北京地区9103例体检人群骨密度流行病学调查研究

目的调查北京地区9103例体检人群骨密度,探讨本地区原发性骨质疏松症流行病学情况。方法选择2012年3月-7月在我院体检的9103例汉族体检人群为研究对象,年龄16～93岁,采用韩国osteosys公司生产的ExA-3000型骨密度仪,检测受试者非受力侧前臂尺桡骨中远端1/3处骨密度,建立信息采集表,记录体检人群骨密度、身高、体重、体重指数(BMI)等情况,将检测结果以每10岁为一年龄段分组,分析每组骨密度、t、z评分、患病率及相关影响因素。结果北京地区男性、女性峰值骨量均发生在30～39岁年龄段,骨峰值分别为0.528±0.072、0.451±0.067,随着年龄的增长,骨密度逐渐降低,骨质疏松症发病率逐年增高;男性、女性30岁以前骨密度分别为0.47±0.107、0.436±0.060,骨质疏松症发病率分别为21.88%、1.33%;30～39岁骨密度分别为0.528±0.072、0.451±0.067,骨质疏松症发病率分别为7.31%、1.71%;40～49岁骨密度分别为0.52±0.071、0.445±0.065,骨质疏松症发病率分别为9.88%、2.3%;50～59骨密度分别为0.49±0.076、0.396±0.082,骨质疏松症发病率分别为20.83%、18.94%;60～69岁骨密度分别为0.463±0.085、0.328±0.071,骨质疏松症发病率分别为35.49%、52.21%;70～79岁骨密度分别为0.416±0.086、0.268±0.072,骨质疏松症发病率分别为57.31%、77.59%;80岁以上骨密度分别为0.384±0.091、0.222±0.059,骨质疏松症发病率分别为71.37%、95.24%。低BMI人群骨质疏松症发病率明显高于正常和高BMI人群,差距具有统计学意义(P0.05)。结论峰值骨量过后,随着年龄的增加,骨密度均呈下降趋势,骨质疏松症发病率显著上升,且女性绝经后骨量丢失明显加快,骨质疏松症发病率较同龄男性明显升高,差异具有统计学意义(P0.05)。值得关注的是,30岁以前的年轻男性骨密度状况也并不理想,可能跟工作繁忙,生活压力大,缺乏锻炼,生活方式不健康有关。因此,将骨密度检测作为中老年人体检的常规检查项目,早期发现,积极干预,同时加强年轻人群的健康宣教,倡导健康生活方式,提高峰值骨量,对于防治骨质疏松症具有重要意义。

Epidemiological study of bone mineral density in 9103 physical examination subjects in Beijing

Objective To investigate the bone mineral density of 9103 subjects who received physical examination, and to explore the epidemiology of osteoporosis ( OP) in Beijing.Methods BMD of the distal one-third of the radius and the ulna of non-dominant forearm in 9103 Han subjects, who received physical examination in our hospital from March 2012 to July 2012, was detected using DXA ( ExA-3000, Osteosys Co., South Korea).The information of all the subjects, including BMD, height, weight, and BMI, were collected and recorded.The results were grouped in a 10-year range.And BMD, T-score, Z-score, incidence, and related influencing factors in each group were analyzed.Results The peak bone mass in males (0.528 ±0.072) and females (0.451 ±0.067) in Beijing appeared in 30-39 years old group.Along with the increase of age, BMD in each group decreased, while the incidence of OP increased.BMD in males and females younger than 30 years old was 0.47 ±0.107 and 0.436 ±0.060, respectively.And the incidence of OP in males and females was 21.88%and 1.33%, respectively.BMD in males and females in 30-39 years old group was 0.528 ±0.072 and 0.451 ±0.067, respectively.And the incidence of OP in males and females was 7.31%and 1.71%, respectively.BMD in males and females in 40-49 years old group was 0.52 ±0.071 and 0.445 ± 0.065, respectively.And the incidence of OP in males and females was 9.88% and 2.3%, respectively.BMD in males and females in 50-59 years old group was 0.49 ±0.076 and 0.396 ±0.082, respectively.And the incidence of OP in males and females was 20.83%and 18.94%, respectively.BMD in males and females in 60-69 years old group was 0.463 ±0.085 and 0.328 ±0.071, respectively.And the incidence of OP in males and females was 35.49% and 52.21%, respectively.BMD in males and females in 70 -79 years old group was 0.416 ±0.086 and 0.268 ±0.072, respectively.And the incidence of OP in males and females was 57.31%and 77.59%, respectively.BMD in males and females over 80 years old was 0.384 ±0.091 and 0.222 ±0.059, respectively.And the incidence of OP in males and females was 71.37%and 95.24%, respectively.The incidence of OP in people with lower BMI was significantly higher than that in people with normal BMI or higher BMI ( P <0.05 ) . Conclusion After the peak bone mass, BMD decreases along with the increase of age and the incidence of OP increases obviously.Meanwhile, the bone mass of postmenopause women decreases obviously, and the incidence of OP is significantly higher than that in men with the same age.It is noteworthy that BMD of young men under 30 years old is not ideal, which may be related to busy work, stressful life, lack for exercise, and unhealthy lifestyle.Measurement of BMD should become the general project in medical examination, which may benefit to the early discovery and active intervention.Meanwhile, we should strengthen the health education in young people, advocate healthy lifestyle, and increase peak bone mass.All may have great significance in preventing osteoporosis.