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目的:掌握40~60岁女性骨密度(bone mineral density,BMD)的变化及影响因素,为妇女保健工作提供依据。方法:系统随机抽取西安某社区334例40~60岁女性作为研究对象,采用问卷调查基本情况、饮食和运动习惯,双能X线BMD检测仪检测腰椎BMD,并测量心率、身高、体质量、腰围、臀围、前臂长。计量资料2组比较采用t检验,多组比较采用单因素方差分析,多组间两两比较采用LSD-t法,相关性采用Pearson分析,BMD影响因素采用多元线性回归方法。结果:腰椎BMD为(0.933±0.150)g/cm2,骨质疏松症(osteoporosis,OP)发生率为17.1%,骨量减少发生率为27.8%。年龄越大BMD越低,组间有统计学差异(P<0.05)。围绝经期BMD高于绝经后,有统计学差异(P<0.05)。体质指数(body mass index,BMI)越大BMD越大,组间有统计学差异(P<0.05)。摄入大豆或豆制品多量组BMD高于少量组(P<0.05),摄入牛奶、鸡蛋、瘦肉、海产品的BMD在多量组和少量组间无统计学差异(P>0.05),习惯饮咖啡、饮茶少量组BMD高于多量组(P<0.05)。坚持运动2年以上较1年内的BMD明显增高(P<0.05),每天、每周4~6次组较不运动或偶尔运动组BMD明显增高(P<0.05)。BMD与体质量、身高、BMI、腰围、臀围、前臂长呈正相关(r=0.545、0.361、0.332、0.416、0.451、0.312,P值均小于0.05),与年龄、初潮年龄呈负相关(r=-0.413、-0.352,P值均小于0.05),与心率不相关(r=0.16,P>0.05)。多元线性回归结果显示BMD的影响因素有年龄、初潮年龄、绝经、身高、体质量、BMI、前臂长、臀围、腰围、大豆或豆制品、饮茶、咖啡、运动频率和运动时间(β=-1.206、-1.461、0.643、2.125、1.352、0.618、0.252、0.625、0.425、0.552、-2.105、-1.981、0.708、0.537,P值均小于0.05)。结论:绝经期妇女OP发生率为17.1%,骨量减少发生率为27.8%。BMD的影响因素有年龄、BMI、初潮年龄和绝经、饮食及运动习惯。增龄、绝经、初潮年龄晚、习惯饮咖啡、茶水是OP的危险因素,高BMI、大豆或豆制品摄入、坚持规律运动2年以上是保护因素。
Objective: To master the changes and influencing factors of bone mineral density (BMD) in 40-60 years old women and provide basis for women’s health care. Methods: A total of 334 women aged 40-60 in a community of Xi’an were randomly selected as the research object. BMD of lumbar spine was measured by questionnaire survey, diet and exercise habits. The BMD of lumbar spine was measured by two-way X-ray BMD. Heart rate, height, body weight, Waist circumference, hip circumference, forearm length. The t test was used to compare the measurement data in two groups. One-way analysis of variance (ANOVA) was used to compare the two groups. The LSD-t method was used to compare the two groups. Pearson analysis was used to analyze the correlation between the two groups. Multivariate linear regression was used to analyze the influencing factors of BMD. Results: The lumbar BMD was (0.933 ± 0.150) g / cm2. The incidence of osteoporosis (OP) was 17.1%. The incidence of osteopenia was 27.8%. The older the lower the BMD, there was a statistically significant difference between the groups (P <0.05). Perimenopausal BMD was higher than that after menopause, with statistical significance (P <0.05). The larger the body mass index (BMI), the larger the BMD. There was a significant difference between the two groups (P <0.05). BMD of soybeans or soy products was higher than that of small amount of soybeans or soy products (P <0.05). BMD of milk, eggs, lean meat and seafood did not show statistical difference (P> 0.05) Drinking coffee, tea drinking a small amount of BMD group was higher than the number of groups (P <0.05). BMD was significantly higher (P <0.05) than insomnia for more than 2 years and 1-year (P <0.05). BMD was positively correlated with body weight, height, BMI, waist circumference, hip circumference and forearm length (r = 0.545,0.361,0.332,0.416,0.451,0.312, P values were less than 0.05), and was negatively correlated with age and menarche age = -0.413, -0.352, P values were less than 0.05), not related to heart rate (r = 0.16, P> 0.05). Multivariate linear regression analysis showed that the influencing factors of BMD were age, menarche age, menopause, height, weight, BMI, forearm length, hip circumference, waist circumference, soy or soy products, tea, coffee, exercise frequency and exercise time (β = -1.206, -1.461, 0.643, 2.125, 1.352, 0.618, 0.252, 0.625, 0.425, 0.552, -2.105, -1.981, 0.708, 0.537, all P values less than 0.05). Conclusion: The incidence of OP in postmenopausal women was 17.1% and the incidence of osteopenia was 27.8%. The influencing factors of BMD are age, BMI, menarche age and menopause, diet and exercise habits. Age, menopause, late menarche, habit of drinking coffee, tea is a risk factor for OP, high BMI, soy or soy products intake, insisted regular exercise for more than 2 years is a protective factor.