甘肃省兰州地区中老年女性骨密度现状调查及危险因素分析

目的调查研究甘肃省兰州地区中老年女性的骨密度情况,并分析体重指数与骨质疏松的相关性。方法选取2019年5月1日至2019年10月30日期间于甘肃省妇幼保健院行健康体检的女性。详细记录其年龄、绝经状态、身高及体重,采用双能X线吸收骨密度仪进行检测。结果共纳入2 078名研究对象。其中绝经前组204名,占9.82%,平均年龄(41.10±3.19)岁;围绝经期组443名,占21.32%,平均年龄(49.29±2.18)岁;绝经后组1 431名,占68.86%,平均年龄(56.25±7.59)岁。围绝经期组及绝经后组平均绝经年龄分别为(50.43±1.30)岁、(48.42±3.06)岁。三组平均身高、体重及体重指数分别为(1.59±0.05) m、(59.58±7.78) kg及(23.71±3.11) kg/m2。左侧股骨颈的平均骨密度分别为:绝经前组(0.85±0.14) g/cm2、围绝经期组(0.91±0.15) g/cm2、绝经后组(0.82±0.12) g/cm2;左侧全部髋关节的平均骨密度分别为:绝经前组(0.99±0.16)g/cm2、围绝经期组(0.97±0.17) g/cm2、绝经后组(0.88±0.13) g/cm2。腰1～4全部椎体的平均骨密度分别为:绝经前组(1.13±0.22) g/cm2、围绝经期组(1.10±0.20) g/cm2、绝经后组(0.97±0.15) g/cm2。所有绝经前女性的骨密度均正常;围绝经期女性中,正常骨密度占45.15%,骨量减少占32.28%,骨质疏松占22.57%;绝经后女性中,正常骨密度占19.57%,骨量减少占33.54%,骨质疏松占46.89%。Spearman等级相关分析结果示BMI与骨质疏松的发病率呈正向显著相关。结论甘肃省兰州地区中老年女性的骨质疏松发病率随年龄的增长而明显增高,尤其是绝经后及肥胖者,定期监测骨密度成为其不可或缺的体检项目。

Investigation of bone mineral density and analysis of its influencing factors in middle-aged women in Gansu Lanzhou area

Objective To explore the bone mineral density (BMD) of middle-aged women in Gansu Lanzhou area, and to analyze the correlation between BMI and osteoporosis (OP). Methods The middle-aged women, who had health examination from May 1 to October 30, 2019, were selected as subjects. The age, menopausal state, height, and weight were recorded. Dual-energy X-ray absorptiometry scan were performed. Results Among the 2078 subjects, 204 were in premenopausal group (9.82%). The average age was 41.10±3.19 y. 443 were in perimenopausal group (21.32%). The average age was 49.29±2.18 y. 1431 were in postmenopausal group (68.86%). The average age was 56.25±7.59 y. The mean menopausal age of perimenopausal and postmenopausal group were 50.43±1.30 y and 48.42±3.06 y, respectively. The average height, weight, and body mass index were 1.59±0.05 m, 59.58±7.78 kg, and 23.71±3.11 kg/m2, respectively. The average BMD of the left femoral neck was:0.85±0.14 g/cm2 in premenopausal group, 0.91±0.15 g/cm2 in perimenopausal group, and 0.82±0.12 g/cm2 in postmenopausal group. The average BMD of left hip joint was 0.99±0.16 g/cm2 in premenopausal group, 0.97±0.17 g/cm2 in perimenopausal group, and 0.88±0.13 g/cm2 in postmenopausal group. The average BMD of lumbar vertebrae 1-4 were 1.13±0.22 g/cm2 in premenopausal group, 1.10±0.20 g/cm2 in perimenopausal group, and 0.97±0.15 g/cm2 in postmenopausal group. The BMD of all premenopausal women was normal. In perimenopausal women, normal BMD accounted for 45.15%, decreased bone mass accounted for 32.28%, and osteoporosis accounted for 22.57%. In postmenopausal women, normal BMD accounted for 19.57%, decreased bone mass accounted for 33.54%, and osteoporosis accounted for 46.89%. Spearman rank correlation analysis showed that BMI was positively correlated with the incidence rate of osteoporosis. Conclusion The incidence rate of osteoporosis in middle-aged women in Gansu Lanzhou area increases significantly with age, especially in postmenopausal and obese women. Regular monitoring of BMD is an indispensable item in health examination.