哈尔滨地区健康人群1631名骨密度分析 性别及地区差异

Analysis on bone mineral density in 1 631 healthy persons in Harbin district:difference of sex and district

目的：探讨哈尔滨地区健康人群腰椎、股骨近端骨密度的年龄变化规律，确定达到峰值骨量年龄段和各年龄段骨密度平均值，了解与腰椎、股骨近端骨密度相关的因素。 方法：①调查于2004-03／12在哈尔滨医科大学第二附属医院老年病科完成，对1631名健康人群进行测试，男817名，女814名，年龄20～89岁。②采用美国Lunar公司生产的DPX-MD型双能X射线骨密度仪对受试者进行L_(2～4)椎体正位、股骨近端骨密度测量。受试者年龄20～89岁，每5岁为一年龄组，将其分成14组。记录L_(2～4)正位椎体、股骨近端骨密度值。③计量资料差异比较采用t检验。采用多变量的相关分析。 结果：①正常男性腰椎及股骨近端骨峰值年龄均在25～29岁。随着年龄增长，各部位骨密度逐渐降低，但腰椎骨密度在75岁以后有反弹现象。②正常女性腰椎骨峰值年龄在35～39岁，股骨近端骨峰值年龄在25～29岁，随着年龄增长，各部位骨密度开始下降，55～59岁为女性骨量丢失加速期(P<0．01)。③哈尔滨地区各部位骨峰值稍低于北京地区，但高于广州、昆明地区。哈尔滨地区男性与女性腰椎骨峰值差异不明显(P>0．05)，股骨近端骨峰值明显高于女性(P<0．01)。④身高、体质量与腰椎和股骨近端骨密度呈显著正相关(r=0．172～0．419，P<0．01)。⑤L(2～4)椎体：男性下降12．1％，女性下降24．1％；股骨Ward三角区：男性下降41．6％，女性下降49．8％。 结论：①男性腰椎及股骨近端骨峰值年龄在25～29岁，女性腰椎骨峰值年龄出现在35～39岁，股骨近端在25～29岁。②哈尔滨地区男性股骨近端骨峰值明显高于女性。③哈尔滨地区健康人群腰椎及股骨近端骨峰值稍低于北京地区，但高于广州、昆明地区。④哈尔滨地区健康男性骨量呈缓慢下降趋势，腰椎骨密度在75岁以后有反弹现象，女性在55～59岁是骨量丢失的加速期。⑤哈尔滨地区健康人群腰椎及股骨近端骨密度均与体质量和身高有关。⑥利用股骨Ward三角区评价骨密度状况比L(2～4)椎体骨密度更有意义。

AIM： To explore the changes of bone mineral density （BMD） of lumbar spines and proximal femur with increasing age in healthy persons in Harbin district, to make sure the age period that reaches the peak BMD and average value of BMD in every age period, and understand the related factors with BMI） of lumbar vertebrae and proximal femur. METHODS： ①The experiment was conducted at the Department of Geriatrics, Second Affiliated Hospital, Harbin Medical University from March to December 2004. 1631 healthy subjects were investigated, including 817 males and 814 females, aged 20-89 years. ②The BMD of eutopie vertebral body （L2-4） and proximal femur was measured by DPX-MD type, dual-energy X-ray densitometer produced by Lunar Company. The testees were aged from 20 to 89 years, every. 5 years as an age group, and they were divided into 14 groups. The BMD value of eutopic lumbar vertebrae and proximal femur （L2-4） was recorded. （3）The differences of measurement data were compared with t-test and multiple variable correlation analusis. RESULTS： ① The peak BMD of lumbar spine and proximal femur in normal males all appeared in the age from 25 to 29. With the age increasing, the bone mineral density decreased gradually, but that of lumbar spine would increase after 75 years old. ② The peak BMD of lumbar spine in normal females appeared between the age of 35 and 39 years, and that of proximal femur appeared hetween 25 and 29.The BMD decreased gradually with the age increasing, but significant loss of BMD was found between 55 and 59 years （P 〈 0.01）. ③ The peak BMD of every part in Harbin district was lower than that in Beijing, but higher than Guangzhou and Kunming. The difference of peak BMD of lumbar vertebrae was insignificant between males and females in Harbin district （P 〉 0.05）, and the peak BMD of proximal femur was higher significantly than that in females （P 〈 0.01）. ④ The height, body mass and lumbar vertebrae with BMD of proximal femur showed significant positive correlation （r=0.172- 0.419,P 〈 0.01）. ⑤ L2-4 vertebral body： Decreased 12.1% in males, 24.1% in females; Femur Ward triangular region： Decreased 41.6% in males, 49.8% in females. CONCLUSION： ① The peak BMD of lumbar spine and proximal femur in males appeares from in the age of 25 to 29. The peak BMD of lumbar spine in females appeares between the age of 35 and 39 years, and that of proximal femur appeares between 25 and 29. ② The peak BMD of proximal femur in males is significantly higher than that in females in Harbin district. ③ The peak BMD of lumbar vertebrae and proximal femur in Harbin district is lower than that in Beijing, but higher than Guangzhou and Kunming. ④ The content of bone in healthy males in Harbin district shows the tendency of decrease, but that of lumbar spine will increase after 75 years old, and significant loss of BMD is found between 55 and 59 years in females. ⑤ The BMD of lumbar vertebrae and proximal femur is related to body mass and height in healthy persons in Harbin district. ⑥ The evaluation on status of BMD with femur Ward triangular region is more significant as compared with BMD of L2-4 vertebral body.