北京社区绝经后女性骨质疏松性骨折相关危险因素和防治现况

Risk factors and preventive/therapeutic status of osteoporotic fracture in postmenopausal women in two communities of Beijing

目的了解北京社区绝经后女性骨质疏松性骨折相关危险因素和防治现况。方法选取2016年3月至2017年11月就诊于北京两个社区卫生服务中心的绝经后女性2990例,在取得书面知情同意后,由医生询问、受访者回答填写自行设计的骨质疏松症危险因素及防治情况的调查问卷,回收有效问卷2866份。对问卷内容进行统计分析,将无骨质疏松性骨折史者作为对照组,有骨质疏松性骨折患者作为骨折组,分析骨质疏松性骨折相关危险因素和防治情况。结果受试者中有明确骨质疏松性骨折史170例,占5.9%。骨折组比对照组年龄更大(67±7)vs.(62±7)岁,P<0.0001,绝经年限更长(16.9±7.5)vs.(12.2±7.8)年,P<0.0001,身高下降≥4 cm的比例更大(30.6%vs.16.4%,P<0.0001)。两组规律服用钙剂的比例均不足30%,均很少补充维生素D。无受试者规律应用双膦酸盐类药物抗骨质疏松治疗。结论年龄、绝经年限、身高下降是否超过4 cm是绝经后女性是否发生骨质疏松性骨折的重要危险因素。即使是已发生骨质疏松性骨折的社区绝经后女性,骨质疏松症的基础措施和抗骨质疏松药物治疗仍极不充分。

Objective To investigate the differences of osteoporotic risk factors and preventive/therapeutic status of osteoporosis between postmenopausal women with and without osteoporotic fracture history in communities of Beijing.Methods Totally 2990 postmenopausal women were screened in two community health service centers in Beijing from March 2016 to November 2017.After signing informed consent,they were interviewed by trained community doctors,answered questions and filled in the questionnaires which were about the risk factors and clinical characteristics associated with osteoporosis.A total of 2866 effective questionnaires were collected.The participants without osteoporotic fracture history were included in the control group.The participants with osteoporotic fracture history were regarded as the fracture group.Statistical analysis of the questionnaires was conducted to compare the risk factors associated with osteoporotic fracture and the therapeutic status between the fracture group and control group.Results There were 170 subjects with osteoporotic fracture history which accounted for 5.9%of all subjects received the questionnaire survey.Compared with the control group,participants in the fracture group were significantly older[(67±7)vs.(62±7)years old,P<0.0001],had longer postmenopausal duration[(16.9±7.5)vs.(12.2±7.8)years,P<0.0001],and had a higher percentage of height loss≥4 cm(30.6%vs.16.4%,P<0.0001).The percentages of subjects regularly taking calcium were less than 30%in both the fracture group and control group.The subjects of two groups seldomly took vitamin D daily.No subject regularly took bisphosphonates as an anti-osteoporotic therapy.Conclusions Age,the postmenopausal duration,and height loss≥4 cm are important risk factors associated with osteoporotic fracture in postmenopausal women.The basic intervention and anti-osteoporotic therapy for osteoporosis are far from sufficient even in those postmenopausal women with osteoporotic fracture history.