健康人群腰椎aBMD和vBMD检测及临床应用

Measurements and clinical practice of aBMD and vBMD of lumbar spine in healthy people

目的观察成都地区健康人群腰椎面积骨密度（aBMD）、体积骨密度（vBMD）的变化规律;探讨体重指数（BMI）、体表面积（BS）与腰椎aBMD、vBMD的关系。方法①用LUNAR公司生产的EXPERT-XL双能X线骨密度仪,按常规的骨密度检测方法,测定成都地区健康体检者636例（男性247例,女性389例）,年龄20～90岁,测定部位包括腰椎正位、侧位L2-4。计算出体积骨密度。②统计学处理：用SPSS 13.0统计软件,按年龄、性别分别输入数据,以10岁为一年龄组,分别计算各组骨密度值,结果以-x±s表示。BMI、BS与aBMD、vBMD相关性用pearson相关分析。结果①男性腰椎aBMD、vBMD峰值骨密度出现在30～39岁;女性腰椎aBMD、vBMD峰值骨密度出现在20～29岁;随着年龄增加,骨密度逐渐降低。②男女腰椎aBMD累积最高丢失率分别为11.2%、30.1%,女性累积丢失率明显高于男性。男女腰椎vBMD累积最高丢失率分别为14.2%、30.4%,女性累积丢失率明显高于男性。③男性BMI、BS与aBMD骨密度呈正相关,r=0.241～0.371（P〈0.01）;与vBMD L2-4无明显相关性（P〉0.05）。女性BMI、BS与aBMD呈正相关,r=0.143～0.425（P〈0.01）;与vBMD L2-4无明显相关性（P〉0.05）。结论①男、女腰椎aBMD、vBMD分别在30～39岁,20～29岁达峰值;女性更应注意预防骨质疏松。②健康人群BMI、BS与腰椎aBMD呈正相关,与vBMD无明显相关性。

Objective To investigate the changes of aBMD （areal bone mineral density） and vBMD （volumetric bone mineral density） of lumbar spine and to explore the relationship between body mass index （BMI）, body surface area （BS） and aBMD and vBMD of lumbar spine in healthy people. Methods 1.636 heathy people aged 20 ～ 90 were measured at the lumbar spine and lateral lumbar spine by Lunar Expert-XL dual energy X-ray absorptiometry.2. Data of aBMD and vBMD were analyzed by 10 years a group of male and female respectively. 3.The results were analyzed with SPSS version 13.0 and pearson correlation analysis were used. Results 1 .The peak bone mass（PBM） of aBMD and vBMD of lumbar spine in male and female were in age groups of 30 - 39 and 20 ～ 29 respectively ; ABMD and vBMD of lumbar spine declined with increasing age. There were significant positive correlation between BMI, BS and aBMDs in male and female（ r = 0. 241 ～ 0.371, r = 0. 143 ～ 0.425 P 〈 0.01 ）, but no correlation with vBMD. Conclusions 1. PBM of aBMD and vBMD of lumbar spine in male and female were in age groups of 30 ～ 39 and 20 ～ 29 respectively ; Women should pay more attention on the prevention and treatment of osteoporosis. 2. BMI and BS are important factors influencing aBMD, but not vBMD of lumbar spine.