女性骨密度的地区差异及多中心参考数据库对诊断骨质疏松的影响  

Geographic differences in female bone mineral density and the effect of multi-center reference database on the diagnostic osteoporosis

作　　者：伍西羽[1] 周琦 张娜[1,3] 张红[1] 袁凌青[1] 戴如春[1] 盛志峰[1] 谢忠建[1] 伍贤平[1] 廖二元[1] WU Xiyu;ZHOU Qi;ZHANG Na;ZHANG Hong;YUAN Lingqing;DAI Ruchun;SHENG Zhifeng;XIE Zhongjian;WU Xianping;LIAO Eryuan(National Clinical Research Center for Metabolic Diseases,Institute of Endocrinology and Metabolism,the Second Xiangya Hospital,Central South University,and Key Laboratory of Metabolic Osteopathology,Changsha 410011;GE Health Care ( Shanghai) Co.,Ltd.,Zhang Jiang Hi-Tech Park,Shanghai 201203;Medical College of Hunan Normal University,Changsha 410013,China)

机构地区：[1]国家代谢性疾病临床医学研究中心中南大学湘雅二医院代谢内分泌研究所代谢性骨病学湖南省重点实验室,湖南长沙410011 [2]通用电气医疗集团(GE Health care)上海有限公司,上海201203 [3]湖南师范大学医学院,湖南长沙410013

出　　处：《中国骨质疏松杂志》2019年第10期1398-1404,共7页Chinese Journal of Osteoporosis

摘　　要：目的了解我国大陆女性骨密度(bone mineral density,BMD)的地区差异及多中心融合参考数据库对诊断骨质疏松的影响。方法女性参考人群10 343名,年龄范围20~89岁,分别来自长沙、北京、南京、上海、嘉兴、广州和成都地区。除长沙地区1 157名外,其他资料均由通用电气医疗集团(GE Health care)公司提供。受试者均采用GE-Lunar系列DXA骨密度仪测量腰椎和股骨颈BMD。结果 8种不同回归模型分析显示,BMD随年龄变化均采用3次回归模型拟合优度最佳,拟合曲线的决定系数(R^2)为0. 149~0. 546(P均=0. 000)。腰椎BMD随年龄变化的最佳拟合曲线,北京与成都女性之间的差异最大[(12. 9±4. 9)%],北京与南京女性之间的差异最小[(3. 0±3. 4)%];各地区女性之间,股骨颈BMD拟合曲线的差异相对较小。与多中心融合BMD参考数据库比较,北京地区数据库对腰椎骨质疏松的检出率显著升高(17. 5%vs 12. 2%,P=0. 028),嘉兴(23. 9%vs 30. 3%,P=0. 001)、长沙(30. 4%vs 35. 9%,P=0. 037)和成都(34. 8%vs 41. 0%,P=0. 032)地区数据库对骨质疏松的检出率显著降低。结论我国大陆女性BMD存在地区差异,特别是腰椎BMD。提示我国需要建立多个区域性BMD参考数据库。Objective To understand the geographic differences of bone mineral density(BMD) in women and the effect of using a multi-center combined reference database for diagnosing osteoporosis. Methods The reference population comprised 10 343 females, aged 20-89 years old, from Changsha, Beijing, Nanjing, Shanghai, Jiaxing, Guangzhou, and Chengdu. Except for Changsha(n=1 157), data were obtained from the GE Health Care service. Lumbar spine and femoral neck BMD was measured in the subjects using a bone densitometer(GE-Lunar DXA series). Results Data were analyzed using eight different regression models. We found that the cubic regression model was the best for describing age-related changes in BMD. The coefficients of determination(R2) of the fitting curve were 0.149 to 0.546(all P=0.000). For the best-fit curve of lumbar spine BMD with age, the minimal difference was between Beijing and Nanjing(3.0%±3.4%), and the maximal difference was between Beijing and Chengdu(12.9%±4.9%). The differences in curve values for femoral neck BMD were relatively small between regions. Compared with the multi-center combined BMD database, the detection rate for lumbar spine osteoporosis was higher by using the Beijing database(17.5% vs. 12.2%, P=0.028), and the rates were lower by using the Jiaxing(23.9% vs. 30.3%, P=0.001), Changsha(30.4% vs. 35.9%, P=0.037) and Chengdu databases(34.8% vs. 41.0%, P=0.032). Conclusion There are geographic differences in female BMD in China's Mainland, especially for lumbar spine BMD, so multiple regional BMD reference databases should be established in China.

关 键 词：骨密度 地区差异 参考数据库 骨质疏松 

分 类 号：R589.5[医药卫生—内分泌]