坐位工作人群超声骨密度下降的影响因素分析

Analysis of influencing factors affecting the reduced quantitative ultrasound bone mineral density in sedentary work population

目的探究影响坐位工作人群超声检测骨密度下降的相关因素。方法纳入广州中医药大学第一附属医院体检科2019年1月-2021年1月期间接收的坐位工作职业健康检查对象440人,根据超声检测骨密度检查结果分为观察组(骨密度下降,n=240)和对照组(骨密度正常,n=200)。收集两组人员的年龄、性别、BMI、肌肉量(LM)、脂肪含量(BF)、腰臀比(BF)、每日持续坐时间、运动习惯、膳食结构、月收入、血清中25羟基维生素D[25(OH)D]、吸烟、饮酒、基础性疾病等资料,采用单因素及多因素logistic回归分析坐位工作人群骨密度下降的相关影响因素。结果观察组年龄[(38.55±9.66)岁vs(32.64±7.69)岁]、女性的比例(58.33%vs 33.00%)、每日持续坐时间≥6 h的比例(57.50%vs 31.00%)、吸烟的比例(40.00%vs 22.50%)均高于对照组(t/χ^(2)=7.009、28.119、30.899、15.342,P均<0.01),BMI[(20.62±3.15)kg/m^(2)vs(23.11±2.69)kg/m^(2)]、规律运动的比例(24.17%vs 52.50%)、奶制品摄入每周>3次的比例(25.83%vs 22.50%)及血清中25(OH)D正常占比(57.50%vs 42.50%)均低于对照组(t/χ^(2)=8.816、37.551、20.873、25.267,P均<0.01)。Logistic多因素回归分析,年龄34~60岁(OR=1.670)、BMI<18 kg/m^(2)(OR=1.947)、每日持续坐时间≥6 h(OR=3.353)、吸烟(OR=1.852)以及血清中25(OH)D缺乏(OR=1.648)是坐位工作人群骨量减低的危险因素,而规律运动是其保护因素。结论坐位工作人群骨量减少与高龄、BMI过低、持续坐时间过长、吸烟、血清中25(OH)D缺乏有关,应改善饮食生活习惯、规律运动,降低骨质疏松的发生率。

Objective To explore the influencing factors affecting the reduced quantitative ultrasound bone mineral density in sedentary work population.Methods A total of 440 subjects with sedentary works underwent occupational physical examination in Physical Examination Center of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from January 2019 to January 2021 were included,and classified into observation group(decreased bone mineral density,n=240)and the control group(normal bone mineral density,n=200)according to the ultrasound examination results.Data including age,gender,body mass index(BMI),lean mass(LM),body fat(BF),waist-to-hip ratio(WHR),duration of daily sitting,exercise habits,dietary structure,monthly income,serum vitamin D,smoking,alcohol consumption,and underlying medical conditions were collected.Univariate and multivariate Logistic regression analyses were performed to screen the factors affecting bone mineral density in populations with sedentary works.Results The age[(38.55±9.66)vs(32.64±7.69)],the proportion of women(58.33%vs 33.00%),the proportion of sitting time≥6h every day(57.50%vs 31.00%),and the proportion of smoking(40.00%vs 22.50%)were higher in observation group than in control group,with statistical difference(t/χ^(2)=7.009,28.119,30.899,15.342,all P<0.01).BMI[(20.62±3.15)kg/m^(2)vs(23.11±2.69)kg/m^(2)],the proportion of regular exercise(24.17%vs 52.50%),the proportion of dairy intake>3 times a week(25.83%vs 22.50%)and the proportion of normal serum 25(OH)D(57.50%vs 42.50%)in the observation group were lower than those in the control group,with statistical difference(t/χ^(2)=8.816,37.551,20.873,25.267,all P<0.01).Logistic multivariate regression analysis suggested that age of 34~60 years(OR=1.670),BMI<18 kg/m^(2)(OR=1.947),daily continuous sitting time≥6 hours(OR=3.353),smoking(OR=1.852)and serum 25(OH)D deficiency(OR=1.648)were risk factors for osteopenia in people with sedentary works,while regular exercise was a protective factor.Conclusion Osteopenia in people with sedentary works is associated with advanced age,low BMI,prolonged sitting time,smoking,and lack of serum 25(OH)D,while healthy dietary habits and regular exercise are of vital importance in reducing the occurrence of osteoporosis.