目的 分析绝经后女性骨质疏松症(OP)的危险因素,探讨骨转换生化标志物(BTMs)与骨密度(BMD)的相关性。方法 采用横断面研究,选取2013年4月至12月北京市某社区参与健康教育的273名绝经后女性为研究对象。根据WHO诊断标准,分为OP组(101例)和非OP组(172例)。收集一般资料、生化指标及BTMs,并行双能X线BMD检测。结果 绝经后女性OP患病率为37.0%,随年龄增长显著升高(<50岁:15.4%;50～64岁:29.9%;≥65岁:47.2%)。与非OP组相比,OP组年龄更大、绝经年限更长、身高、体重及体质量指数(BMI)更低,血清碱性磷酸酶(ALP)和骨钙素(OC)水平更高(P＜0.05)。相关性分析显示,腰椎BMD与身高、体重、BMI呈正相关,与年龄、绝经年限、ALP、血钙、OC、Ⅰ型胶原羧基端肽(CTX)呈负相关(P＜0.05)。不同部位BMD与各指标的相关模式存在差异:腰椎与代谢指标相关性更强,股骨近端与力学指标相关性更强。Logistic回归分析显示,绝经年限(OR=1.091,95% CI:1.001～1.181)及ALP(OR=1.028,95%CI:1.006～1.047)和OC(OR=1.037,95%CI:1.002～1.071)是OP的独立危险因素。结论 绝经年限、ALP及OC是绝经后女性OP的独立危险因素。不同部位BMD与临床指标的相关模式存在差异,综合上述易获取指标有助于社区OP高危人群的早期识别与分层管理。
Abstract
Objective To analyze the risk factors of osteoporosis(OP) in postmenopausal women and investigate the correlation between bone turnover biomarkers (BTMs) and bone mineral density (BMD). Methods A cross-sectional study was conducted on 273 postmenopausal women who participated in a health education program in a community of Beijing from April to December 2013. According to the WHO diagnostic criteria, the participants were divided into an OP group (101 cases) and a non-OP group (172 cases). General data, biochemical indicators and BTMs were collected, and dual-energy X-ray BMD was measured. Results The prevalence of OP in the postmenopausal women was 37.0%, which significantly increased with age (15.4% for <50 years old; 29.9% for 50-64 years old; 47.2% for ≥65 years old). Compared with the non-OP group, the OP group was older, and had a longer menopause duration, lower height, weight and body mass index (BMI), and higher levels of serum alkaline phosphatase (ALP) and osteocalcin (OC) (P＜0.05). Correlation analysis revealed that lumbar BMD was positively correlated with height, weight and BMI, and negatively correlated with age, menopause duration, ALP, blood calcium, OC and type I collagen carboxy-terminal peptide (CTX) (P＜0.05). The correlation patterns of BMD in different sites with various indicators were different: lumbar BMD showed a stronger association with metabolic indicators, while proximal femoral BMD had a stronger correlation with mechanical factors. Logistic regression analysis identified menopause duration (OR=1.091, 95%CI: 1.001-1.181), ALP (OR=1.028, 95%CI: 1.006-1.047) and OC (OR=1.037, 95%CI: 1.002-1.071) as independent risk factors for OP. Conclusions Menopause duration, ALP, and OC are independent risk factors for OP in postmenopausal women. The correlation patterns of BMD in different sites with clinical indicators are different. Comprehensive use of these available indicators may facilitate the early identification and stratified management of high-risk OP populations in a community.
关键词
绝经后女性 /
骨质疏松症 /
骨密度 /
骨转换生化标志物 /
危险因素
Key words
postmenopausal women /
osteoporosis /
bone mineral density /
bone turnover biomarkers /
risk factors
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