产后妇女骨质疏松的危险因素分析

Analysis on risk factors of osteoporosis in postpartum women

目的探讨产后妇女发生骨质疏松的危险因素。方法选取2013年4月-2016年4月在广东省人民医院进行分娩的产后30 d妇女562例为研究对象。对患者进行骨密度测量,依据测量结果将产妇分为骨量正常组、骨质疏松组及骨量减少组,比较各组一般情况、BMI、钙摄入量及骨质疏松家族史等,并分析与骨质疏松发生的关系。结果 562例产妇中32例发生骨质疏松,发病率为5.69%,214例发生骨量减少(不包含骨质疏松患者),发病率为38.08%。对3组产妇年龄、身高、孕次、产次、新生儿体质量采用单因素方差分析,发现孕妇年龄、身高、孕次、产次、新生儿体质量与骨质疏松发病无明显相关性(P>0.05)。BMI<20 kg/m^2,骨质疏松发生率为8.36%,BMI≥24 kg/m^2,骨质疏松发生率为2.33%,产妇BMI越低,发生骨质疏松的风险越高(χ~2=59.863,P<0.001)。补钙产妇骨质疏松发生率明显低于不补钙产妇(χ~2=17.462,P<0.001);孕期每周摄入牛奶量≤2杯、3~4杯、5~6杯、7杯及7杯以上者,其骨质疏松发生率分别为6.54%、5.71%、4.35%、1.89%,各组差异有统计学意义(χ~2=48.833,P<0.001)。对具有统计学意义的单因素进行Logistic回归分析,发现BMI、钙摄入量及骨质疏松家族史为产后妇女发生骨质疏松的独立危险因素(P<0.05)。结论产后妇女发生骨质疏松及骨量减少的风险较高,而低BMI、钙摄入量不足及骨质疏松家族史为产后发生骨质疏松的独立危险因素,产后密切监测骨密度可尽早诊断骨质疏松及治疗。

Objective To explore the risk factors of osteoporosis in postpartum women. Methods A total of 562 postpartum women at 30 days after delivery were selected from Guangdong Provincial People＇s Hospital from April 2013 to April 2016, bone mineral density （BMD） was measured, then the postpartum women were divided into normal bone mass group, osteoporosis group, and osteopenia group. The general situations, body mass index （BMI）, calcium intake, and family history of osteoporosis in the three groups were compared, and the relationships with occurrence of osteoporosis were analyzed. Results The incidence rale of osteoporosis among 562 postpartum women was 5.69% （32 cases） , the incidence rate of osteopenia （excluding the cases with osteoporosis） was 38.08% （214 cases） . Univariate a- nalysis showed that maternal age, height, gravidity, parity, neonatal birth weight were not correlated with occurrence of osteoporosis （P〉0. 05） . Among the postpartum women with BMI〈20 kg/m^2 , the incidence rate of osteoporosis was 8.36% ; among the postpartum women with BMI ≥24 kg/m^2 , the incidence rate of osteoporosis was 2.33%. The lower BMI was, the higher risk of osteoporosis was （X^2 = 59. 863, P〈0. 001 ） . The incidence rate of osteoporosis among the postpartum women with calcium supplementation during pregnancy was statistically significantly lower than that among the postpartum women without calcium supplementation during pregnancy （X^2 = 17. 462, P〈0. 001 ） . The incidence rates of osteoporosis among the postpartum women with weekly milk intake during pregnancy≤2 cups, 3-4 cups, 5-6 cups, 7 cups or more than 7 cups were 6. 54% , 5.71%, 4. 35% , and 1.89% , respectively, there was statistically significant difference （X^2 = 48. 833, P〈0. 001 ） . Logistic regression analysis showed that BMI, calcium intake, and family history of osteoporosis were independent risk factors of osteoporosis in postpartum women （ P〈0. 05 ） . Conclusion The risks of osteoporosis and osteopenia are high in postpartum women; low BMI, low calcium intake, and family history of osteoporosis are independent risk factors of osteoporosis in postpartum women; close monitoring of postpartum BMD can diagnose and treat osteoporosis as soon as possible.