基于NHANES数据库分析女性特殊生理期相关数值与绝经后骨密度的关系  

The relationship between postmenopausal bone mineral density and specific physiological period values in women based on NHANES database

作　　者：杨云虹 凡一诺 章家皓 张湘琪 赵小凤[3] 陈镇秋[3] 孙晓峰[3] Yang Yunhong;Fan Yinuo;Zhang Jiahao;Zhang Xiangqi;Zhao Xiaofeng;Chen Zhenqiu;Sun Xiaofeng(First School of Clinical Medicine,Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;Third School of Clinical Medicine,Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China)

机构地区：[1]广州中医药大学第一临床医学院,广东省广州市510405 [2]广州中医药大学第三临床医学院,广东省广州市510405 [3]广州中医药大学第一附属医院,广东省广州市510405

出　　处：《中国组织工程研究》2023年第32期5191-5195,共5页Chinese Journal of Tissue Engineering Research

基　　金：广州中医药大学“双一流”与高水平大学学科协同创新团队项目(2021xk46),项目负责人:陈镇秋;国家自然科学基金项目(81573996),项目负责人:陈镇秋。

摘　　要：背景:明确女性特殊生理时期与绝经后低骨密度发生的确切关系,可作为未来预测女性绝经后低骨密度的关键,并为预防低骨密度的发生提供参考价值。目的:探究女性不同特殊时期相关数据与绝经后低骨密度之间的关系。方法:利用2017-2020年NHANES总库收集数据,纳入总样本15560名,筛选出最终参与者1563名,获取其骨密度值后,计算出T分数,将诊断为骨质疏松和骨量减少者合为观察组,正常骨量者为对照组。通过建立3个线性回归模型来评估月经初潮年龄、绝经年龄、孕次、产次对绝经后低骨密度的影响。最后,通过多元逻辑回归的结果相互验证不同孕次、产次与低骨密度之间的关系。结果与结论:①初潮年龄大于13岁参与者绝经后低骨密度的发生率是初潮年龄小于12岁参与者的1.62倍。相对于绝经年龄在45岁以下者,绝经年龄在45-55岁之间者绝经后发生低骨密度的OR值为0.72,55岁以上者绝经后发生低骨密度的OR值为0.51。孕次与股骨部位的T分数呈负相关,与大转子的T分数呈负相关,与腰椎的T分数无相关性。产次与股骨和腰椎的T分数无关,仅有产次和大转子呈负相关。②结果显示,月经初潮年龄越晚,绝经年龄越早,怀孕次数越多,绝经后越容易出现低骨密度;孕次对股骨及大转子骨密度的影响最显著。BACKGROUND:Clarifying the exact relationship between specific physiological periods and postmenopausal low bone mineral density in women can be a key to predicting low bone mineral density in postmenopausal women and provide a reference value for preventing the occurrence of low bone mineral density.OBJECTIVE:To investigate the association between different special periods and postmenopausal low bone mineral density in women.METHODS:A total of 15560 samples were collected from the NHANES database(published from 2017 to 2020),and 1563 participants were screened out.Their bone mineral density values were acquired to calculate the T-score.Those with osteoporosis and osteopenia were enrolled in observation group,while those with normal bone mass acted as controls.Three linear regression models were established to evaluate the effects of age at menarche,age at menopause,gravidity and parity on postmenopausal low bone mineral density.Finally,the results of multivariate logistic regression analyses were used to verify the relationship among gravidity,parity and low bone mineral density.RESULTS AND CONCLUSION:The incidence of postmenopausal low bone mineral density was 1.62 times higher in participants aged>13 years at menarche than those aged<12 years at menarche.Relative to menopausal age under 45,the odds ratio value for postmenopausal low bone mineral density was 0.72 for those between 45-55 years of age at menopause and 0.51 for those over 55 years of age at menopause.Gravidity was negatively correlated with the T scores of the femur and greater trochanter but showed no correlation with the T score of the lumbar spine.Parity was not related to the T scores of the femur and lumbar spine but only negatively related to the T score of the greater trochanter.The later the age of menarche,the earlier the age of menopause,the more pregnancies,the greater the likelihood of postmenopausal lower bone mineral density.Gravidity has the most significant effect on the bone mineral density of the femur and greater trochanter.

关 键 词：生理时期 月经初潮年龄 绝经年龄 孕次 产次 骨密度 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学] R589