中国女性与日本女性股骨颈几何参数的比较  

Comparison of femoral neck geometric parameters between Chinese and Japanese females

作　　者：李琳[1,2] 伍贤平 张红[1] 廖二元[1] 戴如春[1] 伍西羽[1] LI Lin;WU Xianping;ZHANG Hong;LIAO Eryuan;DAI Ruchun;WU Xiyu(Department of Metabolism and Endocrinology,Second Xiangya Hospital,Central South University,National Clinical Research Center for Metabolic Diseases,Hunan Provincial Key Laboratory of Metabolic Bone Diseases,Changsha 410011;Department of Endocrinology and Metabolism,First Hospital of Changsha,Changsha 410005,China)

机构地区：[1]中南大学湘雅二医院代谢内分泌科,国家代谢性疾病临床医学研究中心,代谢性骨病学湖南省重点实验室,长沙410011 [2]长沙市第一医院内分泌代谢科,长沙410005

出　　处：《中南大学学报（医学版）》2022年第3期319-327,共9页Journal of Central South University ：Medical Science

基　　金：湖南省临床医疗技术创新引导课题(2020SK53006);中南大学临床大数据项目([2013]15-86)。

摘　　要：目的:股骨颈脆性骨折是后果最严重、医疗花费最高和病死率最高的骨质疏松性骨折类型。股骨颈几何参数(femoral neck geometric parameters,FNGPs)是反映股骨颈几何学特征的重要参数,与股骨颈强度和脆性骨折风险密切相关。股骨颈脆性骨折的发病率存在明显的种族差异,但FNGPs是否有种族差异尚未明确。本研究旨在比较中国女性与日本女性FNGPs的差异。方法:本研究为横断面研究,从湖南省长沙市及周边地区招募女性健康志愿者3859名,年龄为10.0~86.0(45.7±17.1)岁。测量并记录研究对象的体重、身高,并计算其体重指数(body mass index,BMI),采用双能X线骨密度测量仪测量研究对象的股骨颈投射骨面积(bone area,BA)和股骨颈骨密度(bone mineral density,BMD)。采用BA和/或BMD计算各种FNGPs,包括股骨颈轴长中点的外周直径(outer diameter,OD)、横截面积(cross-sectional area,CSA)、平均皮质厚度(cortical thickness,CT)、内皮质直径(endocortical diameter,ED)、抗曲比率(buckling ratio,BR)、截面系数(section modulus,SM)、截面转动惯量(cross-sectional moment of inertia,CSMI)和抗压强度指数(compressive strength index,CSI)。日本女性FNGPs的数据来自相关的文献。研究对象年龄按10年分组,分别计算各组的身高、体重、BMI、股骨颈BMD和各种FNGPs的平均值及标准差。从各种数学回归模型中选择拟合优度最佳的模型,分析各种FNGPs随年龄的分布趋势及最佳拟合曲线。对于中国女性和日本女性的各种FNGPs的差异采用各组年龄相应的平均值拟合曲线进行配对t检验,并比较其相对变化率。结果:不同年龄的志愿者之间各种FNGPs的均数差异均有统计学意义(均P<0.01)。在30~39岁的志愿者中,股骨颈的CSA、CT、SM和CSMI的均数处于较高水平,之后这些指标随着年龄增大而逐渐下降;CSI的峰值年龄最小为20~29岁,30岁之后随年龄增大而逐渐下降;ED和BR在40岁之前处于Objective: Femoral neck fracture is the most serious osteoporotic fractures that is responsible for high medical costs and high mortality. Femoral neck geometric parameters(FNGPs) are important parameters that reflect the geometrical characteristics of femoral neck, and are closely related to the strength of femoral neck and the risk of fragility fracture. There are differences in the incidence of femoral neck fractures among races.However, whether there is difference in FNGPs among races is unknown. Therefore, this study aims to compare the differences in FNGPs between Chinese and Japanese females.Methods: This study was a cross-sectional study, in which 3 859 healthy females aged 10-86(45.7±17.1) years old were recruited from Changsha City of Hunan Province and surrounding areas. The weight and height were measured and recorded, and the body mass index(BMI) was calculated. A dual energy X-ray absorptiometry(DXA) bone densitometer was used to measure femoral neck projective bone area(BA) and bone mineral density(BMD). FNGPs were calculated using the BMD and BA, which included the outer diameter(OD), cross-sectional area(CSA), cortical thickness(CT), endocortical diameter(ED), buckling ratio(BR), section modulus(SM),cross-sectional moment of inertia(CSMI), and compression strength index(CSI). The data of FNGPs in Japanese females was collected from literature. These subjects were grouped by 10-year age. The mean and standard deviation of height, weight, BMI, femoral neck BMD, and FNGPs of each group were calculated. The model with the best goodness-of-fit was selected from various mathematical regression models to analyze the distribution trend and the best fitting curve of FNGPs with age. The differences in FNGPs between Chinese and Japanese females were analyzed by using age-corresponding mean fitting curve for paired t-test, and the relative change rates of FNGPs were compared.Results: The mean values of FNGPs were significantly different among different years old healthy females(all P<0.01). The mean values

关 键 词：股骨颈几何参数 骨密度测量仪 女性人群 种族差异 

分 类 号：R173[医药卫生—妇幼卫生保健]