南京市2岁以内儿童骨强度状况研究

Bone mineral density of infants under 2 in Nanjing

【目的】了解南京市2岁以内儿童骨强度水平,分析对比采用亚洲儿童和中国儿童两种标准数据库评价结果的差异。【方法】选取2 024例0~2岁常规健康体检儿童,采用超声骨强度测定仪测定其骨强度,以骨骼超声波传播速度（SOS）的数量表示,并记录采用亚洲儿童和中国儿童两种标准数据库分别进行评价后的Z-score,对两者（ZA、ZC）进行分析比较。每个儿童均进行体格检查,记录并分析相关数据。【结果】SOS随着儿童年龄的增加而增高（r=0.870,P〈0.001）;以Z≤1为判断骨强度异常的界值,则ZA异常儿童占20.4%,ZC异常儿童达66.9%,两者之间差异有非常显著的统计学意义（P〈0.001）;且ZA〉1（t=39.357,P〈0.001）,ZC〈1（t=17.501,P〈0.001）;SOS与婴儿的体重和身长均呈正相关（r=0.680和r=0.810,P〈0.001）,与体质指数（BMI）呈负相关（r=0.256,P〈0.001）。【结论】2岁以内儿童骨强度随着年龄的增加而增高;肥胖儿童更容易发生骨强度不足;以亚洲儿童数据库评价南京市儿童的骨强度状况,标准相对宽松,而用中国儿童数据库则过于严格,因此应尽早建立针对本地区儿童的标准数据库。

【Objective】 To understand the bone mineral density（BMD） of infants under 2 in Nanjing monitored by quantitative ultrasound and analyze the outcome evaluated by Asian and Chinese criterion.【Methods】 2 024 healthy in-fants were selected in Nanjing and the quantitative ultrasound system was used to get their speed of sound（SOS） in bone.Then use Asian and Chinese criterion to evaluate the SOS which were noted as ZA and ZC.【Results】 The SOS of infants was increased with chronological age（r=0.870,P0.001）.Z≤1 was classified as BMD abnormal.There were 20.4% of ZA and 66.9% of ZC below the cutoff and they had significant difference（P 0.001）,and ZA 1（t= 39.357,P 0.001）,ZC 1（t= 17.501,P 0.001）.The SOS had positive correlation with weight and length（r= 0.680 andr= 0.810,P0.001） and negative correlation with the BMI（r= 0.256,P 0.001） of the infants.【Conclusions】 The BMD of infants under 2 is increased with chronological age.The obese infants are more vulnerable to be BMD deficiency.The Asian criterion is loose and Chinese criterion is strict to evaluate the infants＇ BMD in Nanjing.So the criterion for local children is needed to establish.