中国男女性骨大小和体积骨密度的探讨

Bone size and volumetric bone mineral density in Chinese men and women aged 15-40

目的 确定中国北方人群在腰椎和股骨部位峰值骨大小和体密度的性别差异 ,并分析影响其大小的因子。方法 年龄 15至 4 0岁 2 5 6例健康男性和 30 9例健康女性 ,他们的腰椎和股骨颈的骨大小和体积骨密度用双能X线骨密度仪测量。椎体和股骨颈近似为圆柱体 ,骨体积V =π× (宽度 2 ) 2 ×高度 ,vBMD =BMC 体积。结果 椎体峰值BMC ,体积和vBMD女性在 30～ 4 0岁达到峰值 ,而男性 15～ 17岁达到峰值。椎体和股骨颈的BMC男性比女性高 18 1%～ 2 6 7% ,而骨体积相应高 2 8 5 %～ 32 0 % ,这样vBMD男性比女性低 4 0 %～ 8 3% (P <0 0 1)。初潮较晚 (≥ 15岁 )绝经前妇女比来潮较早者 (≤ 12岁 ) ,BMC低 10 % (P <0 0 5 )。男性抽烟者与非抽烟者骨大小和vBMD没有统计学差异。饮酒也没有观察到明显的效应。结论 中国男性比女性有较低的vBMD 。

Objective\ To determine the gender differences in peak bone size and to define the effect of several risk factors on the traits. Methods\ Bone size and vBMD of the third lumbar vertebra and femoral neck were measured by dual\|energy X\|ray absorptiometry in 256 healthy Chinese men and 309 healthy Chinese women aged 15 to 40. Results\ Peak vertebral BMC,volume and vBMD were achieved at the age of 30-40 in women,but 15-17 in men,respectively.Peak femoral neck BMC,volume and vBMD were achieved at the age of 15-17 years in both men and women.Vertebral and femoral neck BMC in men were 18\^1-26\^7% higher,while bone volume was 28\^5-32\^0% greater than those in women,so vBMD in men was 4\^0-8\^3% lower than that in women( P<0.01 ).Vertebral BMC in premenopausal women with later onset of menarche(≥15 years old) was 10% lower than that in women with earlier onset of menarche (≤12 years old) ( P<0.05). There were no significant differences in vBMD and bone size between smokers and non\|smokers in men.There was no effect of alcohol on bone size and vBMD. Conclusion\ The significantly lower peak vBMD in Chinese men than in women may partly explain the higher rate of fractures in men than in women.