女性不同骨骼部位峰值骨密度的变异度及其对诊断骨质疏松的影响

目的 :评价女性不同骨骼部位峰值骨量变异度 (V)的变化对诊断骨质疏松 (OP)的影响。方法 :采用DEXAQDR45 0 0A型扇形束双能X线骨密度仪测量 1810例 15～ 96岁健康女性腰椎前后位 (AP)和仰卧侧位、髋部及前臂的骨密度 (BMD) ,求得峰值BMD(PBMD)及其变异度 ,按每 5岁年龄段分组分析结果。结果 :不同骨骼部位PBMD的年龄在 2 0～ 44岁 (包括 2 0岁和 44岁 ) ,PBMD的变异度范围为 6 .0 %～ 17.0 % ,平均 (11.4± 3.1) % ,其中髋部Ward’s区最大 (17% ) ,前臂远端 1/ 3处最小 (6 % )。不同骨骼部位OP检出率随PBMD的变异度不同而变化 ;采用不同的诊断标准 ,OP的检出率也不同。结论 :不同骨骼部位PBMD及其变异度的变化和诊断标准不同严重影响OP的检出率。

Variability of female peak bone mineral density at different skeletal regions and its effect on diagnosis of osteoporosis

Objective: To evaluate the changes in variability (V) of femalepeak bone mineral density (PBMD) at different skeletal regions and its effects on diagnosis of osteoporosis. Methods: Using a Hologic QDR 4500A fan beam X-ray bone densitometer to measure the BMD at different skeletal regions (anteroposterior and supine lateral spine, hip, and forearm) in 1810 women between the ages of 15～96 from Changsha city (Hunan province) in the People's Republic of China, the population grouped in every 5 years of age, then to get PBMD and its variability. Results: According to every 5 years of age, the analysis showed that PBMD occurred varied in the age of 20～44, the variability ranged 6.0% to 17.0%, in an average of (11.4±3.1)%, the maximal value (17%) of V is at Ward's triangle, the minimal value of V is at distal one-third site of forearm (6%). The incidence of osteoporosis changed with V of PBMD at different skeletal regions. With different diagnostic standards, the incidences of OP also differed. Conclusion: Changes in PBMD and its V at different skeletal regions and the different diagnostic standard obviously affects the incidence of OP.