男性老年性骨质疏松症发生率与诊治的研究

A Study of the Male Senile Osteoporosis, Its incidence, Diagnosis and Treatment

目的提高对男性老年性骨质疏松症（ｍａｌｅｓｅｎｉｌｅ ｓｔｅｏｐｏｒｏｓｉｓ）的发生率与相关因素的认识。方法按ＷＨＯ的Ｔ－Ｓｅｏｒｅ法随机抽样，应用ＤＥＸＡ对北京地区健康查体的老人１３９例进行骨密度（ｂｏｎｅｍｉｎｄｒａｌ ｄｅｎｓｉｔｙ，ＢＭＤ）与骨质疏松的测定。结合生活规律调查，如吸烟、饮酒及体育锻炼等；Ｘ线片参数，如掌骨指数、髋Ｓｉｎｇｈ指数及腰椎侧位椎体纵向骨小梁观察；生化指标，如骨钙素、血睾酮、胶原Ⅰ型Ｃ肽、尿钙、尿羟脯氨酸与尿脱氧吡啶啉等测定，进行相关性研究。结果ＤＥＸＡ测定男性老年性骨质疏松发生率为２６．６％，体重与髋骨质疏松有关，吸烟与脊柱骨质疏松有关。在诊断方面，腰椎侧位椎体骨小梁与髋、脊柱骨质疏松的发生均有非常显著相关性，髋Ｓｉｎｇｈ指数与髋骨质疏松有关。各项生化指标与骨质疏松的发生率无显著相关性。结论男性老年性骨质疏松的发生率不低，在无ＤＥＸＡ设备条件下，腰椎侧位Ｘ线片、髓Ｓｉｎｇｈ指数仍有诊断价值。

Objective To investigate the incidence and the factors related to male senile osteoporosiswith dual energy X - ray ahsorptiometry (DEXA). Methods 139 cases of healthy elderly men were examined by WHO T - Score with DEXA to estimate the incidence of male senile osteoporosis. The relationshipbetween osteoporosis and various parameters such as age, body weight, smoking etc. was assessed. The resultsof DEXA examination were compared with those of plain X - ray film of lateral view of lumbar spine, hip Singhindex etc. Bone turnover markers were examined to study their relationship with osteoporosis by DEXA. Results The incidence of male senile osteoporosis was 26. 6%. Body weight and smoking were closely relatedto osteoporosis. No signifieant relationship was found between bone turnover markers and osteoporosis. PlainX - ray film of lumbar spine and hip Singh index bore a relationship with osteoporosis by DEXA. ConclusionIncidence of male senile osteoporosis is rather high, and it is imper'tant to pay more attention to the preventionand treatment of male senile osteoporosis. DEXA equipment is not popular in general hospital, therefore theplain X - ray film of lumbar spine and hip Singh index were found to have some value for the diagnosis of senileosteoporosis.