上海市闵行区中老年群体中不同骨密度人群的尿钙水平调查分析

An investigation on urinary calcium level in middle-aged and elder population with different levels of bone mineral density in Shanghai Minhang District

目的探索上海市闵行区中老年人群钙营养状况及其与骨质疏松的相关性。方法对长期居住在上海闵行区的50岁以上的1460例体检人群进行问卷调查和体格检查,DXA测定腰椎、总髋、股骨颈和Ward三角区的骨密度,化学发光法测定空腹血钙、尿钙。根据WHO标准诊断骨量正常、减少和疏松,尿钙低于1.7 mmol/L为缺钙,骨质疏松尿钙高于5.3 mmol/L为高尿钙流失,其余为正常尿钙水平。结果 1460人中,骨质疏松人数为337人,占总人数的23.08%,骨量正常人数为420人,占总人数的28.77%。其中男性骨质疏松率为4.12%,女性骨质疏松率为37.88%。尿钙水平偏低人数为365人,占总人数的25.0%,高尿钙水平人数为176人,占总人数的12.1%。其中男性尿钙水平偏低率为30.32%,女性尿钙偏低率为22.78%。尿钙水平值以60岁以下骨量减少组3.67 mmol/L最高。三年尿钙水平变化值以女性骨质疏松组差异最显著(P<0.05)。结论缺钙率女性略低于男性群体,但骨质疏松率女性远远高于男性。老年群体中缺钙为普遍现象,缺钙外加高钙流失是导致老年性骨质疏松的主要因素。骨质疏松干预过程中,除补钙外,采取有效防治钙流失的措施是防治骨质疏松的关键。

Objective To investigate the calcium nutrition condition and to explore its association with osteoporosis prevalence of in middle-aged and elder population in Shanghai Minhang District. Methods A questionnaire investigation was conducted and physical examination was performed in 1460 over 50 years old regular residents in Shanghai Minhang District. BMD of the lumbar spine,total hip,femur neck,and Wards triangle was measured using dual energy X-ray absorptiometry. Fasting serum and urine calcium were determined with chemiluminescence method. Osteoporosis,osteopenia,and normal bone mass were diagnosed according to World Health Organization（WHO） criteria. Urinary calcium level below 1. 7 mmol/L was diagnosed as calcium deficiency. Urinary calcium level above 5. 3 mmol/L was diagnosed as high calcium loss. The rest was normal urinary calcium.Results Among 1460 subjects,337 were osteoporosis（23. 08%）,and 420 were normal bone mass（28. 77%）. Osteoporosis prevalence was 4. 12% in males and 37. 88% infemales. Urinary calcium deficiency was found in 365 persons（25. 0%）. High calcium loss was found in 176 persons（12. 1%）. Calcium deficiency was 30. 32% in males and 22. 78% in females. The highest urinary calcium level（3. 67 mmol/L） was found in subjects below 60 years old in osteopenia group. The 3-year changes of urinary calcium level were significant in female osteoporosis groups. Conclusion Calcium deficiency is higher in males than in females,but osteoporosis prevalence is much higher in females than in males. Calcium deficiency is common in aged population. Calcium deficiency plus high calcium loss are the main factors leading to senile osteoporosis. In the process of preventing osteoporosis in aged population,it is very important to avoid high calcium loss besides calcium supplement.