成年男性发生骨质疏松和骨量减少的影响因素分析

Analysis of Influencing Factors of Osteoporosis and Osteopenia in Adult Men

目的:探讨成年男性发生骨质疏松和骨量减少的相关影响因素。方法:选取2017年1月-2021年6月于本院进行健康体检,年龄20~60岁,并自愿进行骨密度检测的成年男性798例,根据骨密度检测结果,分为骨密度正常组561例和骨密度异常组237例(包括骨质疏松和骨量减少),探究各项体检指标与其发生骨量减少和骨质疏松的关系。结果:本院体检的成年男性骨密度异常的检出率为29.70%,其中骨质疏松症的检出率为4.01%,骨量减少的检出率为25.69%。骨密度异常组年龄、高密度脂蛋白、舒张压、同型半胱氨酸水平均明显高于骨密度正常组(P<0.05),而体重指数、血尿酸均明显低于骨密度正常组(P<0.05),而两组血糖、总胆固醇、甘油三酯、低密度脂蛋白、收缩压比较,差异均无统计学意义(P>0.05)。骨密度异常组中合并高血压、幽门螺杆菌感染、颈动脉内膜斑块、脑血流图异常、动脉硬化的比例高于骨密度正常组(P<0.05),合并脂肪肝的比例低于骨密度正常组(P<0.05)。二元logistic回归分析结果显示,年龄>40岁、高水平的高密度脂蛋白(高密度脂蛋白>1.42 mmol/L)、高同型半胱氨酸血症(同型半胱氨酸>15 μmol/L)是发生骨密度异常的危险因素,高体重指数(体重指数>23.9 kg/m^(2))是骨密度正常的保护因素(P<0.05)。结论:研究人群中骨密度异常的检出率较高,其中骨量减少的人数多于骨质疏松的人数;骨密度值与年龄、体重指数、血压、高密度脂蛋白、同型半胱氨酸、幽门螺杆菌感染、颈动脉内膜斑块、脑血流图异常、动脉硬化相关。其中年龄>40岁、高水平的高密度脂蛋白、高同型半胱氨酸血症是发生骨密度异常的危险因素,高体重指数是骨密度正常的保护因素。

Objective:To explore the related factors influencing the occurrence of osteoporosis and Osteopenia in adult men.Method:A total of 798 adult males aged 20-60 who underwent physical examination in our hospital from January 2017 to June 2021 and voluntarily underwent bone mineral density test were selected.According to the bone mineral density test results,they were divided into 561 cases in the normal bone mineral density group and 237 cases in the abnormal bone mineral density group (including osteoporosis and osteopenia).The relationship between various physical examination indicators and the occurrence of osteopenia and osteoporosis was explored.Result:The detection rate of abnormal bone mineral density of adult men in our hospital physical examination was 29.70%,among which the detection rate of osteoporosis was 4.01%,and the detection rate of osteopenia was 25.69%.The age,high-density lipoprotein,diastolic blood pressure,and homocysteine levels of abnormal bone density group were significantly higher than those of the normal bone density group (P<0.05),while the body mass index and blood uric acid were significantly lower than those of the normal bone density group (P<0.05),there were no significant differences in blood glucose,total cholesterol,triglycerides,low-density lipoprotein,and systolic blood pressure between the two groups (P>0.05).In the abnormal bone density group,the proportion of hypertension,Helicobacter pylori infection,carotid intimal plaque,abnormal cerebral blood flow pattern,and arteriosclerosis were higher than those of the normal bone density group (P<0.05),and the proportion of fatty liver was lower than that of the normal bone density group (P<0.05).Binary logistic regression analysis showed that age >40 years old,high levels of high-density lipoprotein (high-density lipoprotein >1.42 mmol/L),hyperhomocysteinemia (homocysteine >15 μmol/L) were risk factors for abnormal bone density,high body mass index (body mass index >23.9 kg/m^(2)) was a protective factor for normal bone density (P<0.05).Conclusion:The detection rate of abnormal bone density in the research population is relatively high,among which the number of people with osteopenia is more than the number of people with osteoporosis;bone mineral density is related to age,body mass index,blood pressure,high-density lipoprotein,homocysteine,Helicobacter pylori infection,carotid artery intimal plaque,abnormal cerebral blood flow pattern,and arteriosclerosis.Among them,age >40 years,high levels of high-density lipoprotein,and hyperhomocysteinemia are risk factors for abnormal bone density,and high body mass index is a protective factor for normal bone density.