中国40岁及以上绝经后女性骨质疏松症患病率及其影响因素研究

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目的:了解我国≥40岁绝经后女性骨质疏松症患病率及其影响因素,为我国骨质疏松症防控工作提供科学依据。方法:本研究数据来自2018年中国骨质疏松症流行病学调查,覆盖全国11个省(直辖市)44个县(区),通过问卷调查、体格检查收集调查对象相关变量,并采用双能X线吸收法测量腰椎和股骨近端骨密度。应用复杂抽样加权估计我国≥40岁绝经后女性骨质疏松症患病率及其95%n CI并分析其影响因素。n 结果:纳入分析5 728人,中国≥40岁绝经后女性骨质疏松症患病率为32.5%(95%n CI:30.3%~34.7%)。其中,40~、50~、60~、70~、≥80岁绝经后女性骨质疏松症患病率为16.0%(95%n CI:4.5%~27.5%)、18.4%(95%n CI:15.9%~20.8%)、37.5%(95%n CI:34.5%~40.4%)、52.9%(95%n CI:47.5%~58.3%)和68.0%(95%n CI:55.9%~80.1%);文盲或小学以下文化程度和家庭人均年收入<10 000元人群骨质疏松症患病率较高(n P<0.001),分别为47.2%(95%n CI:43.0%~51.3%)和40.3%(95%n CI:36.9%~43.7%);农村[35.1%(95%n CI:32.0%~38.1%)]高于城市(n P<0.001);低体重、正常体重、超重、肥胖人群骨质疏松症患病率分别为69.9%(95%n CI:59.0%~80.8%)、42.2%(95%n CI:38.7%~45.7%)、24.2%(95%n CI:21.3%~27.1%)和14.6%(95%n CI:11.1%~18.0%)。月经维持年限≤30年和绝经年限≥11年骨质疏松症患病率相对较高(n P<0.001),分别为46.1%(95%n CI:40.8%~51.3%)和48.2%(95%n CI:45.0%~51.3%)。多因素logistic回归分析结果显示,年龄≥60岁、文盲或小学以下文化程度、家庭人均年收入<10 000元、低体重、月经维持年限≤30年、绝经年限≥11年绝经后女性骨质疏松症患病风险高。n 结论:我国≥40岁绝经后女性骨质疏松症患病率较高,且在不同社会经济地位组间存在差异,应有效开展重点人群骨质疏松症防控工作。“,”Objective:To understand the prevalence of osteoporosis and related factors in postmenopausal women aged ≥40 years in China and provide scientific evidence for osteoporosis prevention and control.Methods:Data of this study were from the 2018 China Osteoporosis Epidemiological Survey, covering 44 counties (districts) in 11 provinces in China. Related variables were collected by questionnaire survey and physical measurement, and the BMD of lumbar spine and proximal femur was measured by dual-energy X-ray absorption method. The prevalence of osteoporosis and its 95%n CI in postmenopausal women aged ≥40 years were estimated with complex sampling weights.n Results:A total of 5 728 postmenopausal women aged ≥40 years were included in the analysis and the prevalence of osteoporosis was 32.5% (95%n CI: 30.3%-34.7%). The prevalence of osteoporosis in postmenopausal women aged 40-49 years, 50-59 years, 60-69 years, 70-79 years, and ≥80 years were 16.0% (95%n CI:4.5%-27.5%), 18.4% (95%n CI:15.9%-20.8%), 37.5% (95%n CI:34.5%-40.4%), 52.9% (95%n CI: 47.5%-58.3%), and 68.0% (95%n CI:55.9%-80.1%) respectively. The prevalence of osteoporosis was higher (n P<0.001) in those with education level of primary school or below (47.2%, 95%n CI: 43.0%-51.3%) and in those with individual annual income less than 10 000 Yuan, (40.3%, 95%n CI: 36.9%-43.7%). The prevalence of osteoporosis was 35.1% in rural areas (95%n CI: 32.0%-38.1%), which was higher than that in urban areas (n P<0.001). The prevalence of osteoporosis in low weight, normal weight, overweight and obese groups were 69.9% (95%n CI: 59.0%-80.8%), 42.2% (95%n CI: 38.7%-45.7%), 24.2% (95%n CI: 21.3%-27.1%) and 14.6% (95%n CI: 11.1%-18.0%), respectively. The prevalence of osteoporosis in those with menstrual maintenance years ≤30 years and in those with menopause years ≥11 years were 46.1% (95%n CI:40.8%-51.3%) and 48.2% (95%n CI:45.0%-51.3%), respectively. Multivariate logistic analysis showed that age ≥60 years, education level of primary school or below, annual household income per capita less than 10 000 Yuan, low body weight, menstrual maintenance years ≤30 years, menopause years ≥11 years were risk factors of osteoporosis in postmenopausal women in China.n Conclusions:The prevalence of osteoporosis was high in postmenopausal women aged ≥40 years in China, and there were differences in osteoporosis prevalence among different socioeconomic groups. Effective interventions should be taken for the prevention and control of osteoporosis in key groups in the future.
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