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| 昆明地区中老年人群定量CT骨密度测定及骨质疏松症患病率调查 |
| Quantitative CT bone mineral density measurement and prevalence of osteoporosis in middle-aged and elderly population in Kunming |
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| DOI：10.3969/j.issn.1006.7108.2022.09.014 |
| 中文关键词: 昆明地区 高原 骨质疏松症 患病率 定量CT |
| 英文关键词:Kunming area plateau osteoporosis prevalence quantitative computed tomography |
| 基金项目:2019云南省“万人计划”名医人才专项（YNWR-MY-2019-011） |
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| 中文摘要: |
| 目的 采用定量CT（quantitative computed tomograph，QCT）分析昆明地区中老年人群腰椎和髋部骨密度(bone mineral density，BMD)及骨质疏松（osteoporosis，OP）情况。方法 选取2021年3月至11月于云南省第一人民医院自愿接受腰椎和髋部QCT扫描的昆明地区50岁及以上中老年人，并记录其身高、体重和病史。将受检者以10岁为1个年龄层，按照不同性别，各分为3组（50~59岁，60~69岁，70岁及以上）。分别测量腰1~2椎体平均骨密度（L1-2 BMD）及全髋面积骨密度（TH aBMD）、全髋体积骨密度（TH vBMD）、股骨颈面积骨密度（FN aBMD）、股骨颈体积骨密度（FN vBMD）、股骨大粗隆面积骨密度（TR aBMD）、股骨大粗隆体积骨密度（TR vBMD）、股骨粗隆间面积骨密度（IT aBMD）、股骨粗隆间体积骨密度（IT vBMD）等参数。结果 共纳入555例受检者（男性180例，女性375例），基于腰椎、全髋及二者任一部位BMD测量获取的OP总体患病率分别为33.51 %、12.79 %和36.04 %，其中任一部位的OP检出率与腰椎检出率差异无统计学意义（P＞0.05），腰椎和任一部位的OP检出率均明显高于髋部（P均＜0.001）。50~59岁年龄组，男性与女性L1-2 椎体BMD差异无统计学意义（P>0.05），60~69岁及70岁以上年龄组女性L1-2 椎体BMD均小于男性（P<0.001）。男性髋部各部位BMD与年龄无关（P>0.05），女性则与年龄呈负相关（P<0.05）。50~59岁年龄组男女TH vBMD、FN vBMD、TR aBMD、IT vBMD差异有统计学意义（P<0.05），除女性TR aBMD低于男性外，其余均高于男性；60~69岁年龄组男性TH aBMD、FN aBMD、TR aBMD、TH vBMD、IT aBMD均大于女性（P<0.05）；70岁以上年龄组男性髋部各部位BMD均大于女性（P<0.05）。结论 昆明地区中老年人群腰椎测量OP总体患病率为33.51 %，全髋为12.79 %。60岁以上女性OP患病率显著高于男性，女性髋部BMD较男性更低。 |
| 英文摘要: |
| Objective To analyze bone mineral density (BMD) of the lumbar and hip and osteoporosis (OP) in middle-aged and elderly population in Kunming with quantitative computed tomography (QCT). Methods From March to November 2021, middle-aged and elderly people aged (≥50) in Kunming who voluntarily received QCT of the lumbar spine and hip in Yunnan First People's Hospital were selected. Their medical history, height, and weight were recorded. The subjects were divided into 3 groups (50-59 years old, 60-69 years old, 70 years old and above) according to different genders with 10 years old interval. The mean BMD (L1-2 BMD), total hip areal BMD (TH aBMD), total hip volumetric BMD (TH vBMD), femoral neck areal BMD (FN aBMD), femoral neck volumetric BMD (FN vBMD) , trochanter areal BMD (TR aBMD), trochanter volumetric BMD (TR vBMD), intertrochanter areal BMD (IT aBMD), and intertrochanter volumetric BMD (IT vBMD) were analyzed. Results A total of 555 subjects (180 males and 375 females) were included. The overall prevalence of OP based on BMD measurement of the lumbar spine, whole hip ,and any part of lumbar spine were 33.51%, 12.79% and 36.04%, respectively. There was no difference between the detection rate of OP in any part and that of the lumbar spine (P > 0.05). The OP detection rate of the lumbar spine and any part was significantly higher than that of the hip (P < 0.001). In the 50-59 age group, there was no significant difference between male and female lumbar 1-2 BMD (P>0.05). BMD of the lumbar 1 and 2 in women aged 60-69 and over 70 years old was lower than that in men (P<0.001). There was no correlation between BMD and age in males (P>0.05), but there was a negative correlation between BMD and age in females (P<0.05). TH vBMD, FN vBMD, TR aBMD, and IT vBMD were significantly different between males and females in 50-59 age group (P＜0.05), and all except TR aBMD were higher than males. TH aBMD, FN aBMD, TR aBMD, TH vBMD, and IT aBMD of males in 60-69 age group were higher than those of females (P<0.05). In the 70+ age group, BMD of the hip in males was higher than that in females (P<0.05). Conclusion The overall prevalence of OP measured in the lumbar spine is 33.51% in middle-aged and elderly people in Kunming, and in total hip is 12.79%. The prevalence of OP in women over 60 years old is significantly higher than that in men. The female hip is more fragile and prone to fracture. |
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