绝经年限、体质量和人体质量指数与绝经后妇女的骨密度变化

背景绝经后妇女易于发生骨质疏松,不同年龄和体质量的人群,其骨量丢失的规律不同.目的分析年龄、绝经年限、绝经年龄、身高、体质量及人体质量指数对绝经后妇女骨密度的影响.设计以绝经妇女为研究对象,随机抽样检测.单位一所省级中医药研究院药品临床研究基地,一所大学医院骨科及一所大学骨伤系.对象2000-09/2003-08福州地区自然绝经后妇女603例.方法采用随机抽样方法,记录患者年龄、绝经年限、绝经年龄、身高、体质量及人体质量指数,采用双能X射线骨密度仪检测腰椎和股骨颈、大转子及Ward's区骨密度,用SPSS软件相关回归分析.主要观察指标年龄、绝经年限、绝经年龄、身高、体质量和人体质量指数与骨密度的相关性及回归方程.结果绝经后妇女的年龄、绝经年限、体质量和人体质量指数与腰椎、股骨颈、大转子及Ward's区骨密度的相关性十分显著;低体质量组骨密度明显低于超体质量组(P＜0.01);影响腰椎、大转子骨密度的主要因素为年龄和体质量,影响股骨颈骨密度的重要因素为绝经年限和体质量.影响腰椎骨密度的因素依次为年龄、体质量和绝经年龄,回归方程y=0.927-0.0093X1+0.003 7X2+0.004X3,影响股骨颈骨密度的因素依次有绝经年限、体质量和绝经年龄,回归方程y=0.687-0.0081X1+0.004 8X2-0.003 4X3,影响大转子骨密度的因素依次有年龄、体质量和绝经年限,回归方程y=0.591-0.0038X1+0.004 2X2-0.002 4X3,影响Ward's区骨密度的因素依次有年龄、人体质量指数和绝经年限,回归方程y=0.686-0.0072X 1+0.013 6X2-0.004 6X3.结论绝经后女性随着年龄的增大,其腰椎和髋部的骨密度呈下降趋势,对于体瘦者,患骨质疏松的危险性要大于正常体质量组及肥胖组.

Effects of menopausal duration, body mass and body mass index on bone mineral density in postmenopausal women

BACKGROUND: Osteoporosis is easily seen in postmenopausal women. The bone loss situation is different among populations of different age and body mass.OBJECTIVE: To analyze the effects of age, menopausal duration,menopause age, height, body mass and body mass index on bone mineral density (BMD) in postmenopausal women.DESIGN: Random sampling test was conducted to postmenopausal women.SETTING: A clinical trial center of a provincial Chinese traditional medicine research institute, an orthopaedic department of a university hospital and a bone wound department of a university.PARTICIPANTS: Totally 603 naturally postmenopausal women in Fuzhou area from September 2000 to August 2003.METHODS: Random sampling method was used. The age of participants,menopausal duration, menopause age, height, body mass and bone mineral index(BMI) were recorded. Dual energy X-ray bone mineral density machine was used to examine the bone mineral density of lumbar, neck of femur, great trochanter and Ward' s area while SPSS software was used to conduct regression analysis.MAIN OUTCOME MEASURES: The correlation between age,menopausal years, menopause age, height, body mass, BMI and bone density as well as the regression equation.RESULTS: There was very significant correlation between age, menopausal duration, body mass, BMI of postmenopausal women and bone mineral density of lumbar, neck of femur, great trochanter and Ward' s area. The BMD in low body mass group is greatly lower than that of obesity group( P ＜ 0.01 ). The main factors impacting BMD of lumbar are in turn age, body mass and menopause age while the regression equation: y = 0. 927 - 0. 0093 X1+ 0. 0037X2 + 0. 004X3. The factors impacting BMD of neck of femur are in turn menopausal duration, body mass, menopause age and the regression equation was: y = 0. 687 - 0. 0081 X1 + 0. 0048 X2 - 0. 0034 X3. And the factors affecting BMD of greattrochanter are age, body mass and menopause age while the regression equation was y = 0. 591 - 0. 0038 X1 + 0. 0042 X2 - 0. 0024 X3. Age, body mass index and menopausal duration are main factors affecting BMD of Ward' s area and the regression equation was y =0. 686 -0. 0072 X1 +0. 0136 X2 -0. 0046 X3.CONCLUSION: The BMD of lumbar and hip gradually decreases with the increase of age in postmenopausal women. The risk of getting osteoporosis in people with low body mass is greater than women in normal body mass groupand obesity group.