253例青少年腰椎骨密度分析

Analysis of the bone mineral density of the lumbar vertebrae in adolescents: a report of 253 cases

目的了解青少年骨骼健康状况,探讨腰椎(L2-4)骨密度与性别、血清25-(OH)D3、体重指数、饮食习惯、体育锻炼、性发育早晚的关系。方法双能X线仪测定腰椎(L2-4)骨密度,应用Z值,半自动酶标法测定血清25-(OH)D3,饮食习惯、体育锻炼、性发育早晚均采用调查法,并分组,作方差及组间统计分析。结果 Z值≤-2.0者百分比为6%,男女组BMD及Z值无显著差异(P>0.05),Z值≤-2.0组的25-(OH)D3、体重指数较其他组低(P<0.01),素食厌食组的Z值较其他组低(P<0.01),有效运动量及性发育早晚不同的各组间Z值均有显著差异(P<0.01)。结论双能X线测定腰椎(L2-4)骨密度适合于评估青少年骨骼健康状况,骨密度Z值水平与血清25-(OH)D3、体重指数、饮食习惯、体育锻炼、性发育早晚等有关。

Objective To learn the bone health status in adolescents, and to explore the relationship between the bone mineral density （BMD） of the lumbar vertebrae （L2-4） and gender, serum 25-（OH）D3, body mass index （BMI）, diet habit, physical exercise, and sexual developmental.Methods BMD of L2-4 was detected using dual energy X-ray absorptiometry （DEXA）, and Z value was obtained.The serum concentration of 25-（ OH） D3 was determined using semi-automatic enzyme immunoassay. The data of diet habit, physical exercise, and sexual developmental were acquired using survey method.Then all the subjects were divided into different groups.The difference between groups was statistical analyzed.Results Among all the subjects, 6%had a Z value≤--2.0.No significant difference of BMD and Z value between men and women was observed （P〉0.05）.The serum 25-（OH）D3 concentration and BMI in the group with Z value≤ -2.0 were lower than those in other groups （P〈0.01）.The Z value in vegetarian anorexia group was lower than that in other groups （ P〈0.01 ） .The Z value in effective exercise amount and different sexual development groups showed significant difference （P〈0.01）.Conclusion The detection of L2-4 BMD using DEXA is suitable for the evaluation of bone health in adolescents.The Z value of BMD is correlated with the serum 25-（ OH） D3 concentration, BMI, diet habit, physical exercise, and sexual development.