骨折病史对中老年人群髋部骨密度影响的研究  

Research of the effect of fracture history on hip bone mineral density in middle-aged and elderly people

作　　者：谢晓明 刘志 刘光辉 朱勇[2] 林涨源[2] 赵树山[2,3] XIE Xiaoming;LIU Zhi;LIU Guanghui;ZHU Yong;LIN Zhangyuan;ZHAO Shushan(Guangdong Shunde District New Rongqi Hospital,Shunde 528303,China;Department of Orthopedics,Xiangya Hospital Central South University,Changsha 410008,China;National Clinical Medical Research Center for Geriatrics(Xiangya Hospital),Changsha 410008,China)

机构地区：[1]广东顺德区新容奇医院骨科,广东顺德528303 [2]中南大学湘雅医院骨科,湖南长沙410008 [3]国家老年疾病临床医学研究中心(湘雅医院),湖南长沙410008

出　　处：《中国骨质疏松杂志》2023年第4期503-508,共6页Chinese Journal of Osteoporosis

基　　金：湖南省自然科学基金(2020JJ4928);国家自然科学基金(81902222)。

摘　　要：目的利用NHANES数据库分析50岁之前骨折病史是否影响患者50岁后的髋部骨密度。方法纳入NHANES数据库5个调查年份的人群数据,通过筛查选出完成髋部骨密度检查并完成自我报告骨折病史调查者,通过统计学分析比较骨折组与非骨折组髋部骨密度的差异。结果共纳入研究个体10476例,其中非骨折组9536人,骨折组940人,骨折组男性比率明显高于女性。骨折组人群平均年龄(62.8±9.1)岁,BMI值(29.24±5.77)kg/m^(2),非骨折组人群平均年龄(64.7±9.5)岁,BMI值为(28.55±5.59)kg/m^(2),结果差异有统计学意义。骨折组人群的合并症中肾功能障碍及关节炎显著高于非骨折组。协方差分析结果提示骨折组的髋部骨密度,股骨颈、大转子、转子间及Ward三角骨密度均显著下降。亚组分析结果显示髋部骨折组及腕部骨折组的骨密度均显著下降,而脊柱骨折组患者骨密度差异无统计学意义。结论50岁之前骨折病史将会导致患者50岁之后髋部骨密度显著下降,尤其是腕部骨折及髋部骨折病史。Objective Using the NHANES database to analyze whether the fracture history before age 50 affects the bone mineral density of patients after age 50.Methods The population of the NHANES database in 5 survey years was included,and those who completed the hip BMD examination and self-reported fracture history were selected through screening,and the differences in hip BMD between the fracture group and the non-fracture group were compared by statistical analysis.Results A total of 10,476 people were included in the study,including 9,536 in the non-fracture group and 940 in the fracture group.The ratio of males in the fracture group was significantly higher than females.The average age of the fracture group was 62.77±9.07 years old,and the BMI of 29.24±5.77.The average age of the non-fracture group was 64.73±9.50 years old,and the BMI of 28.55±5.59.The result were statistical differences.The renal dysfunction and arthritis among the comorbidities in fracture group were significantly higher than non-fracture group.The result of covariance analysis showed that the bone mineral density of the hip,femoral neck,the greater trochanter,intertrochanteric and Ward’s triangle were significantly decreased in the fracture group.The result of subgroup analysis showed that the bone mineral density of the hip fracture group and the wrist fracture group decreased significantly,but there was no statistical difference in the bone mineral density of the spine fracture group.Conclusion Fracture history before age 50 result in a significant decrease in hip BMD after age 50,especially the wrist and hip fractures history.

关 键 词：骨折病史 骨密度 髋部 急性骨丢失 NHANES 

分 类 号：R68[医药卫生—骨科学]