更年期女性骨密度及其影响因素分析

Analysis of bone mineral density and its influencing factors in menopausal women

目的分析更年期女性骨密度(BMD)及其影响因素,为提高此人群骨健康提供依据。方法选择2018年1月至12月在兵器工业521医院体检的484例更年期女性为研究对象,采用调查问卷方式记录基本资料,双能X线BMD检测仪检测腰椎、髋部、前臂的BMD,多因素Logistic回归分析骨质疏松患者的相关因素。结果 484例调查对象中骨质疏松(OP)者95例(19.62%),低骨量者146例(30.17%)。骨质疏松组产次显著高于骨量正常组(t=2.547,P<0.05),而豆制品、海产品、牛奶及鸡蛋摄入率显著低于骨量正常组(χ~2值分别为14.072、14.228、5.375、6.108,均P<0.05),且户外运动、钙剂补充及使用绝经激素治疗(MHT)率均显著低于骨量正常组(χ~2值分别为6.605、21.121、4.191,均P<0.05)。多因素Logistic回归分析结果显示:多次生产是更年期女性骨质疏松的危险因素(OR=1.654,P<0.05),豆制品摄入、海产品摄入、牛奶摄入、鸡蛋摄入、户外运动、钙剂补充、使用MHT是保护因素(OR值0.274~0.580,均P<0.05)。绝经前组女性腰椎、髋部及前臂BMD均显著高于绝经后组(t值分别为2.908、2.774、2.853,均P<0.05),而低骨量和OP患病率均显著低于绝经后组(χ~2值分别为8.717、7.657,均P<0.05)。结论更年期女性骨健康受生育次数、生活习惯、钙剂补充、绝经状态及MHT等多种因素影响,此人群应监测BMD,尽早预防骨质疏松。

Objective To analyze the bone mineral density(BMD)and its influencing factors in menopausal women,and to provide a basis for improving bone health of these people.Methods 484 menopausal women who underwent physical examination in No.521 hospital of ordnance industry during the period from January to December 2018 were selected as subjects,and the basic data were recorded through questionnaires.BMD of lumbar spine,hip and forearm were detected by dual-energy X-ray BMD detector,and the related factors of osteoporosis patients(OP)were analyzed by multivariate Logistic regression.Results Among the 484 subjects,95 patients were OP(19.62%)and 146 patients had low bone mass(30.17%).The number of delivery in OP group was significantly higher than that of the group with normal bone mass(t=2.547,P<0.05),and the rate of outdoor sports,calcium supplementation,and use of MHT were significantly lower compared with the group with normal bone mass(χ~2 value was 6.605,21.121,and 4.191,respectively,P<0.05).The results of multivariate Logistic regression analysis showed that fertility was a risk factor for OP in menopausal women(OR=1.654,P<0.05),and the intake of soy products,seafood,milk,eggs,outdoor exercise,calcium supplements and MHT were protective factors(OR value was 0.274~0.580,P<0.05).BMD of lumbar spine,hip and forearm of the premenopausal group were significantly higher compared with postmenopausal group(t value was 2.908,2.774 and 2.853,respectively,P<0.05),while the prevalence of low bone mass and OP was significantly lower than that of the post-menopausal group(χ~2 value was 8.717 and 7.657,respectively,P<0.05).Conclusion Bone health of menopausal women is affected by many factors,such as lifestyle,calcium supplementation,menopausal status and MHT.BMD should be monitored in this group in order to prevent OP as soon as possible.