身高缩短值作为中老年人骨质疏松症自测指标的研究  

Study on index of osteoporosis with height-shortening value for self-examination in middle-aged and elderly population

作　　者：李硕颀[1] 王海清[1] 陈梦施[1] 罗凯炜[1] 江月华[1] 王瑞燕[1] 

机构地区：[1]中南大学湘雅公共卫生学院流行病与卫生统计学系,长沙410078

出　　处：《中华流行病学杂志》2007年第5期499-502,共4页Chinese Journal of Epidemiology

基　　金：湖南省科研基金重点课题资助项目（A2004-001）

摘　　要：目的 探索以身高缩短值作为中老年人骨质疏松症或骨量减少自测指标的运用价值。方法 在整群随机抽样的长沙市4个社区中老年人群中,符合纳入标准者作为调查对象。计算调查对象本次测量身高值和青年时身高值之差及身高缩短百分比。以双能X线吸收仪测定结果作为金标准,分别以不同的身高缩短值和身高缩短百分比作为阳性界值,计算其灵敏度、特异度和约登指数,绘制受试者工作特征曲线,以求得最适宜灵敏度和特异度时的阳性界值,并计算该自测方法在不同人群中的预测值。结果 身高缩短3 cm为骨质疏松症自测的阳性界值,其灵敏度、特异度及约登指数分别为75．4%、76．7%和0．521;身高缩短2 cm为骨量减少自测的阳性界值,其灵敏度、特异度及约登指数分别为81．7%、75．6%和0．573;该自测方法在65岁以上女性人群中阳性预测值最高（76．4%, 88．7%）。结论 一定的身高缩短值可作为中老年人简便易行的自测骨质疏松症或骨量减少的初筛指标。Objective To probe into the application value of the height shortening value as the self- examination index of the middle-aged and aged group＇s osteoporosis or reduced bone mineral density in communities. Methods Four communities were selected by cluster sampling at random in Changsha city to be the objects of study, among which women were 45 years old or older and men were 60 years old. Difference and the percentage proportion of the height shortening between the height of the research objects which was measured at their youth and the height measured at this study, were calculated. Mineral density of the anteroposterior lumber spine L2-L4, the left femur neck of each object of study with the DPX-IQ dual energy X-ray （DEXA） were both examined. Results examined by DEXA were recognized as ＂Golden Standards＇and different absolute and relative height shortening values were taken as positive cutoff points. Sensitivity,specificity and Youden＇s index were calculated to draw the receiver operator characteristic curve in order to get the positive cutoff which was most suitable to both sensitivity and specificity,and to calculate the predicative values of that self-examination method among different groups. Results 3 cm of height shortened seemed to be the positive cutoff of the self-examination of osteoporosis, and its sensitivity, specificity and Youden＇s index were 75.4 % ,76.7 % and 0. 521 respectively. 2 cm of height shortened was suggested as the positive cutoff of the self-examination method of reduced bone mineral density, while its sensitivity, specificity and Youden＇ s index were 81.7%, 75.6% and 0.573 respectively. In this self- examination method,positive predicative value was the highest （76.4 % ; 88.7 % ） among the women group aged over 65. Conclusion Certain height-shortening value could be used as the rough index of screening osteoporosis of reduced bone mineral density, which set a simple and easy way of self-examination for the middle-aged and elderly population.

关 键 词：骨质疏松症 中老年人 身高 缩短值 

分 类 号：R686[医药卫生—骨科学]