绝经后妇女2060名月经初潮年龄等因素与骨密度的关系  

Relationship of menarche age,menopause age and other factors with bone mineral density in 2060 postmenopausal women

作　　者：肖文金[1] 陈社堂[2] 高杲[1] 胡云秋[1] 李淼[1] 章振林[1] 

机构地区：[1]上海交通大学附属第六人民医院骨质疏松科,骨代谢和遗传研究室,200233 [2]山东胜利石油管理局滨海医院

出　　处：《上海医学》2010年第4期367-371,共5页Shanghai Medical Journal

基　　金：国家自然科学基金(30771019、30570819)资助项目;上海市优秀学科带头人计划(08XD1403000)资助项目

摘　　要：目的探讨绝经后妇女月经的初潮年龄、绝经年龄、绝经年限等因素与腰椎及股骨近端骨密度(BMD)的关系。方法调查2060名上海地区绝经后妇女的月经初潮年龄、绝经年龄、绝经年限,测量其身高、体重、L1～L4和股骨近端的BMD。结果调整年龄、身高、体重后,初潮年龄、绝经年限与L1～L4(r=-0.0717、-0.123)、股骨颈(r=-0.035、-0.127)、全髋(r=-0.054、-0.127)、大转子(r=-0.067、-0.090)的BMD呈负相关(P值分别<0.05、0.01),绝经年龄、行经时间与L1～L4(r=0.123、0.144)、股骨颈(r=0.126、0.129)、全髋(r=0.122、0.136)、大转子(r=0.089、0.112)的BMD呈正相关(P值分别<0.05、0.01)。初潮年龄≤14岁、初潮年龄>14且<18岁、初潮年龄≥18岁组间L1～L4、股骨颈、大转子和全髋的BMD的差异均有统计学意义(P值均<0.05),随初潮年龄的增大各部位的BMD呈下降趋势;绝经年龄≥54岁组各部位的BMD显著高于绝经年龄>45且<54岁组(P值均<0.05),后组又显著高于绝经年龄≤45岁组(P值均<0.05)。多元回归分析发现,体重及绝经年限分别可解释其变异的15.0%～28.3%及4.5%～24.6%,初潮年龄及行经时间对BMD变异的贡献较小,仅可分别解释腰椎及全髋BMD变异的0.4%及0.2%。结论绝经后妇女月经初潮年龄越大、绝经年龄越早、绝经年限越长,BMD相对越低,体重和绝经年限对BMD变异的影响最大。本研究有助于建立筛选骨质疏松高危妇女的标准。Objective To explore the relationship of menarche age,menopause,menopausal period with bone mineral density （BMD） of lumbar spines and hip in postmenopausal women.Methods Totally 2 060 healthy postmenopausal women in the urban area of Shanghai were included in this study.The ages of menarche and menopause,menopausal period,height,weight and lumbar vertebra and hip （Neck,Troch,Total） BMD data were collected.Results After adjusting for age,height and weight,correlation analysis showed that the age of menarche and the menopausal period were negatively correlated with BMD at L1k-L4 （r=-0.071 7,-0.123）,Neck （r=-0.035,-0.127）,Total （r=-0.054,-0.127） and Troch （r=-0.067,-0.090）（P0.05 or P0.01）,and positively correlated with the age of menopause and number of years menstruating and L1-L4 （r=0.123、0.144）,Neck （r=0.126,0.129）,Total （r=0.122,0.136） and Troch BMD （r=0.089,0.112）（P0.05 or P0.01）.According to the ages of menarche and menopause,the subjects were divided into 3 groups separately,namely,≤14 years,14-18 years,≥18 years,and ≤45 years,46-53 years,≥54 years,respectively.The one-way ANOVA showed significant differences in the lumbar vertebra and hip BMD among three groups （P0.05）.Multiple stepwise regression analysis showed that weight and menopausal period were dominant determinant of BMD at all sites,accounting for 15.0%-28.3% and 4.5%-24.6% of the variance,respectively.The age at menarche and number of years menstruating were not significant predictors of BMD and it could only explain 0.4% and 0.2% of the variance at the lumbar spine and total hip,respectively.Conclusion The later the menarcheis,the earlier the menopause is;the longer menopausal periodis,the lower the BMD is.Weight and menopausal period are dominant determinants of BMD at all sites.This study may help to identify women who are at greater risk for subsequent low postmenopausal BMD.（Shanghai Med J,2010,33：367-371）

关 键 词：绝经后 月经初潮 绝经年龄 骨密度 

分 类 号：R580[医药卫生—内分泌]