唐山市青少年骨密度变化趋势及相关因素分析

Trend and associated factors of bone mineral density among adolescents in Tangshan

目的了解青少年骨密度水平以及影响骨密度变化的相关因素,为制定促进青少年骨发育的有效干预措施提供科学依据。方法分层整群选取唐山市2所中学的七年级至高三年级的1 583名学生作为调查对象,经学生和家长知情同意,进行骨健康相关因素调查、体格测量和右足跟骨骨密度测定,建立数据库,采用SAS 9.1.3软件包统计分析。结果青少年超声骨密度的声波传导速度（speed of sound,SOS）值范围在（1 476～1 654）m/s,平均值为（1 541.3±23.1）m/s,16岁开始男生各年龄段SOS值均高于女生（P值均〈0.05）;男生13～18岁SOS值随年龄增长而升高（P〈0.05）,18～19岁SOS值差异无统计学意义;女生13～17岁SOS值随年龄增长而升高（P〈0.05）,17～18岁SOS值差异无统计学意义,18～19岁SOS值略有增长（P〈0.05）。对青少年SOS值有正性影响作用的因素由大到小依次是饮奶情况、食用鱼虾情况、食用豆制品情况、食用蔬菜情况、体质量指数（BMI）、运动方式、睡眠时间、第二性征出现、活动总时间;而被动吸烟对青少年SOS值有负性影响。结论青少年期骨密度快速增长。应针对影响因素进行控制和干预,以促进更高骨量的积累。

Objective To understand trend and associated factors of bone mineral density for adolescents in Tangshan,and to provide scientific evidence for the Intervention measurement.Methods A total of 1 583 students aged 13-19 years old were selected from 2 junior schools and 2 high schools in Tangshan.After informed consent to students and parents,bone health related information was investigated.Bone mineral density admeasurements were determined on the calcaneus of right foot.The data was analyzed with SAS 9.1.3 software.Results Speed of sound（SOS） level of ultrasonic bone mineral density was 1 541.3± 23.1（m / s） [95% CI：1 476-1 654 m/s].The SOS in boy increase at the age from 13 to 18,while girls was at 13 to 17.The SOS level of boys during 16-19 years was higher than that of girls（P〈0.05）.Multivariate analysis showed that consumption of milk,fish,shrimp,beans and vegetables,BMI,physical activity,sleep duration,appearance of secondary sexual characteristics and passive smoking were all associated with bone density.Conclusion A comprehensive health care-based lifestyle intervention can effectively increase bone mineral gains in adolescents.