摘要
目的建立女性前臂骨不同测量部位的峰值骨量和标准差值,并探讨其可能影响因素,为周围型DEXA测定开展OP研究提供基础数据。方法对上海市区365例21～59岁社区女性健康志愿者,采用美国NORLAND-Stratec周围型双能X线骨矿测量仪(pDEXA)测量了非优势侧(左侧)前臂远端桡骨和尺骨(Distal radius and ulna,Dist.R+U)、近端桡骨和尺骨(Proximal radius and ulna,Prox.R+U)和近端桡骨(Proximal radius,Prox.R)的BMD值,并分析了其年龄分布,建立了女性前臂骨不同测量部位的峰值骨量和标准差值。同时,以问卷调查了可能影响因素。结果前臂骨各部位的BMD值均符合正态分布,可以采用均数±标准差(-x±s)的形式表示,OP的骨量诊断标准也可以用骨量峰值的算术均数降低标准差的形式建立。45岁以前女性前臂骨不同测量部位的BMD值均随年龄增加而逐步上升,但不同年龄段BMD值的差异并不显著(P>0.05),45岁以后BMD值明显下降。前臂骨不同测量部位的骨量峰值均出现在40～44岁年龄段,前臂远端桡+尺骨(Dist.R+U)、近端桡+尺骨(Prox.R+U)和近端桡骨(Prox.R)的骨量峰值及标准差分别为(0.3717±0.0423)g/cm2、(0.7958±0.0771)g/cm2和(0.7802±0.0671)g/cm2。此外,体重和怀孕次数对峰值骨量的形成有较大影响,体重过轻和怀孕次数过多均不利于峰值骨量的形成。结论建立女性前臂骨不同部位的骨量峰值和标准差,可为周围型DEXA测定开展OP研究提供基础数据,尤其是用于高危人群筛查以确定是否需进一步开展中轴骨测量或进行药物干预。
Objective To establish the peak bone mass and analyze the possible lifestyle determinants of bone mineral density in females of Shanghai. Methods A total of 365 healthy females aged 21 - 59 years were recruited to participate in the measurement of forearm bone mineral density by peripheral dual-energy X-ray absorptiometry （pDEXA）, and all subjects completed a questionnaire to obtain information on lifestyle. The scan sites include distal （area of minimum BMD in the distal radius ＋ ulna）, proximal （1/3 site or proximal radius ＋ ulna） and both. Values were expressed as BMD（ Bone Mineral Density, g/cm^2 ）and the distribution of various age groups was analyzed to establish the forearm BMD value of peak bone mass and standard deviation fir different scan site. Results Forearm BMD value for each scan site are in line with the normal distribution and can be represented as mean ± standard deviation（x^ -＋ s ）. The distal and proximal forearm BMD in different scan site in females increased with age before age 45, and reached the peak value at age 40 - 44, then decreased gradually. The peak BMD value represented as mean± standard deviation for the distal radial and ulna（Dist. R ＋ U BMD）, the proximal radial and ulna（Prox. R ＋ U BMD）, and proximal ulna（Prox. R BMD） were 0.3717 ± 0.0423 g/cm^2 ,0.7958 ± 0.0771 g/cm^2 and 0.7802 ± 0.0671 g/cm^2, respectively. Meanwhile, body weight and number of pregnancies were identified as significant predictors of peak bone mass, low body weight and excessive numbers of pregnancies were the major risk factors for low peak bone density. Conclusion Establishing the device-specific cut-points for peripheral BMD measurement would be useful to supply the basis data for the study of osteoporosis, such as screening patients for selection to central DXA testing, or identify individuals who might benefit from pharmacological intervention.
出处
《中国骨质疏松杂志》
CAS
CSCD
2009年第12期877-881,共5页
Chinese Journal of Osteoporosis
基金
上海市卫生局科研项目(054023)
关键词
峰值骨量
骨密度
周围型双能X线骨矿测量仪
影响因素
Peak bone mass
Bone mineral density
Peripheral dual-energy X-ray absorptiometry （pDEXA）
Lifestyle determinant
