老年人群骨密度与平衡功能的相关性

摘要

目的：分析老年人群骨密度（ BMD）与平衡功能的相关性。方法对729名年龄45～85岁受检者的临床资料进行回顾性分析。收集受试者年龄、身高、体重、既往病史、跌倒史，采用双能X线骨密度仪测量患者BMD，采用平衡测定仪（IBS）评估平衡功能，获得跌倒风险指数（FI）和各项平衡参数。分析骨密度和各平衡参数的相关性。结果729名受检者中女性557名，男性172名，女性平均年龄（65.58±9.7）岁，全髋、股骨颈、腰椎L1-4 BMD均值分别为（0.81±0.14）、（0.77±0.13）和（0.86±0.17） g／cm2。男性平均年龄（66.29±10.7）岁，全髋、股骨颈、腰椎L1-4 BMD均值分别为（0.88±0.16）、（0.83±0.15）和（1.02±0.21） g／cm2。线性回归分析显示既往1年内的跌倒史、性别、年龄、体重指数（ BMI）、腰椎BMD （ L1-4）对跌倒风险指数（ FI）有影响，相关系数分别为0.225、0.089、0.121、0.096、0.130，股骨颈和全髋骨密度对跌倒风险指数无显著影响。比较男性与女性两组之间平衡参数，平视前方及保持平视前方姿势下F2-4差异有统计学意义。对各平衡参数行ANCOVA分析，结果显示仰头闭眼姿势（ HB）总体稳定性（ ST）、 F2-F6傅里叶转换指数与腰椎BMD （ L1-4）显著相关。结论年龄增长，高BMI，既往跌倒史对平衡能力有负性影响。男性跌倒风险较女性高。髋关节BMD对平衡功能无明显影响，腰椎BMD与平衡功能相关，提示受检者平衡控制策略的改变。%Objective To identify the effect of BMD ( bone mineral density) on balance control ability intheelderlypopulation.Methods 729subjectsofourosteoporosiscenterwereenrolled,agedfrom45to85 years old.The information of age, gender, height, and weight were obtained while the DXA ( dual-energy X-ray absorptiometry)andinteractivebalancesystem(IBS)testwereperformed.Results 557femalesand172 males were enrolled in this study.In the female group, the mean age was (65.58 ±9.7) years old.The mean BMD value of total hip, femoral neck and L1-4 was (0.81 ±0.14), (0.77 ±0.13) and (0.86 ±0.17) g/cm2, respec-tively.In the male group, the mean age was (66.29 ±10.7) years old.The mean BMD value of total hip, femoral neck and L1-4 was ( 0.88 ±0.16 ) , ( 0.83 ±0.15 ) and ( 1.02 ±0.21 ) g/cm2 , respectively.The linear regression analysis revealed that fall in previous twelve months , gender, age, BMI ( body mass index) and BMD of L1-4 made a significant contribution to the FI (fall index), with coefficients counted as 0.225, 0.089, 0.121, 0.096, and 0.130 respectively.Areal BMD at total hip and femur neck had no significant influence on FI.There are significant differences between male and female groups in postural characteristics of F 2-4 in NO and PO position.In HB position, ST ( general stability ) was found to be moderately correlated with BMD at L 1-4 (F=1.332, P=0.004); Fourier Transformation in frequency (F2-F6) was associated with BMD at L1-4. Conclusion The increased age, higher BMI, and the history of previous falls have a significantly inverse effect on the balance control in elder population.Males have a higher risk of falls than females.In addition, BMD of hip has no specific effect on the balance control ability , and the abnormal increased BMD of lumbar indicates a compensation mechanism of inadequate balance control .