老年人群骨质疏松发生情况及血清25-羟维生素D对其影响

Incidence of Osteoporosis and the Effect of 25-Hydroxyvitamin D on Osteoporosis in Older People

目的探讨老年人群骨质疏松发生情况及25-羟维生素D对其的影响。方法选取2016年11月~2019年12月行双能骨密度仪检查的2869例患者进行流行病学分析,检测患者骨质疏松的发生情况及血清25-羟维生素D水平,采用多因素logistic回归分析探讨25-羟维生素D在骨质疏松发生中的影响作用。结果经双能骨密度仪检查,骨质疏松者1450例,骨量减少者410例,骨量正常者1009例,骨质疏松检出率为50.54%(1450/2869)。骨质疏松组血清25-羟维生素D和骨密度低于骨量减少组和骨量正常组(P<0.05);25-羟维生素D与骨密度呈正相关性(r=0.628,P<0.05);骨质疏松组年龄结构、女性比例、糖尿病及高血压比例高于非骨质疏松组(P<0.05),每天运动>30 min、每日摄入牛奶、每日摄入豆类和服用钙剂比例低于非骨质疏松组(P<0.05);logistic回归分析显示:女性、年龄、糖尿病是发生骨质疏松的独立危险因素(P<0.05);血清25-羟维生素D、每天运动>30 min、每日摄入牛奶、服用钙剂是骨质疏松发生的独立保护因素(P<0.05)。结论老年骨质疏松发生率高,针对相关影响因素,应给予相应干预措施,如补充维生素D、加强运动、服用钙剂等。

Objective To investigate the incidence of osteoporosis in older people and the effect of 25-hydroxyvitamin D on osteoporosis.Methods A epidemiological analysis was performed on 2869 persons who underwent dual energy bone densitometry examination from November 2016 to December 2019.The incidence of osteoporosis and the level of serum 25-hydroxyvitamin D were determined.Multivariate logistic regression analysis was used to discuss the role of 25-hydroxyvitamin D in the development of osteoporosis.Results The dual energy bone densitometry examination showed that there were 1450 cases with osteoporosis,410 cases with osteopenia,and 1009 cases with normal bone mass.The detection rate of osteoporosis was 50.54%(1450/2869).The serum 25-hydroxyvitamin D level and bone mineral density in the osteoporosis group were lower than those in the osteopenia group and normal bone mass group(P<0.05).There was a positive correlation between 25-hydroxyvitamin D level and bone mineral density(r=0.628,P<0.05).The age,the proportion of female,the proportions of cases with diabetes and hypertension in the osteoporosis group were higher than those in the non-osteoporosis group(P<0.05),while the proportions of cases with daily exercise>30 min,daily intake of milk,beans and calcium in the osteoporosis group were lower than those in the non-osteoporosis group(P<0.05).Logistic regression analysis showed that female,age and diabetes were independent risk factors for osteoporosis(P<0.05);25-hydroxyvitamin D level,daily exercise>30 min,daily intake of milk and calcium were independent protective factors(P<0.05).Conclusion The incidence of osteoporosis in older individuals is high.The corresponding interventions should be given to the patients according to the influential factors,such as supplementing vitamin D and calcium,strengthening exercise.