成都地区健康人群骨密度的变化及不同T-score截断值对骨质疏松症患病率的影响

Changes of the bone mineral density and effects of different T-score cut-off on the diagnosis of osteoporosis in healthy people in Chengdu

目的观察成都地区健康人群骨密度的变化及不同T-score截断值对骨质疏松患病率的影响。方法用美国GE LUNAR公司生产的Prodigy advance双能X线骨密度仪（DXA）测定成都地区15273例健康人群骨密度,其中男7117例,女8156例,年龄20-96岁。测量部位包括腰椎（L1-L4）、左股骨颈（Neck）、大转子（Troch）、Wards区、股骨干（Shaft）、全髋（Total）。按年龄、性别分别输入数据,以10岁为一年龄组,分别计算各组骨密度值。对比以T-score≤-2.5SD及T-score≤-2.0SD为骨质疏松诊断截断值的骨质疏松的发生率。结果用spss17.0统计软件处理。结果 1.男性腰椎、股骨各部位骨密度峰值出现在20-29岁,女性骨密度峰值出现在30-39岁,随年龄增加骨密度逐渐降低。同年龄组女性骨密度累积丢失率明显高于男性.2.男、女随增龄骨质疏松检出率增加,女性50岁组以后骨质疏松发病率明显增高。同年龄组女性骨质疏松检出率明显高于男性。3.以T-score≤-2.0SD为截断值,骨质疏松检出率均明显高于T-score≤-2.5SD。腰椎＋股骨联合检测提高骨质疏松检出率。结论 1.本组健康人群腰椎、股骨骨密度为成都地区骨质疏松防治提供参考依据。2.随年龄增长伴随骨密度丢失,以女性更为明显。3.腰椎＋股骨联合检测提高骨质疏松检出率。

Objective To investigate the changes of the bone mineral density（ BMD） and the effects of T-score cut-off on the diagnosis of osteoporosis in healthy people in Chengdu. Me thods BMD of 15273 healthy people（ 7117 men and 8156 women）aged 20-96 years old was measured using dual energy X-ray absorptiometry（ DXA）. The measuring location included the spinal vertebrae（ L1-L4）,the left femoral neck（ Neck）,great trochanter（ Troch）,Wards region,femoral shaft,and total hip. All persons were divided into 10-year subgroups. The prevalence of osteoporosis was compared between T-score ≤- 2. 5 SD and Tscore≤- 2. 0 SD as the cut-off. The results were analyzed with SPSS version 17. 0. Re sults 1） The peak bone mass of male and female was in age groups of 20-29 and 30-39,respectively. The accumulative bone loss percentage in female was much higher than that in male in same age-group. 2） The prevalence of osteoporosis increased with age in both genders,and in women was higher than that in men. 3） The prevalence of osteoporosis in cut-off of T-score≤- 2. 0SD was higher than that in T-score≤- 2. 5SD.The detection rate of osteoporosis in combined detection of the lumbar spine and proximal femur was higher than that in the lumbar spine or proximal femur alone. Conclusions 1） The data of BMD of the lumbar spine and the femur provide reference for the diagnosis and treatment of osteoporosis in Chengdu. 2） BMD in women shows more evident declined trend with age than that in men. 3） Combined detection of various skeletal sites improves detection rate of osteoporosis.