摘要
目的:调查北京市社区中老年人群骨量状态及骨质疏松症检出率,以期了解社区高危人群的骨量异常发生发展趋势。方法:采用横断面调查研究方法,现场采集10个社区1540例中老年人口信息数据,其中男415例,女1125例;年龄45~80(63.02±7.15)岁;身高(161.34±7.24)cm;体重(65.90±10.19)kg;身体质量指数(25.29±3.32)kg/m2。采用双能X线骨密度仪测量受试者腰椎(L1-L4)、双髋部位骨密度,评价各年龄段人群骨密度及骨量水平差异,计算受试者不同部位骨质疏松检出率。采集受试者空腹状态下肘静脉血,检测并比较血清骨代谢标志物水平的性别差异。结果:调查对象β-CTX水平(0.27±0.12)ng/ml,血清Ⅰ型原胶原氨基酸端肽(procollagen type 1 N-terminal propeptide,P1NP)水平为(51.03±22.36)ng/ml,25(OH)D3水平为(16.68±6.24)ng/ml,血钙水平为(2.34±0.09)mmol/L,血磷水平为(1.43±0.37)mmol/L,血镁水平为(0.94±0.07)mmol/L,碱性磷酸酶(alkaline phosphatase,ALP)水平为(79.28±20.48)U/L,甲状旁腺激素(parathyroid hormone,PTH)水平为(3.09±1.60)pmol/L,血清骨钙素(osteocalcin,OST)水平为(13.29±6.65)ng/ml。除血镁外,其余指标不同性别组间比较差异均有统计学意义(P<0.05)。调查人群骨密度T值与骨量水平提示:腰椎与双髋骨密度均随年龄递增而波动下降;女性各部位骨量水平在不同年龄段间差异有统计学意义(P<0.05),男性除腰椎外,其余部位骨量水平在不同年龄段间比较差异有统计学意义(P<0.05)。全人群腰椎骨质疏松检出率为27.89%,左髋骨质疏松检出率14.80%,右髋骨质疏松检出率14.47%。结论:不同部位之间的骨质疏松及低骨量检出率具有较大差异,建议临床应联合骨密度与骨代谢标志物共同诊断骨质疏松症。随着北京市社区中老年人群的骨质疏松患病率上升,以社区基层医疗单位为哨点,持续开展随访研究工作可促进社区中老年骨质疏松高危人群的早筛查、早诊断、早治疗。
Objective:To investigate the relevance ratio of osteoporosis and bone mass of middle aged and elderly people in Beijing communities,in order to understand occurrence and development trend of abnormality of bone mass in high-risk population from community.Methods:Based on the method of cross-sectional investigation,the information data of 1540 middle-aged and elderly people from 10 communities were collected,including 415 males and 1125 females,aged from 45 to 80 years old with the average of(63.02±7.15)years old;the height was(161.34±7.24)cm,the weight was(65.90±10.19)kg,body mass index was(25.29±3.32)kg/m2.Bone mineral density(BMD)of lumbar vertebrae(L1-L4)and both hips were measured by dual energy X-ray absorptiometry(DEXA).The differences of bone mineral density and bone mass in different age groups were evaluated,and the relevance ratio of osteoporosis in different parts of the subjects was calculated.Elbow venous blood was collected on an empty stomach,and the gender differences of serum bone metabolic markers were detected and compared.Results:The level ofβ-CTX was(0.27±0.12)ng/ml,procollanen type 1 N-terminal propeptide(P1NP)was(51.03±22.36)ng/ml,25(OH)D3 was(16.68±6.24)ng/ml,serum calcium was(2.34±0.09)mmol/L,blood phosphorus was(1.43±0.37)mmol/L,and blood magnesium was(0.94±0.07)mmol/L,alkaline phosphatase was(79.28±20.48)U/L,parathyroid hormone was(3.09±1.60)pmol/L,osteocalcin was(13.29±6.65)ng/ml.Except for blood magnesium,the other indexes had significant differences between different sex groups(P<0.05).Results of T value of bone mineral density and level of bone mass showed that bone mineral density of lumbar vertebrae and both hips fluctuated and decreased with the increase of age,and there were significant differences in level of bone mass among different age groups in women(P<0.05),and except lumbar vertebrae in males,there were significant differences in other parts of bone mass among different age groups(P<0.05).The relevance ratio of lumbar osteoporosis,left hip osteoporosis,and right hip osteoporosis was 27.89%,14.80%and 14.47%,respectively.Conclusion:There are obvious differences in relevance ratio of osteoporosis and low bone mass among different sites.It is suggested that the clinical diagnosis of osteoporosis should be combined with bone mineral density and bone metabolic markers.With the increasing prevalence of osteoporosis among middle-aged and elderly people in Beijing community,continuous follow-up research based on community primary health care units could promote early examination,early diagnosis,and early treatment of middle-aged and elderly people at high risk of osteoporosis in community.
作者
章轶立
魏戌
谢雁鸣
朱立国
高景华
申浩
柴言
孙梦华
张成
孙凯
唐彬
姜俊杰
支英杰
于忱忱
ZHANG Yi-li;WEI Xu;XIE Yan-ming;ZHU Li-guo;GAO Jing-hua;SHEN Hao;CHAI Yan;SUN Meng-hua;ZHANG Cheng;SUN Kai;TANG Bin;JIANG Jun-jie;ZHI Ying-jie;and YU Chen-chen(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China)
出处
《中国骨伤》
CAS
CSCD
2020年第10期916-921,共6页
China Journal of Orthopaedics and Traumatology
基金
国家中医临床研究基地项目第二批科研专项(编号:JDZX2015076)
中华中医药学会(2017—2019年度)青年人才托举工程项目(编号:CACM-2017-QNRC2-A03)
中国中医科学院优秀青年科技人才(创新类)培养专项(编号:ZZ13-YQ-039)
中国中医科学院循证能力提升建设项目(编号:ZZ13-024-7)。
关键词
骨质疏松
横断面研究
骨密度
中年人
老年人
Osteoporosis
Cross-sectional study
Bone mineral density
Middle aged
Aged
