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目的确立青岛地区正常成年女性骨密度(BMD)的正常参考范围,建立诊断成年女性骨质疏松的多骨骼部位BMD参考值,并预测骨折的风险性。方法用双能X线骨密度仪测量868名25～83岁女性参考人群和191例骨折患者的腰椎(L_2-L_4)和左侧髋部(股骨颈、大转子、Ward’s三角区)6个骨骼区域的BMD,用8种回归模型拟合健康成年女性人群BMD随年龄的变化,找出最佳拟合的方程和建立数据库,并对骨折患者的BMD进行分析,预测骨折的风险性。结果6个骨骼区域BMD随年龄变化,不同部位骨峰值出现的时间不同,腰椎在25～29岁,髋部在40～44岁。用三次回归模型拟合程度优于其他回归模型,拟合曲线的决定系数(R~2)为0.21±0.09(P＜0.01)。骨折患者BMD明显降低,与同地区同年龄正常女性相比,BMD下降幅度有限；而与同地区正常女性峰值骨量相比,BMD下降1.6～2.5s。结论女性在45岁以后骨丢失加速。50岁以后女性BMD低于同地区峰值BMD 1.6～2.5s,其骨折风险增加。
Objective To establish the normal reference range of bone mineral density (BMD) in normal adult women in Qingdao and to establish the reference value of multi-skeletal BMD for diagnosis of adult female osteoporosis and to predict the risk of fracture. Methods Bone energy was measured by dual energy X-ray absorptiometry in 868 female subjects aged 25-83 years and 191 patients with fractures of the lumbar spine (L_2-L_4) and the left hip (femoral neck, greater trochanter, Ward’s triangle) Region of BMD, 8 kinds of regression models were fitted to healthy adult women BMD changes with age, to find the best fit equation and the establishment of a database, and BMD fracture patients were analyzed to predict the risk of fracture. Results The bone mineral density (BMD) of 6 skeletal regions varied with age. The bone spikes at different sites appeared at different times. The lumbar spine was between 25 and 29 years old and the hip was between 40 and 44 years old. The cubic regression model was better than other regression models. The coefficient of determination (R ~ 2) of the fitted curve was 0.21 ± 0.09 (P <0.01). BMD was significantly lower in fracture patients than in normal females in the same age group, but BMD decreased 1.6 ~ 2.5s compared with peak bone mass in normal females in the same area. Conclusions Females accelerate bone loss after the age of 45. After 50 years of age, the female BMD is lower than the peak BMD of 1.6 ~ 2.5s in the same region, and the fracture risk increases.