中国女性的年龄相关骨密度、骨丢失率、骨质疏松发生率及参考数据库--多中心合作项目

Age-related bone mineral density,bone loss rate,prevalence of osteoporosis and reference database of women at multiple centers in China

目的本研究采用多中心合作调查了中国女性的年龄相关骨密度(BMD)、骨丢失率和骨质疏松发生率。调查结果被用来建立一个BMD参考数据库,用以诊断中国女性的骨质疏松。方法采用双能X线吸收骨密度测量仪(DXA)测量了北京、上海、广州、成都、南京和嘉兴地区20～89岁女性的腰椎(L1～L4)(n=8142)和髋部(n=7290)的BMD值。不同部位骨骼BMD随年龄的变化用三次回归模型拟合来描述。结果股骨颈和全股骨的BMD峰值出现在30～34岁,脊柱和股骨粗隆部的峰值出现在40～44岁。年轻成人的(YA)的BMD值(均值和标准差(SD)用20～39岁年龄段的平均BMD进行计算)在后前位脊柱、股骨颈、股骨粗隆和全股骨分别为1.116±0.12g/cm2、0.927±0.12g/cm2、0.756±0.11g/cm2和0.963±0.13g/cm2。85岁老年女性脊柱的BMD减少了32%,股骨减少了30%～35%。骨质疏松的定义是BMD值与本研究组中确立的年轻成人BMD值相比≤-2.5个标准差,在50岁及以上的女性,发生率分别为脊柱28%、股骨任何部位15%、脊柱或者股骨为31%。结论本研究为中国女性骨质疏松的预防和治疗提供了重要数据,并且建立了一个可供全中国范围内女性骨质疏松诊断使用的可靠的参考数据库。

Objective Our study surveyed age-related bone mineral density （BMD）, bone loss rate, and prevalence of osteoporosis in women at multiple research centers in China, Survey results were used to establish a BMD reference database for the diagnosis of osteoporosis in Chinese women nationwide. Methods Utilized dual- energy X-ray absorptiometry （DXA） bone densitometers to measure BMD at posteroantefior （PA） lumbar spine （L1-L4） （ n = 8 142） and proximal femur （ n = 7 290） in female subjects age 20 - 89 years from Beijing, Shanghai, Guangzhou, Chengdu, Nanjing, and Jiaxing. A cubic regression-fitting model was used to describe the change of BMD with age at various skeletal sites. Results Peak BMD occurred between the ages of 30 to 34 years for femur neck and total femur, and between 40 - 44 years for spine and trochanter measurement sites. Young adult （YA） BMD values （mean and standard deviation （SD）, calculated as the average BMD in the age range of 20-39, were 1.116±0.12 g/cm^2,0.927±0.12 g/cm^2, 0.756±0.11 g/cm^2 and 0.963±0.13 g/cm^2 at PA spine, femoral neck, trochanter, and total femur, respectively. The BMD of 85 year old women reflected a loss of 32% at the spine and 30% to 35% at femur messurement sites.The prevalence of osteoporosis,defined as a BMD of ≤-2.5 standard deviations from YA values established in this study ,in fenale subjects age 50 yesrs or older,was 28% for the spine ,15% for any femur site,and 31% for any spine or femur site.Conclusion This study provids important information for formulating osteoporosis prevention and treatemnt strategies in Chinese women,and it establishes a reliable BMD reference database for the diagnosis of osteoporosis of Chinese women nationwide.