长沙市郊区女性骨质疏松纵向观察

目的 纵向观察长沙市马王堆乡骨质疏松防治社区女性不同骨骼部位年骨丢失率及其与绝经时间的关系。方法 用DXAQDR4500A型扇形束骨密度仪测量220例年龄36—60岁妇女的腰椎,髋部和桡骨远端的骨密度（BMD）,3．9—4．1年后复测骨密度,求得年骨丢失速率。结果 髋部股骨颈和桡骨远端开始明显骨丢失是在绝经前组;腰椎前后位L1-L4（AP）和髋部大转子在围绝经组已发生明显骨丢失;骨丢失在绝经早期组最快,AP、股骨颈、大转子及桡骨远端年骨丢失率分别为1．70％、2．21％、1．92％和1．56％;骨丢失在绝经晚期趋缓。年龄与绝经后妇女AP、大转子和桡骨远端的年骨丢失率呈正相关（γ=0．223—0．547,P〈0．05～0．01）。绝经年限与绝经后妇女AP、大转子的年骨丢失率呈正相关（γ=0．432～0．569,P〈0．05-0．01）。体重、体重指数与绝经后妇女AP、股骨颈、大转子的年骨丢失率呈负相关（γ=0．239—0．466,P〈0．05-0．01）。结论 不同骨骼部位的年骨丢失速率存在差异。年龄、绝经年限与体重影响不同骨骼部位的骨丢失。

Prospective investigation of annual bone loss rate in females in Changsha city, Hunan province

OBJECTIVE: To investigate prospectively the annual bone loss rate at spine, proximal femur and distal radius in females and its relationship to relevant factors. METHODS: The bone mineral density (BMD) at anteroposterior lumber, proximal femur and distal radius in 220 women of Mawangdui Township, aged 36 - 60, was measured twice, March to April 2000 and March to April 2004, using a Hologic QDR 4500A fan beam X-ray bone densitometer. RESULTS: The annual bone loss rate was the highest during the period of 1 to 5 years since menopause, showing an annual bone loss of 1.70% at the anteroposterior spine, and 2.21%, 1.92%, and 1.56% at the femoral neck, greater trochanter, and distal radius respectively. Even before menopause bone loss was found at the femoral neck and distal radius. BMD loss at the anteroposterior spine and greater trochanter was found in the peri-menopause group. The bone loss rate was the highest in the early menopause group (1.56%/year, P < 0.01), and became lower, however, not significantly in the late menopause group (0.38%/year, P > 0.05). Age was positively correlated with the annual bone loss rates at the anteroposterior spine, greater trochanter, and distal radius (gamma = 0.223 - 0.547, P < 0.05 - 0.01), and the number of year since menopause was also positively correlated with the annual bone loss rate at anteroposterior spine and greater trochanter (gamma = 0.432 - 0.569 P < 0.05 - 0.01). However, body weight and body mass index were negatively correlated with the annual bone loss rates at the anteroposterior spine, femoral neck, and greater trochanter (gamma = 0.239 - 0.466, P < 0.05 - 0.01). CONCLUSION: Annual bone loss varies at different skeletal region. Age, years since menopause, and body weight influence the bone loss at different skeletal regions in females.