宁夏1925名正常体检人群的骨密度及与人体成份的关系

Determination of Bone Mineral Density and Its Relationship with Body Composition in 1925 Physical Examination Subjects of Ningxia

目的了解宁夏体检人群骨质疏松症的患病情况,探究人体成份对骨密度的影响,为骨质疏松症的预防和治疗提供临床依据。方法收集宁夏某医院21岁以上正常体检人群1925名,MEDIX90 X线双能骨密度仪测定其骨密度T值判断骨质疏松症的患病情况;采用人体成分分析仪测定受试者人体成分。分析年龄、性别、体重、身高、BMI与骨质疏松症的关系;多因素非条件Logistic回归分析骨密度与人体成份的关系。结果不同性别人群的年龄差异无统计学意义(P>0.05),女性骨质疏松症的患病风险是男性的2.37倍(二项分类Logistic回归:OR=exp(b)=2.37,95%CI:1.630~3.445);男性骨质疏松症的患病率与年龄无明显的线性关系(趋势χ~2=2.329,P>0.05);女性骨质疏松症的患病率随年龄的增长而增高(趋势χ~2=172.767,P<0.001);各年龄组两两比较,男性骨质疏松症的患病率只在≤40岁与51岁~两组之间的有统计学意义(P<0.05),女性除≤40岁与41岁~组之间骨质疏松症患病率差异无统计学意义(P>0.05)之外,其他各组间均有统计学意义(P<0.001),且50岁后骨质疏松症的患病人数明显增多。不同性别研究对象的身高、体重、BMI差异有统计学意义(P<0.05),同性别诊断为骨量正常、低骨量和骨质疏松症组间其身高、体重、BMI的差异有统计学意义(P<0.05),随着骨量减低,身高、体重、BMI均降低。多因素非条件Logistic回归、偏态相关分析显示,骨骼肌肉量的增多是骨质疏松症的保护因素,增龄与蛋白质含量减低是其危险因素;矿物质含量、骨矿物质含量、骨骼肌肉量、体脂肪量、蛋白质含量、肥胖程度均与骨密度均呈正相关(P<0.05)。结论宁夏正常体检人群中,女性骨质疏松症较男性高发,50岁后尤甚,骨骼肌肉量、蛋白质含量对骨密度均有影响,临床可利用人体成分分析结合患者年龄,指导饮食、锻炼、生活、用药等,预防和治疗骨质疏松症。

Objective To investigate the prevalence of osteoporosis in a physical examination population of Ningxia and to explore the characteristics of human body composition on bone mineral densitywhich would provide clinical evidence for the prevention and treatment of osteoporosis.MethodsInformation of 1925 physical examination subjects over 21 years old from one hospital in Ningxia were collected and bone mineral density were measured in the subjects by MEDIX90 dual-energy X-ray absorptiometry to determine the prevalence of osteoporosis while the body composition of the subjects were determined by body composition analyzer.Multivariate unconditional logistic regression analysis was used to analyze the relationship between bone mineral density and body composition.ResultsThere was no statistical significance in different age of different gender（P〉0.05）. Women were 2.37 times more likely to suffer from osteoporosis than men（binary Logistic：OR=exp（b）=2.37,95%CI：1.630~3.445）. There was no significant linear relationship between the male osteoporosis prevalence and age（Linear-by-linear Association：χ2=2.329,P〉0.05）,but the female osteoporosis prevalence increased with age（Linear-by-linear Association：χ2=172.767,P〈0.001）. Compared in age groups, the prevalence of male had statistical significance only in the two groups of≤40 years old and 51~years old （P〈0.05）. The female osteoporosis prevalence in all groups had statistical significance（P〈0.001）except the groups of≤40 years old and 41~years old（P〉0.05）,and the osteoporosis prevalence increased significantly after 50 years old. The difference in height, weight and BMI between different genders had statistical significance （P〈0.05）. The difference of them between the two groups was statistically significant in patients with normal bone mass,low bone mass, osteoporosis（P〈0.05）. With the decrease of bone mass,the height,weight,BMI were dropped accordingly. Multivariate unconditional logistic regression and the skewness analysis showed that the increase of muscle mass was the protective factor of osteoporosis while aging and protein content decreased were the risk factors for osteoporosis. Mineral content, bone mineral content, skeletal muscle, body fat, protein content and fat level were positively correlated with bone mineral density（P〈0.05）.ConclusionIn physical examination crowd in Ningxia, osteoporosis in women were more prevalent than that in men, especially after the age of 50. Skeletal muscle, protein content all impacted on BMD.