绝经后妇女椎体骨骼大小对骨密度和诊断骨质疏松的影响

Effects of vertebra size on the bone mineral density and diagnosis of osteoporosis in postmenopausal women

目的 探讨绝经后妇女椎体骨骼大小对骨密度 (BMD)和诊断骨质疏松 (OP)的影响。方法 采用QDR - 4 50 0A型扇形束双能X线吸收法骨密度仪 ,测量 1 0 81例年龄 42～ 96岁健康绝经妇女腰椎正位投射骨面积(BA)、骨矿含量 (BMC)、面积骨密度 (ABMD)及腰椎侧位面积骨密度和体积骨密度 (VBMD)。结果 BA与骨矿含量(r=0 .60 6)和面积骨密度 (r=0 .2 70 ,P =0 .0 0 0 )呈正相关 ,与体积骨密度相关无显著性意义 (r=- 0 .0 55 ,P =0 .1 0 1 )。BA每增加 1cm2 ,骨矿含量和面积骨密度分别相应增加 6 .2 9%和 1 .2 8%。大BA组与中等BA组及中等BA组与小BA组比较 ,妇女的身高、体重、骨矿含量、面积骨密度和OP检出率的差异均具有显著性的意义 (P =0 .0 0 0 )。腰椎正位和侧位的OP检出率 ,大BA组分别为 2 4 .9%和 39.9% ,中等BA组分别为 36 .4%和 54.5 % ,小BA组分别为 55 .2 %和 70 .9%。各组之间体积骨密度的OP检出率的差异无显著性的意义。多元线性回归分析结果显示 ,影响骨骼大小和骨密度的主要因素为身高和体重。结论 绝经后妇女腰椎较大者面积骨密度较高和OP检出率较低 ,椎体较小者面积骨密度较低和OP检出率较高。腰椎体积骨密度不随骨骼大小而改变。

Objective To probe into the effects of vertebral bone size on the bone mineral density (BMD) and diagnosis of osteoporosis (OP) in postmenopausal women. Methods The anteroposterior spine (L 1～4 ) projective bone area (BA), bone mineral content (BMC), and areal bone mineral density (ABMD), and the lateral spine ABMD and volumetric bone mineral density (VBMD) were measured by QDR-4500A fan beam DXA bone densitometer in 1 081 healthy postmenopausal women, the interrelationships among these parameters were then analyzed. Results BA was significantly correlated with BMC( r =0.606) and ABMD ( r =0.270, P =0.000),but not with VBMD ( r =-0.055, P = 0.101 ). BMC and ABMD were increased by 6.29% and 1.28%,respectively,with every cm 2 increase of BA. The average body height, weight, BMD and ABMD among various BA groups were significantly related to the detected rate of OP, but it was not the case with VBMD among these groups. Multiple linear regression analysis demonstrated that the body height and weight were the major factors affecting the skeletal size and BMD. Conclusion It is suggested that higher value of ABMD and lower detected rate of OP are usually seen in the postmenopausal women who have larger lumbar vertebra, while the detected OP rate is relative lower. On the contrary,low value of ABMD and higher OP detected rate can be found in those with small BA. The VBMD is not directly related to the size of lumbar vertebra.