贵阳市40岁及以上社区居民骨质疏松性骨折的发病率及危险因素调查

Osteoporotic fractures in the population of 40 years old and over in Guiyang city: the incidence and risk factors

目的了解贵阳市40岁及以上社区居民骨质疏松性骨折的发病率及其影响因素,为该地区骨质疏松性骨折的防治提供理论依据。方法 2011年5月至2011年10月随机抽取贵阳市主城区云岩区40~77岁常驻居民8960人。所有调查对象均进行问卷调查、体格检查、超声骨密度测定等。2014年对该人群进行了随访,将排除对象剔除后,入组总人数5697人,随访率为63.58%。骨质疏松性骨折的诊断标准:居民自我报告脆性骨折史或居民提供的影像学骨折的报告。脆性骨折定义为从站立位或低于站立位的高度跌倒在地或相似程度的外伤所致的骨折。结果 1骨质疏松性骨折的发病率为4.86%(277例,男性31例,女性246例)。主要骨折部位是前臂远端、踝部、脊椎。其中女性的发病率(5.94%)较男性发病率(1.99%)明显增高(P<0.01)。2女性(odds ratio[OR]=3.427;95%CI:1.98~5.93;P<0.001)、骨密度T值<-2.5(OR=2.054;95%CI:1.30~3.26;P=0.002)、血脂异常(OR=1.474;95%CI:1.02~2.13;P=0.038)、年龄(OR=1.029;95%CI:1.01~1.05;P=0.002)均是发生骨质疏松性骨折的危险因素。结论骨质疏松性骨折的发病率随年龄的增加而升高,且女性明显高于男性,前臂远端是最常见的发病部位;增龄、女性、血脂异常、骨密度T值<-2.5均是其危险因素。

Objective To study the prevalence and risk factors of osteoporotic fractures in Guiyang residents aged 40 years old and above,and to provide a theoretical basis for the prevention and treatment of osteoporotic fractures in the area. Methods A total of 8960 adults,aged 40 to77 years old,living in the Yunyan community in Guiyang of Guizhou,were randomly selected from May 2011 to October 2011. All of them were investigated with questionnaire,physical examination,and ultrasonic bone mineral density measurement. The follow-up rate was 63. 58%. Diagnostic criteria for osteoporosis fracture were the self-reported history of brittle fracture or imaging report of fractures. A brittle fracture is defined as a fracture that falls from a standing position or belowthe height of a standing position to the ground or to a similar degree. Results（ 1） The incidence of osteoporotic fractures was 4. 86%（ 277 cases,31 males and 246 females）. The main fracture site was the distal forearm,the ankle,and the spine. The incidence in females（ 5. 94%） was significantly higher than that in males（ 1. 99%）,and the difference was statistically significant.（ 2） Female gender（ OR = 3. 427; 95% CI： 1. 98-5. 93; P 〈 0. 001）,BMD T-score 〈- 2. 5（ OR = 2. 054,95% CI： 1. 30-3. 26; P = 0. 002）,dyslipidemia（ OR = 1. 474,95% CI： 1. 02-2. 13; P = 0. 038）,age（ OR = 1. 029,95% CI： 1. 01-1. 05; P = 0. 002） were the significant risk factors. Conclusion The incidence of osteoporotic fracture increases with age,and it is significantly higher in females than in males. Distal forearm is the most common site of the fracture. The increase of age,female gender,dyslipidemia,and BMD T-score 〈- 2. 5 are risk factors of the osteoporotic fracture.