甘肃省20-80岁和绝经后女性骨质疏松症患病影响因素分析

目的 了解甘肃省20-80岁汉族女性以及绝经女性骨质疏松症患病率，探讨女性骨质疏松症的影响因素。 方法 2016年7-8月采用分层整群随机抽样方法在甘肃省兰州市、张掖市、高台县、肃南裕固族自治县选取20-80岁汉族女性进行问卷调查，应用法国Medilink公司生产的Pegasus超声骨密度仪检测跟骨骨强度，采用?2检验和非条件logistic回归对骨质疏松症的可能影响因素进行分析。 结果 甘肃省20-80岁汉族女性骨质疏松症总患病率为15.10%，40-80岁绝经后女性骨质疏松症患病率为25.88%。体重指数越大(OR=0.392,95%CI: 0.229-0.672)、从事的职业劳动强度重(OR=0.461,95%CI: 0.295-0.721)和体育锻炼频次多(OR=0.565,95%CI: 0.407-0.786)有利于降低骨质疏松症发生，有既往骨折史的女性发生骨质疏松症风险高(OR=1.544, 95%CI: 1.080-2.205)。绝经是骨质疏松症的危险因素(P未绝经组=8.33% vs P绝经组=22.76%，P?0.0001;OR=2.633,95%CI: 1.655-4.190)，其中绝经年限越长骨质疏松症的发生风险越高(OR=2.910,95%CI: 1.426-5.939)，女性绝经年龄越晚发生骨质疏松症的风险越低(OR=0.354,95%CI: 0.172-0.628)。 结论 针对体重指数低、有既往骨折史、运动少、绝经年龄早和绝经年限长的女性应该格外关注。在膳食上注意补充钙和维生素D，生活上经常锻炼运动。了解骨质疏松症的患病情况及研究其影响因素对成年妇女的健康促进具有重要意义。

The influential factors of osteoporosis among 20-80-year-old population and postmenopausal women in Gansu province

Objective To investigate the prevalence of osteoporosis among female adults and postmenopausal women in Gansu province, and to explore the influential factors of osteoporosis. Methods Individuals aged 20-80 years old were recruited using a multi-stage cluster sampling method from Lanzhou City, Zhangye City, Gaotai County, and Sunan Autonomous County of Yugur in Gansu province. Face to face questionnaire surveys were conducted among all the participants. Quantitative ultrasound parameters of the right calcaneus were measured with a Pegasus device (Medilink, France). The associated factors of osteoporosis were analyzed using Chi-square test and logistic regression model. Results The prevalence of osteoporosis among 20-80 years old Han females was 15.10%, while 25.88% in postmenopausal women aged 40-80 years old in Gansu province. Higher BMI (OR=0.392, 95% CI: 0.229-0.672), heavier physical activities (OR=0.461, 95% CI: 0.295-0.721), and higher exercise frequency (OR=0.565, 95% CI: 0.407-0.786) protected subjects from osteoporosis. People with fracture history were more likely to suffer from osteoporosis (OR=1.544, 95% CI: 1.080-2.205). Menopause was associated with osteoporosis (P Non-menopausal=8.33% vs P menopausal=22.76%, P?0.0001; OR=2.633, 95% CI: 1.655-4.190). Women with longer duration of menopause had higher risk of suffering from osteoporosis (OR=2.910, 95% CI: 1.426-5.939). Women who had later-age menopause had lower risk of osteoporosis (OR=0.354, 95% CI: 0.172-0.628). Conclusion Calcium and vitamin D supplement, and regular exercise, should be emphasized among women, especially those with lower body mass index, history of fracture, less exercise, earlier age, and longer years of menopause. It is significant to understand the prevalence of osteoporosis and its related factors for health promotion of female adults.