昆明地区正常人群骨矿密度观察

Measurement of BMD with DEXA in people living in Kunming area

目的了解昆明地区正常人群骨密度(BMD)的年龄变化规律,建立该地区骨矿密度正常值标准。方法 1998～2003年间,采用美国 Lunar 公司生产的 Expert 型双能骨密度仪(DEXA)测量年龄在20～90岁之间的1035例正常人腰椎及股骨近端骨密度值。每10岁为一个年龄组,共分为男女各7个组。数据用 SPSS 统计软件进行统计分析。结果 (1)男女两性均于30～39岁呈现骨峰值；此后随年龄的增长,骨矿密度逐渐开始下降(80岁以上组除外)。(2)第一腰椎的骨峰值较第四腰椎为低(P＜0．01)；(3)80岁以上组骨密度出现反向增高,特别是在腰椎。结论 (1)昆明地区正常人群 BMD 值较北方地区低,可能是由于海拔(1800～2000m)较高,造成一定的低气压和缺氧环境的缘故。另外,云南人的身高和体重普遍较北方人低,也是造成其骨密度均值较低的一个重要因素；(2)昆明正常人群的骨密度明显高于成都。这可能是由于昆明日照时间(平均2522h/年)较长的缘故；(3)80岁以上年龄组骨质的退变、软组织的钙化都使得骨矿密度假性增高。

Objective To observe the regularities of lumbar and femur BMD values of different age to set up the normal BMD data in Kunming, Yunnan province. Methods Bone mineral density（BMD）of anterior-posterior lumbar and proximal femur of 1035 healthy individuals living in Kunming area were measured with a Dual energy X-ray absorptiometry （DEXA Expert-XL） from 1998 to 2003. All the people were divided into 7 groups according to their ages （range from 20 to 90）. The data was statistically analyzed with SPSS by sex and site. Results The result indicated that whatever males or females the PBM （Peak Bone Mineral） comes at 30-39 years old and then the BMD began to deeline gradually with age inereasing. The PBM of females are equal to that of males. In age eighty group, the decline in males is 13.8 %（ Total of femur） and 10.4 %（Lumbar） and in females are 19.9 %（ Total of femur） and 20.3 %（Lumbar）. The PBM of L1 is lower than that of L4 （P〈0.01）. Conelusions In age eighty group, BMD is higher than that of 70＇s group. The BMD values of lumbar and femur are related with both bone loss and degeneration. The data showed that the BMD is higher in Kunming area than in Chengdu. This resuh could be attributes to the long sunshine time of Kunming. However, the BMD of in Kunming is lower than that of in northern China area. The results also indieated the people living in Kunming area with low atmospherie pressure and oxygen of plateau and the less height and body weight may affeet their BMD values.