湖南省2018年4个县区≥40岁人群骨质疏松症流行病学与影响因素

An epidemiological features and risk factors study of osteoporosis among residents aged 40 and over in four counties of Hunan,2018

目的了解湖南省2018年4个县区≥40岁人群中骨质疏松症及骨量低下的检出率与分布特征及骨质疏松症患病危险因素,为防控以及相应卫生资源配置提供数据支持。方法采用多阶段分层随机抽样方法进行抽样,对研究对象进行问卷调查并对骨密度、身高、体重和腰围进行测量。采用率、构成比、均数等指标进行统计描述,率的比较采用Rao⁃Scottχ^(2)检验。采用SAS 9.4软件的多因素Survey logistic回归分析模型进行危险因素分析。结果共调查≥40岁人群1597人,其中男性704人(44.08%),女性893人(55.92%)。骨质疏松症患病率为15.37%(95%CI:12.08~18.65),女性(26.95%)高于男性(4.55%)(Rao⁃Scottχ^(2)=54.34,P<0.001)。患病率随年龄增长而增加(Rao⁃Scottχ^(2)=131.00,P<0.001)。骨量低下检出率为53.33%(95%CI:49.61~57.04,P<0.001),男、女性骨量低下检出率分别为54.28%和52.01%,性别差异无统计学意义(Rao⁃Scottχ^(2)=0.63,P=0.420)。多因素Survey logistic回归分析模型分析提示,与男性患骨质疏松相关的因素有BMI<18.5 kg/m^(2)(OR=6.52,95%CI:1.51~28.12,P=0.010),与女性患骨质疏松相关的因素有在45岁前停经(OR=2.47,95%CI:1.53~3.90,P<0.001)、骨折病史(OR=2.76,95%CI:1.62~4.65,P<0.001)、BMI<18.5 kg/m^(2)(OR=17.67,95%CI:2.54~122.87,P=0.004)、≥60岁(OR=11.35,95%CI:3.62~35.56,P<0.001)。结论湖南省≥40岁人群中骨质疏松症患病水平较高,女性患病风险高于男性。潜在发病的骨量低下人群较大,男女性并重。

Objective This research focuses on understanding the epidemiology,prevalence,and associated risks of osteoporosis and low bone mass among individuals aged 40 and over in four counties of Hunan Province.It aims to bolster the efforts in bone health management and osteoporosis prevention in the region.Methods A multi⁃stage stratified random sampling was conducted for this epidemiological study,encompassing questionnaire survey,bone mass measurement and physical measurement such as body weight and height measurements.Rate,constituent ratio and mean were used for statistical despcrition of the data.Rao⁃Scottχ^(2)test was conducted for rate comparisons,and Survey logistic regression model was used for risk factors analysis.All the statistic procedures mentioned above were conducted by SAS 9.4 software.Results A total of 1597 subjects were finally investigated,including 704 males(44.08%)and 893 females(55.92%).The overall prevalence of osteoporosis in the cohort was 15.37%(95%CI:12.08-18.65),increasing with age(Rao⁃Scottχ^(2)=131.00,P<0.001)and higher in females than males(26.95%∶4.55%,Rao⁃Scottχ^(2)=54.34,P<0.001).Low bone mass was prevalent in 53.33%of the population(95%CI:49.61-57.04,P<0.001),while low bone mass was 54.28%prevalent in the studied males and 52.01%in females,and no statistically signif⁃icant gender differences was found(Rao⁃Scottχ^(2)=0.63,P=0.420).Risk factors for osteoporosis in males included a BMI<18.5 kg/m^(2)(OR=6.52,95%CI:1.51-28.12,P=0.010).While in females,they risk factors included menopause before 45(OR=2.47,95%CI:1.53-3.90,P<0.001),history of fracture(OR=2.76,95%CI:1.62-4.65,P<0.001),BMI<18.5 kg/m^(2)(OR=17.67,95%CI:2.54-122.87,P=0.004),and being aged≥60 years(OR=11.35,95%CI:3.62-35.56,P<0.001).Conclusions Osteoporosis prevalence is notably high in Hunan Province,particularly among females.The study underscores the significant potential risk for osteoporosis in both genders.