女性年龄与骨密度、骨质疏松的关系及发生骨质疏松的影响因素分析

Analysis of the correlation of age with bone density and osteoporosis in females,and the influencing factors of osteoporosis occurrence

目的分析女性年龄与骨密度、骨质疏松的关系及发生骨质疏松的影响因素。方法215例女性健康体检者,按不同年龄段划分,≤44岁为青年组(59例)、45~59岁为中年组(94例)、≥60岁为老年组(62例)。比较三组受试者腰椎1~4及股骨颈骨密度、骨质疏松发生情况,并比较发生与未发生骨质疏松受试者的基本临床资料{受教育程度、体质量指数(BMI)、酗酒、家族骨质疏松史、血清25-羟基维生素D[25(OH)D]水平、四肢骨骼肌指数(ASMI)、幽门螺杆菌(Hp)感染、匹兹堡睡眠质量指数(PSQI)},采用Logistic回归分析女性骨质疏松的影响因素。结果老年组腰椎1~4骨密度(0.95±0.10)g/cm^(2)及股骨颈骨密度(0.76±0.08)g/cm^(2)明显低于中年组的(1.04±0.13)、(0.93±0.10)g/cm^(2)、青年组的(1.09±0.16)、(1.02±0.12)g/cm^(2),且中年组低于青年组,差异有统计学意义(P<0.05)。215例受试者中,有31例发生骨质疏松,占比14.42%,其中老年组骨质疏松发生率30.65%(19/62)明显高于青年组的6.78%(4/59)、中年组的8.51%(8/94),差异有统计学意义(χ^(2)=18.678,P<0.05)。发生骨质疏松女性的BMI(21.88±1.39)kg/m^(2)、血清25(OH)D水平(13.59±1.45)mmol/L、ASMI(5.36±0.58)kg/m^(2)低于未发生骨质疏松的(23.86±1.17)kg/m^(2)、(16.24±1.71)mmol/L、(6.41±0.72)kg/m^(2),发生骨质疏松女性的Hp感染占比83.87%高于未发生骨质疏松的59.78%,差异有统计学意义(P<0.05);发生与未发生骨质疏松的女性受教育程度、酗酒、家族骨质疏松史、PSQI评分比较,差异无统计学意义(P>0.05)。经Logistic回归分析显示,Hp感染是女性发生骨质疏松的危险因素(OR>1,P<0.05),高BMI、血清25(OH)D水平、ASMI水平均是女性发生骨质疏松的保护因素(OR<1,P<0.05)。结论老年阶段女性骨密度较低,骨质疏松发生风险较高,且BMI、血清25(OH)D水平、ASMI、Hp感染是女性发生骨质疏松的影响因素,临床可据此提出具有针对性、科学合理的干预措施以减少女性骨质疏松的发生。

Objective To analyze of the correlation of age with bone density and osteoporosis in females,and the influencing factors of osteoporosis occurrence.Methods 215 female health examination subjects were divided into youth group(≤44 years old,59 cases),middle-aged group(45-59 years old,94 cases),and old group(≥60 years old,62 cases).The bone mineral density of lumbar vertebrae 1-4,femoral neck bone mineral density and occurrence of osteoporosis of the three groups were compared;basic clinical data{education level,body mass index(BMI),alcohol abuse,family history of osteoporosis,serum 25-hydroxyvitamin D[25(OH)D]levels,appendicular skeletal muscle mass index(ASMI),Helicobacter pylori(Hp)infection,Pittsburgh sleep quality index(PSQI)}were compared between subjects with and without osteoporosis.Logistic regression analysis was used to find out the influencing factors of osteoporosis in women.Results The bone mineral density of lumbar vertebrae 1-4,femoral neck bone mineral density in the elderly group were(0.95±0.10)and(0.76±0.08)g/cm^(2),which were significantly lower than the middle-aged group[(1.04±0.13)and(0.93±0.10)g/cm^(2)],and the youth group[(1.09±0.16)and(1.02±0.12)g/cm^(2)];and the middle-aged group was lower than the youth group;the difference was statistically significant(P<0.05).Among the 215 subjects,31 cases had osteoporosis,accounting for 14.42%.The incidence of osteoporosis in the old group was 30.65%(19/62),which was significantly higher than the youth group[6.78%(4/59)]and the middle-aged group[8.51%(8/94)],the difference was statistically significant(χ^(2)=18.678,P<0.05).In women with osteoporosis,BMI was(21.88±1.39)kg/m^(2),serum 25(OH)D level was(13.59±1.45)mmol/L,ASMI was(5.36±0.58)kg/m^(2),which were lower than those without osteoporosis[(23.86±1.17)kg/m^(2),(16.24±1.71)mmol/L,(6.41±0.72)kg/m^(2)];the proportion of Hp infection of 83.87%in women with osteoporosis was higher than that of 59.78%in women without osteoporosis;the difference was statistically significant(P<0.05).There was no statistically significant difference in education level,alcohol abuse,family history of osteoporosis,and PSQI score between women with and without osteoporosis(P>0.05).Logistic regression analysis showed that Hp infection was a risk factor for osteoporosis in women(OR>1,P<0.05),and high BMI,serum 25(OH)D level and ASMI level were protective factors for osteoporosis in women(OR<1,P<0.05).Conclusion Elderly women have lower bone mineral density and higher risk of osteoporosis,and BMI,serum 25(OH)D level,ASMI,and Hp infection are the influencing factors of osteoporosis in women.Therefore,targeted,scientific and reasonable intervention measures can be proposed to reduce the occurrence of osteoporosis in women.