社区老年健康男性骨质疏松患病率调查及临床危险因素分析

摘要

目的：调查健康老年男性的骨密度（BMD）变化规律并分析和原发性骨质疏松症（OP）相关的临床危险因素。方法在北京市朝阳区团结湖社区采用广告招募的抽样方法，对50岁以上健康老年男性接受自制《北京市老年男性原发性骨质疏松症高危人群临床危险因素调查问卷》调查的同时进行双能 X 线骨密度检查，记录腰椎总（L1-4）、左侧股骨颈（femoral neck）和左髋总（total hip）的 BMD 数值和年龄、体重、既往脆性骨折史、吸烟史、饮酒史等临床危险因素；根据世界卫生组织诊断标准将研究对象分为 OP 组和非 OP 组，分析各临床危险因素与 OP 发生的相关性。结果518例老年男性总体 OP 患病率14.3%（74/518），骨量减少者53.7%（278/518），骨量正常者32.0%（166/518）。既往脆性骨折史、体重指数、体重在 OP 组和非 OP 间存在显著差异性（ P <0.05）。结论社区健康老年男性 OP 患病情况不容乐观，低体重及低体重指数、既往脆性骨折史可能是 OP 相关的临床危险因素，有待于进一步深入研究。%Objective To survey the prevalence of osteoporosis and osteoporosis - related clinical risk factors in community - dwelling healthy elderly male population. Methods By using sampling method of recruitment advertising,healthy elderly males aged 50 and above in Bei-jing Tuanjiehu community had completed our questionnaire were enrolled in this study and they had been accepted testing of bone mineral density (BMD)by using dual energy X - ray absorptiometry. These inhabitants had been classified as osteoporosis group(OP group)and non - osteoporo-sis group(Non - OP group)according to the WHO criteria. Osteoporosis was arbitrarily defined when any T - scores were - 2. 5 standard devia-tions or less at femoral neck,total hip or lumbar spine(L1 - 4 ). The clinical risk factors of each person including age,body weight,body mass in-dex(BMI),previous history of fragile fracture,smoking,alcohol abuse,glucocorticoid therapy and other capable clinical risk factors were collect-ed and compared in OP group and Non - OP group. Results Among 518 persons,14. 3%(74 / 518)of them had osteoporosis,53. 7%(278 /518)had osteopenia and 32. 0%(166 / 518)had normal bone mass. There was significant difference in weight,BMI and previous history of frag-ile fracture between OP group and Non - OP group( P < 0. 05). Conclusion The prevalence of osteoporosis in healthy elder men should not be ignored. Low BMI,weight and previous history of fragile fracture may be osteoporosis - related clinical risk factors in this population.