自贡地区居民(成人)多部位骨密度的现状调查

Investigation on the Bone Mineral Density of Multiple Parts of Residents(Adults)in Zigong Area

目的分析自贡地区不同年龄段常住居民(20岁及以上)腰椎、股骨颈、全髋骨密度(BMD)变化特点,为该地区骨质疏松症的诊断及防治提供科学依据。方法将2017年1月至2020年12月在四川省自贡市第一人民医院健康体检中心测量BMD的1200名健康成人纳入调查,按10岁一个年龄组将其分为6组,即20~29岁组、30~39岁组、40~49岁组、50~59岁组、60~69岁组、70~79岁组,每组200名(男女各100名),利用双能X线吸收测量仪测量研究对象的腰椎正位(L_(1-4))、股骨颈、全髋BMD,并经SPSS 17.0统计软件分析BMD与年龄、性别、部位的关系。结果该研究中,男性股骨颈、全髋的骨峰值出现在30~39岁,腰椎正位(L_(1-4))的骨峰值出现在20~29岁;女性股骨颈、全髋的骨峰值出现在20~29岁,腰椎正位(L_(1-4))的骨峰值出现在30~39岁。男性的腰椎正位(L_(1-4))BMD在50岁以后高于女性,差异均有统计学意义(P<0.05)。50~59岁人群的股骨颈、腰椎正位(L_(1-4))BMD与除20~29岁之外的所有年龄段人群比较,差异均有统计学意义(P<0.05);60~69岁人群的股骨颈、全髋BMD与其余年龄段人群比较,差异均有统计学意义(P<0.05);70~79岁人群的股骨颈、全髋BMD与其余年龄段人群比较,差异均有统计学意义(P<0.05)。腰椎正位(L_(1-4))BMD在所有年龄段与股骨颈、全髋比较,差异均有统计学意义(P<0.05);股骨颈BMD在40岁以后与全髋比较,差异均有统计学意义(P<0.05)。结论随着年龄的增长,BMD逐渐下降;50岁以后的女性腰椎骨量下降速度高于男性;不同部位的BMD下降速度及开始时间不一致,临床需测量多部位的BMD,且在40岁以后推荐测量股骨颈BMD来诊断骨质疏松症。

Objective The characteristics of changes in bone mineral density(BMD)of lumbar spine,femoral neck and total hip of the permanent residents(20 and over 20 years old)of different ages in Zigong area were analyzed to provide scientific proof for the diagnosis and prevention of osteoporosis in this area.Methods 1200 healthy adults whose BMD was measured in the Health Checkup Center of the First People's Hospital of Zigong City,Sichuan Province from January 2017 to December 2020 were included in the survey.The healthy adults were divided into 6 groups(the age span of each group was set as 10 years old),that is,20~29 age group,30~39 age group,40~49 age group,50~59 age group,60~69 age group and 70~79 age group,with 200 persons in each group(100 men and 100 women).Their BMD of lumbar spine anteroposterior projection(L_(1-4)),femoral neck and total hip were measured by dual energy X-ray absorptiometry.The relation of BMD with age,sex and part was statistically analyzed by SPSS 17.0 statistical software.Results In this study,the peak bone mass of femoral neck and total hip of men appeared in the age of 30~39,while that of lumbar spine anteroposterior projection(L_(1-4))of men appeared in the age of 20~29;the peak bone mass of femoral neck and total hip of women appeared in the age of 20~29,and that of lumbar spine anteroposterior projection(L_(1-4))of women appeared in the age of 30~39.The BMD of lumbar spine anteroposterior projection(L_(1-4))of men was higher than that of women at the age of 50 and above,with statistically significant differences(P<0.05).When the BMD of femoral neck and lumbar spine anteroposterior projection(L_(1-4))of 50~59 years old were compared with other age groups except for 20~29 years old,the differences were statistically significant(P<0.05);when the BMD of femoral neck and total hip of 60~69 years old were compared with the other age groups,the differences were statistically significant(P<0.05);when the BMD of femoral neck and total hip of 70~79 years old were compared with the other age groups,the differences were statistically significant(P<0.05).When the BMD of lumbar spine anteroposterior projection(L_(1-4))was compared with femoral neck and total hip at each age group,the differences were statistically significant(P<0.05);when the BMD of femoral neck was compared with total hip at the age of 40 and above,the differences were statistically significant(P<0.05).Conclusion As age increases,BMD gradually decreases;after the age of 50,the decrease rate of lumbar BMD in women is higher than that in men;the decrease rate and start time of BMD in different parts are inconsistent,so it is necessary to measure the BMD of multiple parts,and after 40 years old,it is recommended to measure BMD of femoral neck to diagnose osteoporosis.