部位最为敏感．均为城区大于平原；女性80岁以前．在UD及10%的部位敏感，为城区大于平原。骨质疏松的患病卑．男性各部位均为城区小于平原．女性在UD、33%两个部位为城区小于平原。在调查中发现，BMD较低的受试常伴有前瞥尺。桡骨远端长度变他，尺骨远端转桡骨远端长，形成一“台阶”样改变。经统计分析表明．“台阶”与UD部位BMD之间有显相关美系(P＜0．05)．骨质疏松(OP)试的“台阶”样变化比无OP受试的变化明显(P＜0.15)。作认为尺桡骨远端出现“台阶”样变化的原因可能是桡骨远端微小压缩骨折累积的结果。     

骨密度在髋部骨质疏松性骨折风险评估中的价值

目的评估骨密度在髋部脆性骨折风险预测中的临床价值。方法回顾性研究2014年6月至2019年6月在我院创伤骨科住院的老年髋部骨折患者72例,作为病例组,其中股骨转子间骨折31例,股骨颈骨折41例;对照组选择同期我院骨外科门诊老年体检者63例。使用DXA方法测量患者腰椎和健侧髋部(全髋部、转子间、股骨颈、Ward’s区)的骨密度;对照组测量腰椎和左侧髋部骨密度,统计分析测量结果。结果①骨折组腰椎、髋部骨密度均显著低于对照组,差异有统计学意义(P0.01);②转子间骨折组和股骨颈骨折组在腰椎和髋部区域骨密度比较差异均无统计学意义(P 0.05);③骨折组与对照组在转子间区的T值降低比例最大为122.1%,腰椎降低幅度最小为31.3%,余髋部的T值均有不同程度降低;④骨折后髋部和腰椎T值比存在倒置现象;⑤对照组和骨折组髋部骨质疏松程度比较,差异有统计学意义(P0.01);两组患者腰椎骨质疏松程度比较,差异无统计学意义(P0.05)。结论①髋部骨折患者骨密度均显著低于体检者,提示骨密度与髋部骨折具有一定相关性,但与髋部骨折类型无关;②在髋部骨折风险评估中,髋部骨密度相比腰椎更有价值;③当髋部与腰椎T值比出现倒置时,将不可避免发生髋部骨折;④骨量正常的部分患者发生了脆性骨折,而骨质疏松的部分患者却未发生骨折,表明影响骨折发生的因素除了骨密度外,可能和骨骼的微结构有关。     

宁波男性骨密度和骨质疏松影响因素的研究

目的评价宁波市男性健康人群的骨量和骨质疏松(OP)的发病情况。方法794名健康男性采用Sunlight的超声骨密度测定胫骨的超声速度值(SOS)。并按年龄、民族、生活习惯进行分组,以10岁为1个年龄组,生活习惯包括吸烟、酗酒、户外活动(大于1h/d)和喝咖啡者。结果宁波市男性骨SOS峰值年龄在30～39岁,60岁以后OP患病率23.4%,过量吸烟、饮酒和喝咖啡者骨SOS值低于同年龄组,户外活动者(如爬山、慢跑)平均日照不少于1h/d,骨质情况优于同年龄组其他人,骨质疏松患病率也较低,本市的不同民族男性各年龄段的骨质差异无显著性。结论宁波市健康男性骨质状况良好,但生活不良嗜好是本地区影响骨密度的重要因子,应当提倡良好的生活习惯。     

男性糖尿病患者骨密度和骨质疏松研究新进展

大量临床研究已证实糖尿病患者合并心脏、血管、神经等组织的慢性进行性病变,骨质疏松症是否与T2DM有必然关系至今尚存在争议.本综述选择男性2型DM患者作为研究对象,用双能X线吸收测量法测量其椎体、近端股骨的骨密度(bone mineral density,BMD),针对目前国内外有关男性糖尿病BMD和骨质疏松的研究作一综述.     

老年人腰椎正位及髓部骨密度测量结果分析

目的 了解老年腰椎及髋部骨密度(BMD)变化,并探讨不同部们测量点结果对骨质疏松症诊断的影响。方法 用法国产Lcxxos型双能x线骨密度测量仪(DEXA)对辽宁地区45-89岁老人腰椎正位及髋部骨密度测定,按年龄分组进行统计分析。结果 腰椎正位及髋部本组两性问BMD值差异有显著性(P<0.01),女性50-59岁骨量丢失较快,男性骨量丢失随年龄增长逐渐增加。且男性在75-89组腰椎BMD值保持稳定,并稍有升高趋势。各组腰椎BMD值明显高于髋部BMD值,差异有显著性(P<0.01)。腰椎BMD值诊断敏感性明显低于髋部BMD值。结论 在诊断骨质疏松症中髋部BMD值较腰椎正位BMD值更精确,且腰椎BMD值受影响因素较多,腰椎骨质增生、腰椎骨折畸形等。轻者应对异常高密区加以删除后分析,重者应避免应用压缩骨折明显或侧弯,前后凸明显,较重的腰椎增生性骨关节的腰椎前后位BMD值进行临床分析。这样才能保证诊断更准确。     

268例女性骨质疏松症不同部位骨密度研究

目的探讨骨质疏松症不同部位的诊断率,充实我国骨质疏松症诊断的数据,完善骨质疏松症的诊断标准。方法随机抽取我院门诊就诊的原发性骨质疏松症女性患者268例,测量腰椎、髋部的骨密度值,统计各部位的T值(T-Score),对T值进行统计分析。本研究结果列入范围为腰部(Total)正位(L1-L4)总体、髋部(Total)总体、股骨颈(Neck)、大转子(Troch)、转子间(Inter)、Wards。以上任一部位骨密度T值达≤-2.5SD就入围。结果T值≤-2.5SD的腰部(Total)共有238例;髋部(Total)共有63例;Neck共有176例;Troch共有39例;Inter共有40例;Wards共有209例。结论不同年龄阶段的女性,其不同部位骨质疏松检出率是不同的,在诊断骨质疏松时要参考患者的其他情况,依据不同部位的检测结果,作出综合评价。     

Relative contribution of body composition to bone mineral density at different sites in men and women of South Korea

We examined the relative contribution of body composition to bone mineral density (BMD) at various sites in 1406 Korean rural men and women, aged 19–80 years, from July to August 2004. The BMD was measured at peripheral (distal forearm and calcaneus) and central (lumbar spine at L1–L4, femoral neck, trochanter, and Ward's triangle) using dual-energy X-ray absorptiometry. In multivariate analyses, the linear regression models were adjusted for relevant covariates. In premenopausal women, only lean mass had a significant positive correlation with BMD at all sites. In postmenopausal women, fat mass was significantly positively correlated with BMD at all sites, except the Ward's triangle; fat mass was the only determinant of BMD at the lumbar, distal forearm, and calcaneus sites, whereas both lean and fat mass contributed to BMD at the hip, with the effect of lean mass being slightly greater than that of fat mass. In younger men, lean mass had a significant positive contribution to BMD at all sites, whereas fat mass appeared to contribute negatively to BMD at all sites, except the calcaneus. In older men, lean mass made a significant positive contribution to the BMD at all sites; fat mass also made a significant positive contribution to the BMD at the forearm and calcaneus. These data indicate that in the Korean rural population, lean mass may be an important determinant of the BMD, whereas fat mass may contribute positively to BMD only in postmenopausal women and older men.     

健康中年男性人体成分对骨密度的影响

目的探讨健康中年男性人体成分对骨密度影响,为男性骨质疏松早期防治提供理论依据。方法以上海市奉贤区128名年龄为40~60岁(平均49.10±6.40岁)的健康中年男性为研究对象,测定其身高、体重、腰围、臀围,并计算体重指数(BMI);利用问卷调查调查其文化程度、饮酒吸烟、豆制品及奶制品摄入情况、静坐时间、睡眠时间等一般情况;利用全自动生化分析仪测定血钙(Ca)、血磷(P)、肝肾功能(ALT、AST、BUN、Cr、UA)、血脂(TC、TG、HDL、LDL)、血糖(FPG、2h-PG),高压液相法测定糖化血红蛋白(HbA1c)等生化指标;采用双能X线骨密度仪测定腰椎、股骨颈、股骨干、股骨大粗隆和全身骨密度(BMD),并根据T值或Z值评分结果将所有研究对象分为骨量正常组和骨量低下组;采用人体成分分析仪测定体脂肪含量、蛋白质含量、无机盐含量、骨骼肌含量和各部位肌肉含量。结果 128名年龄为40~60岁健康中年男性中,骨质疏松患者3人,骨量减少患者44人。骨量正常组体重、BMI、腰围、臀围、睡眠时间、蛋白质含量、无机质含量、骨骼肌含量、各部位肌肉含量皆高于骨量低下组,血清尿素及吸烟人数比率低于骨量低下组,且差异具有统计学意义;两组年龄、身高、饮酒情况、文化程度、工作性质、豆制品摄入情况及奶制品摄入情况、Ca、P、Cr、UA、ALT、AST、TC、TG、HDL、LDL、FPG、2h-PG、HbA1c、体脂肪及体脂百分比皆无统计学差异。结论适当延长每天睡眠时间有利于预防骨质疏松的发生;体重、BMI、腰围、臀围是骨质疏松的保护因素,但需通过加强体育锻炼及合理饮食,增加骨骼肌、无机质及蛋白质等非脂肪含量来增加骨密度预防骨质疏松。     

Associations between amino acids and bone mineral density in men with idiopathic osteoporosis

Idiopathic osteoporosis in middle-aged men is characterized by low-level bone formation. Inhibited anabolism may be involved in the pathogenesis of the disease and amino acids may be of importance. In the present study fasting amino acid profiles in plasma and erythrocytes were determined in 22 male idiopathic osteoporosis (MIO) patients and in 20 age-matched healthy men and associated with bone mineral density, bone histomorphometry and hormones.The osteoporotic patients had normal plasma essential amino acids but increased non-essential amino acids (p = 0.001), particularly glutamine and glycine. The ratio essential/non-essential amino acids, an index of protein nutritional status, was decreased in the MIO patients (0.59 (0.04) μmol/l, mean (SD)), compared to controls (0.66 (0.05), p = 0.001).In the MIO patients, the ratio essential/non-essential plasma amino acids (r = 0.60, p = 0.003) was positively correlated with lumbar spine bone mineral density.The erythrocyte amino acids represent a large proportion of the free amino acids in blood. A novel finding was the lower levels of erythrocyte tryptophan in MIO (12 (2) μmol/l) compared to controls (16 (3), p = 0.001) and decreased erythrocyte/plasma ratio (0.28 (0.07) vs. 0.33, (0.06), p < 0.01), suggesting an altered amino acid transport of tryptophan between plasma and erythrocytes. In the combined group of MIO and control men (n = 42), bone mineral density was positively correlated with erythrocyte tryptophan in both the lumbar spine (r = 0.45, p = 0.003) and femoral neck (r = 0.56, p < 0.001). The bone histomorphometric variables wall thickness, trabecular thickness and mineral apposition rate were all positively associated with erythrocyte tryptophan levels in the MIO patients.In the combined group of MIO and controls, a multiple regression analysis showed that erythrocyte tryptophan could explain 22% of the variation of lumbar spine and 30% of the variation in femoral neck bone mineral density.We conclude that men with idiopathic osteoporosis have changes in free amino acid profiles which indicate their altered utilization. The correlations between tryptophan and bone mineral density and bone histomorphometry suggest a link between tryptophan and osteoblast function which may be important for bone health.     

Sarcopenia and its relationship with bone mineral density in middle-aged and elderly European men

Summary

The aim of this study was to determine the relationship between reduced muscle mass (sarcopenia) and areal bone mineral density (BMD_a) in middle-aged and elderly community-dwelling European men. Men with sarcopenia had significantly lower BMD_a and were more likely to have osteoporosis compared with men without sarcopenia.

Introduction

In men, the relationship between reduced muscle mass (sarcopenia) and BMD_a is unclear. This study aimed to determine this relationship in middle-aged and elderly community-dwelling men.

Methods

Men aged 40–79 years from the Manchester (UK) and Leuven (Belgium) cohorts of the European Male Ageing Study were invited to attend for assessment including dual-energy X-ray absorptiometry, from which appendicular lean mass (aLM), fat mass (FM) and whole-body, spine and hip BMD_a were determined. Relative appendicular skeletal muscle mass (RASM) was calculated as aLM/height². Muscle strength was assessed in subjects from Leuven. Sarcopenia was defined by RASM at <7.26 kg/m² and by the recent definition of the European Working Group on Sarcopenia in Older People (RASM at <7.26 kg/m² plus low muscle function). Linear regression was used to determine the associations between aLM, FM, muscle strength and BMD_a and logistic regression to determine the association between sarcopenia and osteoporosis.

Results

Six hundred seventy-nine men with a mean age of 59.6 (SD?=?10.7), contributed data to the analysis; 11.9 % were sarcopenic by the conventional definition. After adjustment for age and centre, aLM, RASM and FM were positively associated with BMD_a. Men with RASM at <7.26 kg/m² had significantly lower BMD_a compared with those with RASM at ≥7.26 kg/m². In a multivariable model, aLM was most consistently associated with BMD_a. Men with sarcopenia were more likely to have osteoporosis compared with those with normal RASM (odds ratio?=?3.0; 95 % CI?=?1.6–5.8).

Conclusions

Sarcopenia is associated with low BMD_a and osteoporosis in middle-aged and elderly men. Further studies are necessary to assess whether maintaining muscle mass contributes to prevent osteoporosis.     

Parity and bone mineral density in middle-aged women

A retrospective study was carried out to determine the relationship between parity and bone mineral density (BMD) in middle-aged women. Eight hundred and twenty-five woman aged 41–76 years were recruited from four general practice registers in Cambridge. Subjects were unselected as to their health status. Each subject completed a detailed health questionnaire. Participation rate was 50%. The main outcome measure was BMD measured at the spine (L2–4,n=825) and hip (neck, intertrochanter and Ward's triangle;n=817) by dual-energy X-ray absorptiometry (DXA) using the Hologic QDR-1000 densitometer. It was found that the unadjusted mean BMD was significantly higher at all sites among the parous women (p=0.031 to <0.00001), and remained significantly higher at the femoral neck (p=0.025), intertrochanter (p=0.001) and Ward's triangle (p=0.045) after adjusting for age and body mass index (BMI). Similar findings were seen after stratifying for potential confounding variables. There was a consistent upward trend of BMD with increasing parity at all sites. Parity remained a significant independent predictor of BMD at all sites after controlling for age, BMI, menopausal status, oral contraceptive and hormone replacement therapy use, smoking status and breast-feeding status in multiple linear regression analyses. There was, on average, a 1.0% increase in BMD per live birth. Our findings therefore suggest a positive relationship between parity and bone mass.     

苏南地区中青年男性人群骨密度及其生活习惯的相关性研究

目的调查苏南地区中青年男性体检人群骨密度及其与生活习惯的相关性,为本地区骨质疏松防治提供参考依据。方法选择2014年7月至2015年10月间1578例在我院体检的苏南地区≤60岁男性人群为研究对象,采用美国HOLOGIC公司的Discovery WI骨密度仪对受试者L1-L4椎体进行骨密度检测,同时自行设计调查表进行问卷。将824例骨质减少人群作为病例组,将754例骨质正常人群作为对照组进行研究。采用IBM SPSS19.0统计软件进行分析,以P0.05为差异有统计学意义。结果苏南地区男性人群在26~30岁形成腰椎骨量峰值,之后BMD逐渐下降,46岁以后BMD下降加速。运动、喝牛奶、吸烟及饮酒与骨质减少与否有关,差异有统计学意义(P0.05)。苏南地区中青年男性人群每天运动大于30 min的占31.115%、每天喝牛奶的占27.82%,而每天抽烟的占50.76%、每天喝酒的占43.346%。结论喝牛奶及30 min/d的运动是骨质健康的保护因素,吸烟和饮酒是骨质健康的危害因素。苏南地区中青年男性人群要改善现有的生活方式。     

Measurements of bone mineral density by DXA total body absorptiometry in different skeletal sites in postmenopausal osteoporosis.

In order to evaluate the bone mineral density (BMD) of the entire skeleton and its major anatomical areas, total body DXA absorptiometry was performed in 330 postmenopausal women whose ages ranged from 42-85 years. Sixty-three of them were normal women and constituted the control group (Group 1). Two hundred sixty-seven were patients affected with postmenopausal osteoporosis: 107 osteoporotic patients had vertebral biconcavity deformities of grade 1 (Group 2), and the other 160 had vertebral wedge, biconcavity, and compression deformities of grade 2 (Group 3). Total body absorptiometry was assessed by a DXA system (Lunar DPX). Significant reduction in total body BMD values was observed in patients in Groups 2 and 3 (p less than 0.01): the bone loss was more intense in osteoporotic women of Group 3. The low values of the BMD in osteoporotic patients are, moreover, localized in the areas of spine, arms, and legs; the osteopenia was particularly enhanced in patients with grade 2 vertebral deformities. Multiple linear regression indicated that values of total BMD were significantly related to age and BMI. Receiver operating characteristic (ROC) analysis showed that total BMD provided high sensitivity: At 90% of specificity it was 78% for Group 2 and 89% for Group 3. DXA total body absorptiometry has demonstrated that, in postmenopausal osteoporotic women, the reduction in bone mass is not localized only in the spine, but also involves the appendicular skeleton.     

海口地区各年龄段人群骨密度变化及中老年骨质疏松患病率调查

目的分析海口地区常住居民各年龄段人群骨密度(bone mineral density,BMD)值变化情况,并调查分析中老年骨质疏松患病率。方法采用多阶段抽样法抽取海口地区常住居民2 176名,采用双能X线检测腰椎正位BMD、左髋部BMD,并根据性别、年龄分组对骨质疏松患病率进行分析,统计中老年(年龄≥46岁)骨质疏松患病率。结果 BMD值随年龄增加呈下降趋势,51岁以上男性BMD值同年龄段内女性,且组间差异有统计学意义(P0.05);男性在66～70岁年龄段BMD明显增加,其中L1～4最明显;女性51～55岁年龄段内BMD值下降最明显。海口地区城市女性Ward’s、Troch的BMD高于农村女性(P0.05)。海口地区中老年人骨质疏松总发生率为58.17%,中老年人骨质疏松发生率随年龄增加呈上升趋势;相同年龄段内,男性骨质疏松发生率低于女性,男性在66～70岁、76～80岁两个年龄段内骨质疏松发生率略下降。骨折发生率随年龄增加呈上升趋势,同年龄段内男性骨折发生率低于女性,女性76～80岁年龄段内骨折发生率最高;脊柱骨折发生率最高,81岁及以上年龄骨折发生率呈下降趋势。结论海口地区常住居民BMD随年龄增加下降,中老年骨质疏松发生率较高,且随年龄增加上升,女性骨质疏松发生率显著高于男性,因此应加强中老年群体干预与健康教育。