应用不同骨密度诊断标准计算骨质疏松症患病率比较研究

Comparison study on application of different diagnostic criteria to the prevalence rate of osteoporosis

目的应用骨峰值骨密度(BMD)减2.0个或2.5标准差(简称:2.0s或2.5s)计算骨质疏松症患病率,为建立中国一般人群骨质疏松症(OP)骨密度诊断标准提供参考数据。方法采用分层多阶段整群抽样方法对中国五大行政区6381例20岁以上男女人群进行骨密度测量。结果我国部分地区骨质疏松症总患病率(按累计丢失率最高部位计算)为32.3%(2.0s)和14.9%(2.5s),二种骨密度诊断标准计算骨质疏松症患病率相差值为17.4%,相差2.2倍;其中男性26.4%(2.0s)和10.6%(2.5s),差值为15.8%,相差2.5倍;,女性37.2%(2.0s)和18.5%(2.5s),差值为18.7%,相差2.0倍;差值在不同地区、不同年龄组,城乡之间OP患病率亦存在类似结果,差值范围为0.5%～32.3%(1.3～11倍)之间。结论在流行病学人群调查筛选病例,进行危险因素分析和对骨质疏松高危人群进行干预实验时可参考以BMD峰值减低2.0s作为诊断骨质疏松症的标准:而在临床诊断和治疗病人及确定骨质疏松性骨折BMD阈值或进行国际骨质疏松症多中心比较时可参考以BMD峰值减低2.5s作为诊断骨质疏松症的标准。

Objective Using two diagnostic criteria including peak bone values subtracting 2.0 deviation and 2.5 deviation to calculate the prevalence rates of osteoporosis, in order to provide the references data to set up osteoporosis diagnostic criteria in Chinese people. Method Bone mineral density (BMD) was measured from 6,381 people aged above 20 years old in five administrative areas in China, by the stratified-multi-steps-cluster sampling method. Result The total prevalence rate of osteoporosis in part of China was 32.3%(2.0 s) and 14.9%(2.5 s). The deviation is 17.4% (2.2 times of 2.0 s than 2.5 s) according to the most significant parts of the lose rate. Of them, the prevalence rate of osteoporosis in male was 26.4%(2.0 s) and 10.6%(2.5 s). The deviation is 15.8%(2.5 times of 2.0 s than 2.5 s); That of females was 37.2% (2.0 s)and 18.5%(2.5 s). The deviation is 18.7.We also show the same results including the deviation range from 0.5～32.3%( 1.3 to 11 times of 2.0 s than 2.5 s) in different areas, age groups and provinces. Conclusion We suggested that we should use the 2.0 s in the study of screening cases, risk factors analysis and intervention trials and use the 2.5 s in the clinical diagnosis, treatment, study of BMD threshold of fractures and international comparative study on osteoporosis.