绝经后妇女骨质疏松性骨折易发因素的流行病学研究

目的 探讨绝经后妇女骨质疏松性骨折的分布特征和易发因素。方法 以社区50-69岁绝经1年以上妇女为研究对象,问卷调查危险因素,双能X线骨密度仪测量骨密度(Bone MineralDensity,BMD),胸腰椎侧位X摄片分析椎体骨折,结合病史问询调查骨折发生。结果 绝经后妇女骨质疏松性骨折的发生率随年龄和绝经年限的延长而上升,尤其是绝经后的15-20年,骨质疏松性骨折的发生率明显升高。至少有一处以上骨折的绝经后妇女较无骨折妇女的年龄大、绝经年龄早、绝经年限长、生育次数多、哺乳月份长(P<0.01)。结论 绝经早、生育胎数多、哺乳时间长等因素是绝经后妇女骨质疏松性骨折的重要危险因素,可作为骨折高危人群的筛选指标以及制定相应干预措施的依据。

Epidemiological studies on risk factors for osteoporotic fracture in postmenopausal women

Objective To study the distribution and risk factors of osteoporotic fracture in postmenopausal women. Methods In a cross-sectional study, a total of 723 women, aged 50 - 69 years, after an elapse of over one year since menopause, were selected randomly and recruited in Shanghai City. All the subjects completed a questionnaire to obtain information on lifestyle and medical history. Bone mineral density (areal density in g/cm2) was measured by DEXA(DPX-L,Lunar) . Anteroposterior and lateral spinal X-ray films were taken at the time of the bone measurement. Information on fractures was obtained by questionnaire and ascertained by physician or di-agnostic document from a hospital. Vertebral fracture was defined as reduction of at least 20 % in the anterior, middle, or posterior vertebral height. Results The prevalence of osteoporotic fracture increased with chronological age and duration since menopause, and was more noticeable in the second decades since menopause. Compared with the postmenopausal women without fracture, the women with at least one fracture had a history of early menopause, frequent child birth and long period of breast feeding. Conclusion Early menopause, frequent child-birth and long period of breast feeding may be important risk factors of osteoporotic fracture in postmenpausal wom-en, which would be useful in screening the high-risk group and improving the preventive strategies against osteo-porotic fracture.