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| 北京南郊地区成年人桡骨远端骨密度及FRAX骨折风险评分与BMI的相关分析和探索研究 |
| The relationship between BMI and bone mineral density of distal radius and FRAX fracture risk in residents of Beijing southern suburbs |
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| DOI：10.3969/j.issn.1006-7108.2018.08.014 |
| 中文关键词: 骨密度 FRAX骨折风险评分 身体质量指数 骨质疏松 桡骨 |
| 英文关键词:BMD FRAX fracture risk score BMI Osteoporosis Radial |
| 基金项目:北京市科技计划课题《大兴区关于“北京市城镇居民骨质疏松症社区规范化管理标准”等相关技术的推广应用研究》（Z151100004015233） |
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| 中文摘要: |
| 目的 探讨北京南郊地区不同性别成年人非优势手臂桡骨远端骨密度及骨折风险预测工具FRAX计算出的全身骨折风险与身体质量指数（body mass index，BMI）及年龄之间的关系。方法 回顾性分析2015年1 月至2017 年6 月期间在我院接受双能X 线骨密度检测( DEXA) 的体检人群2680名作为研究对象，其中男性944名，女性1736名，收集相关临床指标，计算BMI值，检测受检者非优势手臂的桡骨远端骨密度，登录网站计算 FRAX骨折风险评分。按年龄及BMI分组，采用方差分析的方法分别研究桡骨远端骨密度及FRAX骨折风险评分与BMI及年龄之间的关系。采用最小显著性差异法(least significant difference,LSD)分别比较BMI各组及各年龄组桡骨远端骨密度和FRAX骨折风险评分的组间差异。结果 ① 北京南郊地区成年人非优势手臂桡骨远端骨密度(bone mineral density, BMD)随年龄增高而降低，FRAX骨折风险评分即10 年内发生全身骨质疏松性骨折的概率（probability of a major osteoporotic fracture，PMOF）随年龄增高而增高，差异均有统计学意义（P＜0. 05），且各年龄组骨密度BMD值男性均高于女性，PMOF男性均低于女性，差异有统计学意义（P＜0. 05）。② 北京南郊地区成年人非优势手臂桡骨远端骨密度BMD随 BMI 的升高呈而增高，且差异有统计学意义（P＜0. 05）。不论性别，PMOF在BMI为24~27.9（超重组）达高峰，正常体重组及肥胖组均低于超重组。③ BMI各组中男性BMD值均高于女性，PMOF各BMI组中男性均低于女性，差异有统计学意义（P＜0. 05）。结论 桡骨远端骨密度BMD及PMOF与受检者性别、年龄、BMI均相关，其中同等年龄及BMI情况下，女性的骨折风险均高于男性；随着年龄增长，骨密度降低，骨折风险增加；随着BMI的增高，骨密度BMD逐渐增高，但此时骨折风险不随BMD的增高而降低，而表现为超重人群骨折风险最高，正常体重人群骨折风险最低，故超重亦是使骨折风险增加的危险因素。通过利用FRAX软件，测量桡骨远端骨密度的高低并充分考虑性别、年龄、BMI等因素可有效评估患者的骨折风险。 |
| 英文摘要: |
| Objective To investigate the relationship between BMI and age and fracture risk calculated by FRAX as well as bone mineral density (BMD) of distal radius of the non-dominant arm in male and female residents of Beijing southern suburbs. Methods A retrospective analysis of 2680 patients, including 944 males and 1736 females, who had dual-energy x-ray absorptiometry (DXA) examination in our hospital from January 2015 to June 2017 was conducted, and the related clinical data were collected. BMI values were calculated, BMD of the distal radius of the non-dominant arm of the examinee was measured, and the FRAX website was used to calculate the FRAX fracture risk score. Grouped by age and BMI, analysis of variance was used to study the relationship between distal radius BMD and FRAX fracture risk score and BMI and age. The LSD method was used to compare the differences in BMD and FRAX fracture risk score between the BMI groups and age groups. Results ① BMD of distal radius of the non-dominant arm decreased with increasing age in residents of Beijing southern suburbs. The probability of major osteoporotic fracture (PMOF) of FRAX fracture risk score increased with age, with significant differences among age groups (P <0.05). In all age groups BMD was higher in males than in females. The PMOF FRAX fracture risk score was lower in males than that in females (P <0.05). ② BMD of distal radius of the non-dominant arm of adults in Beijing southern suburbs increased with the increase of BMI, and the differences were statistically significant (P <0.05). Regardless of sex, the PMOF fracture risk score peaked at the 24 to 27.9 BMI (overweight) group, and was lower in the normal BMI and obese groups than in the overweight group. ③ The BMD in each group of BMI was higher in males than that in females. The PMOF FRAX fracture risk score was lower in men than in women, and the difference was statistically significant (P <0.05). Conclusion BMD of the distal radius and the PMOF FRAX fracture risk score were correlated with sex, age and BMI of the subjects. Of the same age and BMI, the fracture risk of females was higher than that of males. With increase in age, BMD decreased, and the risk of fractures increased. With the increase of BMI, the BMD of distal radius increased gradually, but the risk of fracture did not decrease with the increase of BMD, and the risk of fracture was the highest in the overweight category and the lowest in the normal weight category. Therefore overweight is a risk factor for fracture. By using FRAX software, measuring the BMD of distal radius, and taking full account of gender, age, BMI and other factors, the risk of fracture in patients can effectively assessed. |
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