老年健康男性骨质疏松患病的危险因素分析  

Investigation of osteoporosis prevalence and osteoporosis-related clinical risk factors among healthy elderly male

作　　者：张效栋[1] 林吉生[1] 杨秀全 费琦[1] 王炳强[1] 杨雍[1] 李锦军[1] 马钊[1] 赵凡[1] 王奇[1] 

机构地区：[1]首都医科大学附属北京友谊医院骨科,100050 [2]北京市丰台区王佐镇社区卫生服务中心

出　　处：《中华医学杂志》2015年第41期3366-3369,共4页National Medical Journal of China

基　　金：2013北京市科学技术委员会“首都市民健康项目培育”（Z131100006813040）

摘　　要：目的 调查健康老年男性骨密度（BMD）变化规律并分析和原发性骨质疏松症（OP）相关的危险因素.方法 采用横断面研究,对2014年1至10月北京市丰台区王佐社区50岁以上健康老年男性346例进行双能X线骨密度检查和自制《北京市老年男性原发性骨质疏松症高危人群临床危险因素调查问卷》的调查,记录腰椎总（L14）、左侧股骨颈和左髋总的BMD数值和年龄、体重、既往脆性骨折史、吸烟史、饮酒史等临床危险因素;根据世界卫生组织（WHO）诊断标准将研究对象分为骨质疏松组和非骨质疏松组,分析各临床危险因素与骨质疏松症发生的相关性.结果 346例老年健康男性总体骨质疏松患病率18.5％（64/346）,骨量减少者55.5％（192/346）,骨量正常者26.0％（90/346）;股骨颈及股骨总BMD水平随增龄呈逐渐降低趋势,腰椎总BMD水平随增龄变化规律不明显,从50岁起髋部BMD水平明显低于同年龄组腰椎BMD（P＜0.05）.既往脆性骨折史、体重指数、体重及吸烟史在骨质疏松组和非骨质疏松组间差异有统计学意义（P＜0.05）.结论 老年男性骨质疏松患病情况不容忽视,既往脆性骨折史、低体重及低体重指数、吸烟史可能是王佐镇社区老年男性OP的临床危险因素.Objective To investigate the osteoporosis prevalence and osteoporosis-related clinical risk factors among healthy elderly male.Methods A cross-sectional study was conducted from January 2014 to October 2014.Healthy elderly male aged 50 and above from Beijing WangZuo Community who had completed the questionnaire we made were enrolled in this study and accepted bone mineral density （BMD） testing by dual energy X-ray absorptiometry.Subjects were classified as the osteoporosis group （OP group） and the non-osteoporosis group （Non-OP group） according to the WHO criteria,of which osteoporosis was defined arbitrarily when any T-score was-2.5 standard deviations or less at femoral neck,total hip or lumbar spine （L1-4）.The clinical risk factors of each subject including age,body weight,Body Mass Index （BMI）,previous fragility fracture history,smoking,alcohol abuse,glucocorticoid therapy and other capable clinical risk factors were collected and compared in OP group and Non-OP group.Results In the 346 cases of elderly healthy men,18.5% had osteoporosis,55.5% had osteopenia and 26.0% were normal.Femoral neck＇s and total hip＇s BMD level decreased with increasing age.However,the trend was not found at lumbar spine site.There appeared to be a significant difference in BMD standard between lumbar vertebral and total hip when compared with age-matched cohorts （P 〈 0.05）.Weight,BMI,previous fragility fracture history and smoking were found significant differences between OP group and Non-OP group （P 〈 O.05）.Conclusions The prevalence of osteoporosis in healthy older men should not be ignored.Low BMI and weight,previous fragility fracture history and smoking history were clinical risk factors of OP in this population.

关 键 词：骨质疏松症 骨密度 男性 危险因素 

分 类 号：R580[医药卫生—内分泌]