中国成年男性人群脊柱定量CT骨密度参考值和地区差异

Normal reference and regional variation of spinal bone mineral density under the quantitative CT in Chinese male population

目的探究中国成年男性人群定量CT(QCT)脊柱骨密度正常参考值和中国不同地区骨密度差异。方法选取2018年1月至2019年12月在中国东北、华北、华东、华南、华中和西南6个地区接受低剂量胸部CT肺癌筛查的男性人群,采用Mindways公司的QCT系统测量腰椎椎体的骨密度。以10岁为1个年龄段,计算骨密度均值和下降率,按美国放射学院脊柱QCT骨质疏松诊断标准统计骨质疏松患病率。结果纳入男性50682例,年龄为(50.2±12.8)岁(20~98岁)。中国男性总体脊柱QCT峰值骨密度(173.11±28.56)mg/cm3,出现在20~29岁,然后随年龄增长呈下降趋势。在70岁之前,华南地区男性骨密度相对较高,华中和西南地区较低,东北、华北和华东地区居中,差异具有统计学意义(均P<0.001),70~79岁和≥80岁2个年龄段各地区男性骨密度差异均无统计学意义(均P>0.05)。中国男性脊柱QCT骨密度总体下降约46.92%,40~49岁年龄段下降明显加速。≥50岁男性骨质疏松总体患病率约为11.42%,其中西南地区和华中地区患病率较高(分别为14.72%和13.87%),华北和华南地区较低(分别为8.53%和7.71%)。结论建立了中国成年男性人群的脊柱QCT骨密度范围,华南地区骨密度值最高,华中地区骨密度值最低。

Objective To investigate the normal reference values of spinal bone mineral density measured by quantitative computed tomography(QCT)and the differences of bone mineral density(BMD)in different regions of in Chinese adult males.Methods Men who underwent low-dose CT lung scan for cancer screening in regions of Northeast,North,East,South,Central and Southwest of China from January 2018 to December 2019 were selected.And the lumbar vertebrae BMD values in the male subjects were measured by the QCT system(Mindways Software,Inc.).The mean BMD values and their decline rates were calculated at an age interval of 10 years,and the prevalence of osteoporosis was calculated according to the American College of Radiology spine QCT osteoporosis diagnostic criteria.Results A total of 50682 males with a mean age of(50.22±12.79)years(ranged 20 to 98 years)were included in this study.The peak BMD of(173.11±28.56)mg/cm3 in the healthy Chinese adult male population appeared in the age group of 20 to 29 years and then declined with age.Before the age of 70 years,the BMD was relatively higher in males in South China,and it was lower in Central China and Southwest China,and it was intermediate in Northeast,North and East of China,with statistically significant differences.There was no significant differences in BMD in the males in the two age groups of 70 to 79 years and 80 and older among the regions in China.The overall decline rate of spinal BMD in Chinese males under QCT was about 46.92%over the lifetime,and it declined obviouslyin the 40-49 age group.The overall prevalence of osteoporosis in Chinese male population aged 50 years and above was approximately 11.42%,with the highest prevalence in Southwest China and Central China(14.72%and 13.87%,respectively)and the lowest in North China and South China(8.53%and 7.71%,respectively).Conclusions A reference of lumbar spine BMD values for healthy males in China based on QCT is established.BMD values were highest in South China and Lowest in Central China.