苏州市相城区50岁以上女性骨质疏松症影响因素分析  

Analysis of influencing factors of osteoporosis in women aged 50 and above in Xiangcheng District of Suzhou City

作　　者：段蔚宇 张莹 陆艳[2] 吴向青 张群 DUAN Weiyu;ZHANG Ying;LU Yan;WU Xiangqing;ZHANG Qun(Department of chronic Non-communicable Disease Prevention and Control,Center for Disease Control and Prevention of Xiangcheng District,Suzhou 215131,China)

机构地区：[1]江苏省苏州市相城区疾病预防控制中心慢性非传染性疾病防治科,215131 [2]苏州市疾病预防控制中心慢性非传染性疾病防制科

出　　处：《中国煤炭工业医学杂志》2024年第6期597-603,共7页Chinese Journal of Coal Industry Medicine

基　　金：江苏省老年健康科研项目(编号:LKM2023038)

摘　　要：目的 通过对苏州市相城区173名50周岁及以上女性开展双能X线吸收法(DXA)测定骨密度、血生化及相关人口学调查,探讨年龄、体质量指数(BMI)、血生化指标对骨密度变化的影响,为本地区骨质疏松症的防治提供科学依据。方法 收集2021—2022年在苏州大学附属第一医院进行体检,且符合纳入排除标准的50周岁及以上女性173名,采用DXA法测量腰椎(L1-4)和股骨颈骨密度值及血糖、血脂等血生化指标并开展问卷调查,根据骨质疏松症诊疗分为骨量正常者、骨量减少者和骨质疏松者,利用logistic回归分析不同指标和骨质疏松症的相关性,采用受试者工作特征曲线(ROC)和曲线下面积(AUC)评价不同肥胖测量指标对骨质疏松症的预测价值。结果 173名参与者中骨质疏松占26.01%,骨量减少占46.82%,骨量正常占27.17%。三组患者的年龄、身高、体重、BMI、甘油三酯(TG)、TG/HDL-C、内脏脂肪指数(VAI)和脂质蓄积指数(LAP),差异均有统计学意义(P<0.05)。随着年龄增长骨量减少的风险增加(OR=1.07,95%CI:1.01~1.13,P=0.021),骨质疏松的风险也同样增加(OR=1.16,95%CI:1.06~1.26,P<0.001)。随着BMI的增加,骨量减少(OR=0.78,95%CI:0.68~0.90,P<0.001)和骨质疏松(OR=0.62,95%CI:0.49~0.78,P<0.001)的风险会减少。随着LAP的增加,骨量减少和骨质疏松的风险会增加(P<0.001),随着VAI的增加,骨量减少和骨质疏松的风险会减少(P<0.001)。VAI和LAP预测50岁以上女性骨量减少的AUC为0.608(95%CI:0.507~0.710,P=0.041),LAP的AUC为0.605(95%CI:0.504~0.706,P=0.048)。结论 年龄、BMI、VAI和LAP是骨质疏松症的影响因素。随着VAI的增加,骨量减少和骨质疏松的风险会减少,随着LAP的增加,骨量减少和骨质疏松的风险会增加。Objective Through the dual-energy X-ray absorptiometry(DXA)measurement of bone mineral density,blood biochemistry and related demographic survey of 173 women over 50 years old in Xiangcheng District of Suzhou City,this paper discusses the influence of age,body mass index and blood biochemical indexes on bone mineral density changes,and provides scientific basis for the prevention and treatment of osteoporosis in this area.Methods A total of 173 women aged 50 years and above who met the inclusion and exclusion criteria and were treated in the First Affiliated Hospital of Soochow University from 2021 to 2022 were collected.DXA was used to determine the BMD of the lumbar vertebrae(L1-4)and the femoral neck as well as related biochemical indicators and a questionnaire survey conducted.According to the diagnosis and treatment of osteoporosis,it is divided into normal bone mass,osteopenia and osteoporosis.The correlation between different indicators and osteoporosis was analyzed using logistic regression.The predictive value of different obesity indicators for osteoporosis was evaluated using the operating characteristic curve(ROC)and the area under the curve(AUC).Results Among the 173 participants,osteoporosis accounted for 26.01%,osteopenia accounted for 46.82%,and normal bone mass accounted for 27.17%.There were significant differences in age,height,weight,BMI,triglycerides(TG),TG/HDL-C,visceral fat index(VAI)and lipid accumulation index(LAP)between the three groups(P<0.05).The risk of osteopenia increased with age(OR=1.07,95%CI:1.01-1.13,P=0.021),and the risk of osteoporosis also increased(OR=1.16,95%CI:1.06-1.26,P<0.001).With the increase of BMI,the risk of osteopenia(OR=0.78,95%CI:0.68-0.90,P<0.001)and osteoporosis(OR=0.62,95%CI:0.49-0.78,P<0.001)decreased.The risk of osteopenia and osteoporosis increases with an increase in LAP(P<0.001),and with an increase in VAI,the risk of osteopenia and osteoporosis decreases(P<0.001).The area under the ROC curve(AUC)of VAI and LAP for predicting osteopenia in women over 50

关 键 词：骨质疏松症 双能X线吸收法 骨密度 脂质积累产物指标 

分 类 号：R473.2[医药卫生—护理学]