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背景:研究表明,健康男女骨密度峰值出现在大约20～40岁之间,进入中老年后骨量逐渐下降,从而导致骨质疏松症。目的:分析北京市东城区2个居委会289名健康中老年人骨密度变化及骨质疏松患病特征。设计:横断面调查。单位:卫生部北京医院北京老年医学研究所。对象:于1998-06/09采用整群随机方法选择北京市东城区2个居委会的289名45岁以上健康居民,男136名,女153名,年龄45～85岁。排除标准:①肝肾功能异常。②有影响骨代谢的各种因素(如:各种急慢性疾病;长期服用激素、钙剂等药物史;体脂指数小于19kg/m2或大于28kg/m2;长期卧床3个月以上;特殊职业人群)。所有受试对象均对检测项目知情同意。方法:采用美国Lunar公司的双能X线骨密度仪对所有受试对象进行骨密度测定,部位为左侧股骨近端(股骨颈,大转子,Ward’s三角区),腰椎2～4前后位。按世界卫生组织提出的骨质疏松症的诊断标准及本攻关项目获得的骨峰值确定各个部位骨质疏松症的诊断标准,股骨径:男性0.665g/cm2,女性0.677g/cm2;大转子:男性0.598g/cm2,女性0.506g/cm2;Ward’s三角区:男性0.492g/cm2,女性0.514g/cm2;腰椎2～4:男性0.760g/cm2,女性0.835g/cm2。同时参考“九五”攻关课题获得的骨峰值计算骨量丢失率和骨质疏松的患病率。主要观察指标:不同性别不同部位受试对象骨密度、骨量丢失率及骨质疏松患病率。结果:纳入调查对象289名均进入结果分析。①男性的骨密度随年龄增高的趋势不显著,女性骨密度降低以及骨量丢失均十分突出,且以55岁以后更加明显。②按部位分析骨量累积丢失率,男女均依次为Ward’s三角区>股骨径>大粗隆>腰椎2～4。③骨质疏松患病率随年龄明显升高,女性显著高于男性,差异有统计学意义(P<0.01)。骨质疏松发生以股骨径最高,其次是Ward’s三角区和腰椎2～4。结论:女性性别和年龄增加,尤其是绝经期是骨质疏松发生的危险因素,股骨径、Ward’s三角区、以及女性腰椎2～4是易发骨质疏松部位。
Background: Studies have shown that the peak of BMD in healthy men and women occurs between about 20 and 40 years of age, with a gradual decrease in bone mass after middle-aged and elderly people leading to osteoporosis. OBJECTIVE: To analyze the changes of bone mineral density (BMD) and the prevalence of osteoporosis in 289 healthy middle-aged and elderly residents in 2 neighborhood committees in Dongcheng District of Beijing. Design: Cross-sectional survey. Unit: Beijing Hospital of Ministry of Health Beijing Institute of Geriatrics. PARTICIPANTS: A total of 289 healthy people over the age of 45 living in two neighborhoods in Dongcheng District of Beijing were selected from a population randomized method in 1998-06 / 09. There were 136 males and 153 females aged 45-85 years old. Exclusion criteria: ① liver and kidney dysfunction. ② have a variety of factors that affect bone metabolism (such as: a variety of acute and chronic diseases; long-term use of hormones, calcium and other drug history; body fat index of less than 19kg / m2 or more than 28kg / m2; long-term bedridden more than 3 months; crowd). All subjects were informed of the test items. Methods: Bone mineral density (BMD) of all subjects was measured by Lunar dual-energy X-ray absorptiometry. The locations of the proximal femur (femoral neck, greater trochanter, Ward’s trigone) and anterior and posterior lumbar spine were measured. According to WHO diagnostic criteria for osteoporosis and the bone peak obtained from the project, the diagnostic criteria for osteoporosis were determined at each site. The femoral diameters were 0.665g / cm2 for males and 0.677g / cm2 for females. The greater trochanter: Male 0.598g / cm2, female 0.506g / cm2; Ward’s trigone: male 0.492g / cm2, female 0.514g / cm2; lumbar 2-4: male 0.760g / cm2, female 0.835g / cm2. At the same time, refer to the “nine five ” research topics to obtain bone spike peak loss rate and the prevalence of osteoporosis. MAIN OUTCOME MEASURES: Bone mineral density, bone loss rate and prevalence of osteoporosis in different parts of different sexes. Results: 289 subjects were included in the result analysis. ① The tendency of the male’s BMD with age is not significant, the female’s BMD and bone loss are very prominent, and more obvious after 55 years old. ② According to the site analysis of the cumulative loss rate of bone mass, both men and women followed by Ward’s triangle> femoral diameter> greater trochanter> 2 to 4 lumbar. The prevalence of osteoporosis increased significantly with age, the female was significantly higher than the male, the difference was statistically significant (P <0.01). Osteoporosis occurred with the highest femoral diameter, followed by Ward’s triangle and lumbar spine 2 ~ 4. CONCLUSIONS: Female gender and age increase, especially menopause, are risk factors for osteoporosis. Femoral diameters, Ward’s trigone, and female lumbar spine 2 to 4 are sites prone to osteoporosis.