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| 南昌市部分社区40岁以上人群骨质疏松症流行现状调查及影响因素分析 |
| Investigation of the epidemic status of osteoporosis in people over 40 years old in communities in Nanchang and the analysis of the influential factors |
| 投稿时间：2012-07-29 |
| DOI： |
| 中文关键词: 骨质疏松症 患病率 危险因素 流行病学 |
| 英文关键词:Osteoporosis Prevalence Risk factors Epidemiology |
| 基金项目: |
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| 中文摘要: |
| 目的 明确南昌市部分社区40岁以上人群骨质疏松症(Osteoporosis,OP)的患病状况及其影响因素,为OP的社区干预提供基础信息和依据.方法 应用HOLOGIC公司生产的Sahara定量超声骨密度检测仪测量南昌部分社区10071名40岁以上人群跟骨骨密度.对所有受试者进行问卷调查,检测其肝肾功能、血糖、糖化血红蛋白(HbA1C)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、总胆固醇(TC)；测量血压、身高、体重、腰围、臀围,计算其腰臀比(WHR)、体质指数(BMI).首先行单因素Logistic分析,有统计学意义者(P＜0.1)进一步行二分类Logistic回归分析,计算OR值及其95％置信区间.结果 (1)OP的总患病率为9.3％,男性7.1％,女性10.8％；年龄、性别标化后的总患病率为11.3％,男性7.9％,女性11.7％；(2)在男性,单因素分析显示年龄、文化程度、饮酒、饮牛奶、舒张压、HDL-c、BMI、体力劳动、OP家族史等与OP患病可能相关(P＜0.1).二分类Logistic回归分析显示增龄、OP家族史为OP可能危险因素；高文化程度、饮酒、饮牛奶、大BMI为OP的可能保护性因素；(3)在女性,单因素分析显示年龄、婚姻状况、文化程度、吸烟、饮牛奶、收缩压、HDL-c、LDL-c、TG、TC、HbA1c、BMI、WHR、体力劳动、孕次、产次、初潮年龄、绝经状态、绝经年龄、绝经年限、哺乳是OP的可能影响因子(P＜0.1)；二分类Logistic回归分析显示增龄、无配偶、多产次、已绝经、长绝经年限和大WHR是OP的可能危险因素；经常饮用牛奶、晚绝经年龄、高BMI为其可能保护性因素.结论 南昌市部分社区OP骨质疏松症的主要危险因素在男性是OP家族史和增龄；在女性是增龄、绝经、无配偶、多产次以及中心性肥胖.饮牛奶和合适的体质指数是男女共同的OP保护因素,在男性良好的教育和适量饮酒,女性晚的绝经年龄可能有助于减少OP的患病风险.应要采取相应的干预措施,控制OP的可控因素,预防和延缓骨质疏松症的发生. |
| 英文摘要: |
| Objective To clarify the epidemic status and the influential factors of osteoporosis in people over 40 years old in Nanchang communities, in order to provide basic information and basis for the intervention of osteoporosis. Methods Bone mineral density (BMD) of the calcaneus of 10071 people over 40 years old in Nanchang communities was detected using Sahara quantitative ultrasound system (HOLOGIC Co.). A questionnaire survey was performed in all subjects. Hepatic/renal function, blood glucose, glycated hemoglobin (HbA1C), serum triglycerides (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), and serum total cholesterol (TC) were detected. Blood pressure, height, weight, and waist circumference and hip circumference were measured. Waist-hip ratio (WHR) and body mass index (BMI) were calculated. Univariate Logistic analysis was performed firstly. Parameters with significant difference (P<0.1) were selected to perform binary logistic regression analysis. OR value and 95% confidence interval was calculated. Results The prevalence of osteoporosis in people over 40 years old was 9.3%, 7.1% in men and 10.8% in women. The total prevalence standardized by age and gender was 11.3%, 7.9% in men and 11.7% in women. In men, univariate logistic regression analysis showed that age, education, drinking, milk drinking, diastolic pressure, HDL-C, BMI, physical activity, and family history of osteoporosis were possibly associated with osteoporosis (P<0.1). The further binary logistic regression analysis showed that aging (OR=1.46, 95%: 1.27-1.68) and family history of osteoporosis (OR=2.19, 95%CI: 1.20-3.98) were risk factors of osteoporosis. While high education (OR=0.72, 95%CI: 0.53-0.98), drinking (OR=0.72, 95%CI: 0.55-0.94), milk drinking (OR=0.33, 95%CI: 0.27-0.41), and high BMI (OR=0.92, 95%CI: 0.89-0.96) were protective factors of osteoporosis. In women, univariate logistic regression analysis showed that age, marry status, education, smoking, milk drinking, systolic pressure, HDL-C, LDL-C, TC, TG, HbA1C, BMI, WHR, physical activity, gravidity, parity, menarche age, menopausal status, menopausal age, menstruation span, and breastfeeding were all possible influential factors of osteoporosis (P<0.1). The further binary logistic regression analysis showed that aging (OR=1.66, 95%CI: 1.19-2.75), single (OR=1.36, 95%CI: 1.02-1.80), multiple parturition (OR=1.18, 95%CI: 1.02-1.36), postmenopausal (OR=1.31, 95%CI: 1.05-2.35), long live since menopausal (OR=1.06, 95%CI: 1.04-1.08), and large WHR (OR=1.34, (95%CI: 1.12-2.52) were risk factors of osteoporosis. While milk drinking (OR=0.49, 95%CI: 0.39-0.62), delay of postmenopausal (OR=0.97, 95%CI: 0.94-0.99), and high BMI (OR=0.93, 95%CI: 0.87-0.99) were protective factors of osteoporosis. Conclusion For men in Nanchang communities, family history of osteoporosis and aging are main risk factors. For women, aging, postmenopausal, single, multiple parturition, and central obesity are risk factors of osteoporosis. Drinking milk and better BMI are protective factors of osteoporosis both in male and female. Men having a good education and limited drinking and women with delayed age of menopause may help to reduce the risk of osteoporosis. We should take relevant intervention measures, control the controllable factors of OP, and prevent and postpone the occurrence of OP. |
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