骨质疏松性椎体骨折可控风险因素分析

Analysis of controllable risk factors of osteoporotic vertebral fractures

目的 分析骨质疏松性椎体骨折的相关可控风险因素,提示管理可控风险因素的临床价值.方法 绝经后女性626例,收集患者年龄、身高、体重、腰椎和髋部骨密度值及腹部体脂含量等信息,采用Tetrax平衡测试系统评估跌倒风险.通过胸腰段X线侧位片将患者分为椎体骨折组和无椎体骨折组,对两组临床资料进行分析比较,并采用Spearman检验,分析椎体骨折与年龄、身高、体重、体质指数（BMI）及骨密度、跌倒风险、体脂含量等可控因素的相关性.结果 椎体骨折组328例,无椎体骨折组298例,骨折涉及426个椎体.椎体骨折组与无椎体骨折组比较,椎体骨折组具有年龄大[（68.67±9.29）岁比（63.04±9.30）岁]、身高矮[（151.10±4.39）cm比（154.90±5.86）cm]、骨密度低[腰椎骨密度（0.85±0.16）g/cm2比（0.93±0.17）g/cm2,全髋骨密度（0.72±0.18）g/cm2比（0.81±0.13）g/cm2]及腹部脂肪含量高[（41.30±5.20）％比（36.30±5.90）％]、跌倒风险高（41.38±25.79比36.20±26.22）的特点,差异均有统计学意义（P均〈0.001）;相关性分析显示,年龄、身高、BMI、腹部体脂含量、跌倒风险腰椎和全髋骨密度与椎体骨折显著相关,r值依次为0.358、-0.323、0.169、0.186、0.135、-0.398、-0.364（P均〈0.001）.结论 骨量丢失、跌倒风险增高、腹部脂肪含量增加是绝经后女性骨质疏松性椎体压缩性骨折的重要可控风险因素.

Objective To analyze the controlled risk factors of osteoporotic vertebral fractures, and determine the clinical value for the management of risk factors. Methods 626 cases of postmenopausal women were selected, age, height, weight and bone mineral density（BMD） of patients were collected.The Tetrax balance test system was used to assess the fall risks.Vertebral changes of patients were evaluated through X ray of thoracolumbar lateral. The clinical data were analyzed and compared between vertebral fracture group and non-vertebral fracture group. Spearman test was used to analyze the correlation between vertebral fracture and age, height, weight, body mass index（BMI）, the risk of fall, body fat and BMD. Results 328 patients presented with osteoporotic vertebral fractures, while the other 298 cases did not suffer from osteoporotic vertebral fractures. There were 426 vertebral bodies involved. Comparing to non-vertebral fracture group, the vertebral fracture group showed higher age [（68.67±9.29）years vs.（63.04± 9.30）years], lower height[（151.10 ± 4.39）cm vs.（154.90 ± 5.86）cm], lower bone mineral density[lumbar spine BMD （0.85 ± 0.16）g/cm2 vs.（0.93 ± 0.17）g/cm2, hip spine BMD （0.72 ± 0.18）g/cm2 vs.（0.81 ± 0.13）g/cm2],higher body fat [（41.30 ± 5.20）%vs.（36.30 ± 5.90）%] and higher fall risk （41.38 ± 25.79 vs. 36.20 ± 26.22） （ P〈0.001）. While there were no statistical differences in weight and BMI between the two groups, age, height, BMI, body fat, fall risk, lumbar spine and hip BMD were significantly correlated with vertebral fracture （r=0.358,-0.323, 0.169, 0.186, 0.135,-0.398,-0.364, respectively, all P〈0.001）. Conclusions Decreased bone mineral density, increased age, abdomen fat content and increased fall risk, are the risk factors of osteoporotic vertebral fractures.