甘肃兰州地区青春期舞蹈女生骨量减少发病及其危险因素分析

The incidence and risk factors of osteopenia in adolescent dancing girls in Lanzhou,Gansu

目的探讨甘肃兰州地区青春期舞蹈女生骨量减少发病原因,并分析其危险因素,以便于有针对性地进行干预。方法采用横断面整群分层随机抽取舞蹈专业16到20岁女生462名为研究对象,使用超声骨密度测定仪测定骨密度,并进行骨质T-score综合评价,发现骨量减少的68例,为病例组;骨量检测正常的394例为对照组,未检测到OP患者。对2组的年龄、身高、体重等12项因素予以比较分析。所得资料在单因素分析的基础上,又做多元线性回归和多因素logistic回归。结果骨量减少的检测率为14.72%;骨量减少发生的相关因素分析,排除进入模型的其他作用因素后,体重指数、初潮年龄与跟骨骨强度指数(SI)呈线性相关(P<0.05),其中体重指数对SI影响最大(r=0.121>-0.112),初潮年龄与骨强度指数负相关(r=-0.112);月经紊乱患病率为39.18%,患病率较高,月经紊乱者和吸烟者发生骨量减少的危险性分别是月经正常者和不吸烟者的1.88倍和1.92倍,进食奶制品少、进食豆制品少和节食促使发生骨量减少的危险性分别是进食奶制品多、进食豆制品多和不节食的1.84倍、2.20倍和2.65倍(OR值分别是1.88、1.92、1.84、2.20和2.65,其95%可信区间内均不包含1,P均<0.05),促进发病。结论初潮年龄延迟、低体重指数、月经紊乱、吸烟、进食奶制品和豆制品过少及节食是甘肃兰州地区青春期舞蹈女生骨量减少的主要危险因素。

Objective To explore the incidence and the risk factors of osteopenia in adolescent dancing girls in Lanzhou,Gansu,in order to apply targeting intervention. Methods A cross-sectional randomly stratified method was used to select 462 samples,aged from16 to 20 years old,from the adolescent dancing girls. Bone mineral density was measured using ultrasound bone densitometry. T-score was evaluated comprehensively. Sixty-eight cases were diagnosed of osteopenia and as case group. Three hundred and ninety-four cases were with normal bone mass and as control group. Twelve indexes including age,height,and weight were compared between the two groups. Single factor analysis and multi-factor logistic regression were conducted. Results The detection rate of osteopenia was 14. 72%. The analysis of osteoporosis-related factors showed that after excluding other roles into the model,body mass index（ BMI） and age of menarche were linearly related to calcaneus stiffness index（ SI,P ,0. 05）. BMI was the most impact factor on SI（ r = 0. 121）. Age of menarche was negatively associated with SI（ r =- 0. 112）. The prevalence of menstrual disorder was 39. 18%. The risk of osteopenia increased by 1. 88 and 1. 92 times,respectively,in people with menstrual disorder and smoking comparing to those with normal menstruation and nonsmoking. The risk of osteopenia was 1. 84,2. 20,and2. 65 times more in people with less intake of milk products and soy products and dieting than in those with normal intake（ OR =1. 88,1. 92,1. 84,2. 20,and 2. 62,respectively,the 95% confidence interval not containing 1,P 〈0. 05）. Conclusion Late age of menarche,lowbody mass index,menstrual disorder,smoking,less intake of milk products and soy products,and dieting are main risk factors of osteopenia.