2015-2016年上海市某社区老年人骨质疏松追踪调查  

Follow-up of osteoporosis among the elderly in a community in Shanghai Municipality,2015-2016

作　　者：宋徽江 封蕾[1] 瞿红国 杨丽萍[2] 

机构地区：[1]上海市浦东新区三林社区卫生服务中心,上海200124 [2]上海市浦东新区陆家嘴社区卫生服务中心

出　　处：《实用预防医学》2018年第2期147-151,共5页Practical Preventive Medicine

基　　金：上海市卫生和计划生育委员会面上项目(201640352;201540329)

摘　　要：目的通过追踪2015-2016年上海市某社区65岁及以上老年人的骨密度监测结果,分析社区老年人群骨质疏松疾病发生发展变化与关键影响因素,为社区老年骨质疏松的防治管理提供参考。方法以上海市某社区连续2年(2015-2016年)参与社区健康体检的老年人共4 624名作为研究对象,进行问卷调查(包括一般情况、生活方式)及骨密度检查。采用SPSS 23.0进行数据统计分析,配对t检验分析老年人群连续2年骨密度T值的变化差异,符号Wilcoxon秩和检验分析老年人群连续2年骨质疏松分级的变化差异,采用广义估计方程分析一般情况与生活方式对老年骨质疏松的影响作用。结果本次研究共收集有效数据4 227例,有效率为91.41%。4 227名老年人中,男性占43.46%(1 837/4 227),女性占56.55%(2 390/4 227)。2015-2016年,社区老年人的骨密度T值下降0.03,骨质疏松占比增幅0.97%。进一步分析显示,女性老年人的骨密度T值显著降低[(-2.18±1.11)vs.(-2.24±1.11)],差异有统计学意义(paired-t=6.699,P<0.001),骨质疏松分级变化显著升高[39.12%vs.41.17%],差异有统计学意义(paired-Z=3.040,P=0.002);而男性老年人的骨密度T值变化差异无统计学意义(paired-t=-1.212,P=0.226),骨质疏松分级变化差异亦无统计学意义(paired-Z=-0.663,P=0.507)。6.91%(292/4 227)的社区老年人发生骨质疏松分级加重,其中女性占7.74%(185/2 390);男性则占5.82%(107/1 837)。分不同性别,采用广义估计方程对连续2年的骨质疏松检测结果进行影响因素分析可得,女性老年人的骨质疏松的危险因素包括高龄(OR=1.078,95%CI:1.063~1.094,P<0.001)和大腰围(OR=1.017,95%CI:1.003~1.031,P=0.016),其保护因素则包括戒烟(与吸烟相比)(OR=0.195,95%CI:0.043~0.880,P=0.033)、高身高(OR=0.978,95%CI:0963~0.993,P=0.005)和高体重(OR=0.971,95%CI:0.956~0.987,P<0.001);而男性老年人的骨质疏松危险因素包括高龄(OR=1.023,95%CI:1.006~1.040,P=0.006)和高腰围(OR=1.02Objective To analyze the occurrence, development and variation of osteoporosis and its key influencing factors a- mong the community elderly through following-up the monitoring results of bone mineral density of the elderly aged 65 years and a- bove in a community in Shanghai Municipality from 2015 to 2016, and to provide references for prevention, control and manage- ment of osteoporosis among the community elderly. Methods A questionnaire survey （ including general situation and lifestyle ） and bone mineral density test were conducted among 4,624 elders who participated in the community health examination on two successive years （during the years of 2015-2016） in a community in Shanghai Municipality. SPSS 23.0 software was used for sta- tistical data analysis. Paired-samples t-test was used for analyzing the changing differences in the T value of bone mineral density of the elderly on two successive years. Symbols Wilcoxon rank test was used for analyzing the changing differences in the grades of osteoporosis of the elderly on two successive years. Generalized estimating equation was established to analyze the effects of general situation and lifestyle on osteoporosis of the elderly. Results The effective data about 4,227 cases were collected during this study, with the effective rate being 91.41%. Among the 4,227 elders, males and females accounted for 43.46% （1,837/4,227） and 56. 55% （2,390/4,227） respectively. The T-value of bone mineral density in the community elderly during 2015-2016 re- duced 0.03, while the proportion of osteoporosis increased 0.97%. Further analysis showed that the T-value of bone mineral density in the female elderly was significantly declined （ （-2.18-＋ 1.11 ） vs. （-2.24＋1.11 ） ）, while the changes in the grading of osteopo- rosis were significantly increased （ 39.12% vs. 41.17% ） , both showing statistically signficant differences （ paired-t = 6. 699, P〈 0. 001; paired-Z= 3.04, P= 0.002）. No statistically signficant differences were found in

关 键 词：老年人 骨质疏松 追踪调查 

分 类 号：R681[医药卫生—骨科学]