不同骨质疏松风险的男性人群骨定量超声及骨密度分析

Analysis of bone minimal density and bone quantitative ultrasound in men with osteoporotic risks

目的评估以亚洲人骨质疏松自我筛查工具（0sTA）确定的不同骨质疏松风险的男性人群骨定量超声（QUS）相关指标及骨密度（BMD）的特点。方法50岁及以上男性研究对象724例，完成身高、体质量、足跟QUS测定，获得QUS-T值及定量指数（QUI）。依据OSTA指数划分为低危组、中危组和高危组。120例研究对象行双能x线吸收法（DxA）BMD测定，依据WHO骨质疏松诊断标准分为骨量正常组、低骨量组和骨质疏松组。比较各组间BMD、QUS—T值及QUI的差异，分析OSTA与QUS—T值、QUI及髋部、腰椎BMD的相关性。结果低危组408例，占56．4％，中危组204例，占28．2％，高危组112例，占15．5％；BMD测定者中，骨量正常组36例，占30．0％，低骨量组70例，占58．3％，骨质疏松组14例，占11．7％。QUiT值、QUI值在低危组、中危组和高危组患者中逐渐降低，分别为一0．56±1．09、一0．88_4-1．28、一1．21_--4-1．40和98．47±l9．04、92．62±22．49、87．68±24．43，低危组与中危组、高危组之间差异有统计学意义，中危组与高危组间差异无统计学意义。测定BMD者，股骨颈BMD、全髋BMD在3组间逐渐降低，分别为0．89±0．12、0．85±0．10、0．77±0．10和1．00±0．15、0．93±0．11、0．83±0．11，组间差异有统计学意义（均P〈0．01）。骨质疏松患者的百分比在3组分别为3．4％（2例）、13．0％（6例）、37．5％（6例），中危组、高危组骨质疏松的比率显著高于低危组（x2=11．77，P〈0．01）。在骨量正常组、低骨量组、骨质疏松组QUS-T值、QuI逐渐降低，分别为0．99±0．08、-0．70±1．07、-1．96±0．73和109．26±17．05、96．15±18．20、72．54±10．00（F=10．47、11．73，均P％0．01）。线性相关分析显示除腰椎BMD外，OSTA与QUS—T值、QUI及髋部BMD均呈线性正相关，其中与QUiT值及QUI的r值均为o．23，与股骨颈BMD、大转子BMD、全髋BMD的r值分别为O．45、0．38、0．39（均P％O．01）。结论随着OSTA指数降低、骨质疏松风险增高，QUS—T值、QU]、髋部各部位BMD均逐渐下降，OSTA指数与QUiT值、QU[、髋部各部位BMD呈线性正相关。

Objective To analyze the features of bone minimal density and bone quantitative ultrasound in men with different osteoporotic risk graded by osteoporosis self-assessment tool for Asian （OSTA）. Methods After exclude the secondary osteoporosis, 724 subjects over 50 years old were involved. The parameters of bight, weight, quantitative ultrasound index （QUI）, QUiT score were examined. The bone density （BMD） were measured by dual-energy X-ray absorptiometry （DXA） in 120 elderly men. All subjects were grouped into low （osteoporotic） risk group, moderate risk group and high risk group by OSTA index. 120 subjects measured BMD were grouped into normal bone mass group, osteopenia group and osteoporosis group by WHO standard. The differences and correlation analysis in BMD, QUST, and QUI between these groups were analysed. Results The percents of low risk people, moderate risk people and high risk people were 56.4% （408 cases）, 28.2%（204 cases）, 15.5% （112 cases）, respectively. There were 30.0% （36 cases） normal bone mass people, 58.3% （70 cases） osteopenia people and 11.70/00 （14 cases） osteoporosis people in groups measured BMD. QUS-T score, QUI were gradually decreased in groups of low risk, moderate risk and high risk （--0.56--±1.09, --0.88-±1.28, --1.21-±1.40~ 98.47_±19.04, 92.62±_22.49, 87.68~24.43~ all P 〈0.05） and had statistical significant differences between low risk and moderate risk, high risk groups, while had no differences between moderate risk and high risk groups. The femoral neck BMD and total BMD were gradually decreased in all the three groups （0.89±0.12, 0. 85±0.10, 0.77±0.10% 1.0-±0.15, 0.93±0.11, 0.83±0.1; all P〈0.01）. Osteoporosis in the three groups were 3.4% （2 cases）, 13.0% （6 cases） , 37.5~ （6 cases）, respectively and osteoporosis percents in moderate risk group and high risk group were higher compared with low risk group （x2 = 11.77,P〈 0.01）. QUS-T score and QUI decreased gradually in groups of normal mass, osteopenia and osteoporosis （0.99±0.08, -0.70±1.07, --1.96-±0.73% 109.26±17.05, 96.15±18.20, 72.54± 10.00r F= 10.47, 11.73, all P〈 0.01）. Except for lumbar BMD, a positive linear correlation emerged between OSTA and QUS-T score, QUI, hip BMD（all P〈0.01）. The values of R with femoral neck BMD, torch BMD and total hip BMD were 0.45, 0.38, 0.39, respectively. And the same value with QUS-T score and QUI was 0.23. Conclusions With the decreasing of OSTA index, risk of osteoporosis is increased and QUS-T score, QUI and BMD are decreased gradually. There are positive linear correlation between OSTA index and QUS-T score, QUI,hip BMD.