滇西地区农村老年人跟骨骨密度与ADL的关联研究  

Association between calcaneal bone mineral density and activities of daily living among rural elderly people in western Yunnan province

作　　者：刘淑清 张腾 徐亚慧 张霓裳 艾志琼 赵维薇 袁芝琼 刘平果 饶天媛 尹家祥 洪汝丹 LIU Shuqing;ZHANG Teng;XU Yahui;ZHANG Nishang;AI Zhiqiong;ZHAO Weiwei;YUAN Zhiqiong;LIU Pingguo;RAO Tianyuan;YIN Jiaxiang;HONG Rudan(Dali University,Dali 671000,China;Kunming Medical University,Kunming 650500,China;Baoshan Advanced Vocational School of Traditional Chinese medicine,Baoshan 678000,China)

机构地区：[1]大理大学,云南大理671000 [2]昆明医科大学,云南昆明650500 [3]保山中医药高等专科学校,云南保山678000

出　　处：《中国骨质疏松杂志》2023年第4期555-561,共7页Chinese Journal of Osteoporosis

基　　金：云南省基础研究计划青年项目(2019FD100);云南省“兴滇英才支持计划”项目(YNWR-MY-2019-008)。

摘　　要：目的分析滇西地区农村老年人跟骨骨密度与日常生活活动能力(ADL)的关联。方法采用多阶段随机整群抽样方法抽取滇西4个县(区)22个村中≥60岁的2287名老年人进行问卷调查、体格检查和跟骨骨密度测量。结果滇西地区农村老年人ADL的受损率为30.7%。ADL受损者的跟骨超声声速(SOS)和宽带超声衰减(BUA)值均低于ADL未受损者(P<0.001)。多因素Logistic回归分析显示,SOS中水平组和高水平组发生ADL受损的风险分别是低水平组的0.77倍和0.76倍,BUA中水平组和高水平组发生ADL受损的风险均是低水平组的0.77倍。限制性立方样条(RCS)分析显示,SOS、BUA与ADL受损风险呈“U”形关联(P均<0.001)。分层分析显示,女性和60~79岁老年人的SOS、BUA与ADL受损呈负关联(OR<1,P均<0.05),但在男性和≥80岁老年人中无关联(OR包含1,P均>0.05)。结论滇西地区农村老年人跟骨骨密度与ADL相关,且SOS、BUA与ADL受损间呈“U”形非线性关联。尤其要关注女性和60~79岁的老年人骨密度状况。Objective To analyze the association between calcaneal bone mineral density and activities of daily living(ADL)among rural elderly people in western Yunnan province.Methods The multi-stage random cluster sampling method was used to select 2287 rural elderly people(≥60 years old)in 22 villages of 4 counties(districts)in western Yunnan province for questionnaire survey,physical examination and calcaneal bone mineral density detection.Results The impaired rate of ADL of the rural elderly people in western Yunnan province was 30.7%.SOS and BUA were lower in those with impaired ADL than normal(P<0.001).Multivariate logistic regression analysis showed that the risk of ADL impairment with SOS horizontal and high-level were 0.77 and 0.76 times higher compared with the low-level group,respectively,the risk of ADL impairment with BUA horizontal and high-level were both 0.77 times higher compared with the low-level group.RCS analysis showed a U-shaped association between SOS,BUA and the risk of ADL impairment(P<0.001).Stratified analysis showed that SOS and BUA were negatively associated with ADL impairment in women and in 60-79 years of age(OR<1,all P<0.05),but not in men and≥80 years of age(OR contains 1,all P>0.05).Conclusion Calcaneal bone mineral density is closely related to ADL among rural elderly people in western Yunnan province,and there was a U-shaped nonlinear correlation between SOS,BUA and ADL impairment.In particular,women and 60~79 year olds elderly people should be concerned about bone mineral density.

关 键 词：跟骨骨密度 日常生活活动能力 农村老年人 

分 类 号：R195[医药卫生—卫生统计学]