中老年人前臂骨密度变化及其影响因素分析

Change of forearm bone mineral density in mid-aged and elderly people and its impact factors

目的了解中老年人前臂骨密度的状况，分析影响中老年人骨密度的因素。方法在上海市徐汇区田林、枫林、斜土3个街道，采用单能X线骨密度仪测量中老年人左前臂远端1／3桡骨总体、尺骨总体，以及桡尺骨间距为8mm处的桡骨远端、前臂桡骨超远端等部位的骨密度值。结果4个测量部位的骨密度均随年龄增加而下降，女性下降速率快于男性；同一年龄、同一部位的男性骨密度平均值大于女性；4个部位中以前臂远端1／3桡骨总体骨密度最高；除男性60岁～骨量减少的现患率低于55岁～外，前臂远端1／3桡骨总体骨量减少的现患率及骨质疏松症的现患率均随年龄的增加而上升。多因素Logistic回归显示，男性患骨量减少的可能性是女性的0．19倍；以50岁～为参照，55岁～、60岁～、65～71岁与之比较，OR分别为3．17，5．13，15．03；月均收入在1000元以上与1000以下的比较，OR为0．70；补充钙片者与没补充钙片者比较，OR为1．36。结论中老年人骨密度减少的现患率较高，骨密度减少与性别、年龄、月均收入、补充钙片等有关。

Objective To understand the status of the forearm bone mineral density（BMD） in mid- aged and elderly people. To find the potential factors influencing BMD. Methods 1214 mid - aged and elderly people were examined, in Tianlin, Fenglin and Xietu sub districts in Xuhui District, Shanghai. BMD were measured at four regions in left forearm, containing distal radius and ulna 1/3 total, distal radius where the distance of radius and ulna was 8mm, ultra - distal radius, by single energy X - ray densitometer. Results The BMD at all of the four regions descended with the age increasing, and more quickly in female than in male. The average BMD was higher in male than in female, in the same age and region. And distal radius 1/3 total had the highest BMD of the four regions. The incidence of low bone mineral density and osteoporosis in distal forearm 1/3 radio- total ascended with the age increase, with an exception that males aged 60 -- 65 had higher incidence than those aged 55 -- 60. Multiplied logistic regression shows that males had a lower risk to be low bone mineral density, the odds ratio was 0.19 compared with female. With the group aging from 50 to 55, the odds ratio in the group aging from 55 to 60, 60 to 65, 65 to 70 were 3.17, 5.13, 15.03. Compared with those earning a monthly salary less than 1 000, the odds ratio was 0.70 in the those earning a salary more than 1 000. Those taking calcium tablet share an odds ratio of 1.36, comparing with those who don＇t. Conclusion The incidence of low bone mineral density is high in mid-aged and elderly population, and it is related with sex, age, monthly income, calcium tablet intake.