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目的探讨影响成年女性骨质疏松的相关因素,为制定成年女性骨质疏松的预防措施提供理论依据。方法对来我院健康体检的成年女性进行横断面研究,收集体检者临床资料包括年龄、既往病史、吸烟史、饮酒史、绝经情况等,进行人体测量(身高、体重、血压等),空腹抽血行血糖、糖化血红蛋白、血脂、血肌酐等生化指标检测。采用双能X线骨密度(DXA)仪测定腰椎正位(L1-4)和股骨的骨密度(BMD)。根据绝经情况将研究对象分为绝经组和非绝经组,研究两组之间骨质疏松的患病情况,应用多因素logistic回归模型,探讨骨质疏松的相关因素。结果共有807例成年女性纳入该研究,平均年龄为(50.8±12.9)岁,骨质疏松的患病率为4.0%。绝经组高血压、糖尿病、肾功能下降[eGFR<60mL/(min·1.73m2)]比例明显高于非绝经组,其中胆固醇及低密度脂蛋白水平也高于非绝经组,差异均有统计学意义(P<0.001)。绝经组与非绝经组之间BMD差异无统计学意义[(1.06±0.28)对(1.03±0.42),P=0.18],但绝经组T值明显低于非绝经组[(-0.24±1.58)对(0.08±1.23),P=0.002],骨质疏松的患病率高于非绝经组(7.4%对1.8%,P<0.001)。多因素Logistic回归分析显示,年龄(OR 1.02,95%CI 1.01~1.06)和肾功能下降(OR 5.43,95%CI 1.37~21.46)与骨质疏松独立相关。结论年龄、肾功能下降与成年女性骨质疏松相关,在成年女性尤其是绝经期女性发现肾功能下降的同时应筛查骨质疏松情况。
Objective To investigate the related factors affecting adult female osteoporosis and to provide a theoretical basis for the prevention of osteoporosis in adult women. Methods A cross-sectional study was conducted on adult women who came to our hospital for physical examination. The clinical data including age, past medical history, smoking history, drinking history, menopause and so on were collected for body measurement (height, weight, blood pressure, etc.) Blood glucose, glycosylated hemoglobin, blood lipids, serum creatinine and other biochemical detection. Bone mineral density (BMD) of lumbar spine (L1-4) and femur was measured by dual energy X-ray absorptiometry (DXA). According to menopause, the subjects were divided into menopausal group and non-menopausal group to study the prevalence of osteoporosis between the two groups. Multivariate logistic regression model was used to explore the related factors of osteoporosis. Results A total of 807 adult women were included in the study, with an average age of (50.8 ± 12.9) years and a prevalence of osteoporosis of 4.0%. Menopausal group hypertension, diabetes, decreased renal function [eGFR <60mL / (min · 1.73m2)] was significantly higher than non-menopausal group, cholesterol and LDL levels were higher than non-menopausal group, the difference was statistically significant Significance (P <0.001). There was no significant difference in BMD between menopausal group and non-menopausal group [(1.06 ± 0.28 vs 1.03 ± 0.42, P = 0.18], but the T value in menopausal group was significantly lower than that in non-menopausal group [(-0.24 ± 1.58) (0.08 ± 1.23), P = 0.002]. The prevalence of osteoporosis was higher in non-menopausal group (7.4% vs. 1.8%, P <0.001). Multivariate logistic regression analysis showed that age (OR 1.02, 95% CI 1.01 ~ 1.06) and renal function decline (OR 5.43, 95% CI 1.37 ~ 21.46) were independently associated with osteoporosis. Conclusions Age and renal dysfunction are related to osteoporosis in adult women. In adult women, especially in menopausal women, the decline of renal function should be detected and osteoporosis should be screened.