50岁以上男性不同部位骨密度变化特征及骨质疏松检出率

The effect of age on the changes in bone mineral density and osteoporosis detection rates in men over fifty years

目的探讨50岁以上男性骨密度(BMD)的变化特征及骨质疏松检出率。方法回顾性分析解放军总医院年度查体50岁以上男性的一般资料及用双能X线吸收法测定的BMD,根据年龄和WHO骨质疏松症诊断标准将受试者分组,比较组间BMD特点、不同测量部位骨质疏松及低骨量检出率。结果全髋及股骨颈BMD随增龄而逐渐降低,差异有统计学意义(P<0.01);线性相关分析显示全髋及股骨颈BMD与年龄呈负相关(r=-0.36,r=-0.30;P<0.05),腰椎BMD与年龄呈正相关(r=0.14,P<0.05)。该人群骨质疏松总检出率为10.08%,低骨量检出率为43.21%;骨质疏松及低骨量检出率均随增龄而增加(P<0.01);股骨颈部位骨质疏松及低骨量检出率与总检出率的差异无统计学意义(P>0.05)。单侧股骨颈部位骨质疏松、低骨量检出率低于股骨颈部位总检出率。70岁以上者骨质疏松及低骨量检出率显著高于70岁以下者(14.88%比1.99%;47.75%比35.56%,P<0.01)。结论 50岁以上男性全髋及股骨颈BMD随增龄而下降。骨质疏松及低骨量检出率随增龄而增加。股骨颈部位骨质疏松及低骨量检出率与总检出率接近,测量双侧股骨颈BMD有助于提高骨质疏松检出率。

Objective To explore the effect of age on the changes in bone mineral density （ BMD） at different skeletal sites and the osteoporosis detection rates in men over the age of 50. Methods A retrospective analysis was carried out by studying the general information and BMD data. Grouped by age and the osteoporosis diagnostic criteria,comparisons were made among different age groups about BMDs,the detection rates of osteoporosis and osteopenia at different skeletal sites. Results BMDs at total hip and femoral neck decreased with age （ p 0. 01） and were negatively correlated with age by liner correlation analysis （ r = 0. 36, 0. 30; P all 0. 05） ,whereas the BMD at lumbar spine was positively correlated with age （ r = 0. 14; P〈0. 05） . The detection rates of osteoporosis and osteopenia were 10. 08% and 43. 21% respectively,which increased with age,and significantly higher among those over seventy years than under seventy years （ 47. 75% vs 35. 56% ; 14. 88% vs 1. 99% ; P all 0. 01） . The detection rate at the femoral neck was similar to the overall detection rate. Conclusion BMDs at femoral neck and total hip decreased with age. Detection rates of osteoporosis and osteopenia increased with age. Bilateral measurements of femoral neck BMD could help to improve detection rates of osteoporosis and osteopenia.