Limpaphayom K K, Taechakraichana N, Jaisamrarn U, Bunyavejchevin S, Chaikittisilpa S, Poshyachinda M, Taechamahachai C, Havanond P, Onthuam Y, Lumbiganon P, Kamolratanakul P
Department of Obstetrics & Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Menopause. 2001 Jan-Feb;8(1):65-9. doi: 10.1097/00042192-200101000-00011.
To determine the age-specific and age-adjusted prevalence of osteopenia and osteoporosis in pre- and postmenopausal Thai women.
This was a descriptive study of 1,935 Thai women ranging in age from 40 to 80 years, with randomly selected strata using multistage sampling and stratifying from six representative provinces of the country. After recruiting, all the women were interviewed by a well-trained interviewer using structured questionnaires. Bone mineral density (BMD) of lumbar spine 1-4 and nondominant hip was measured by a dual energy photon absorptiometer. The investigators were trained and standardized; inter- and intraobserver variations were measured periodically. Every BMD outcome was re-examined by the specialist. Age-specific prevalence of osteoporosis and osteopenia were determined using both Thai and Western standard BMD values. Age-adjusted prevalence of osteopenia and osteoporosis was calculated using the age-adjusted direct method.
Using the Thai BMD reference, the age-specific prevalence of osteoporosis among Thai women rose progressively with increasing age to more than 50% after the age of 70. The age-adjusted prevalence of osteoporosis also rose progressively. It was 19.8%, 13.6%, and 10% for lumbar spine, femoral neck, and intertrochanteric. The age-adjusted prevalence of osteoporosis indicates the overall magnitude of that condition in the population or country. In our study, using a Western BMD reference resulted in a misleadingly high prevalence of osteoporosis in the population of Asian countries.
It is important to calculate the age-adjusted prevalence of osteopenia and osteoporosis to address the overall magnitude of the problem in Thai women. This will allow us to predict the socioeconomic impact of preventable chronic conditions such as osteoporosis. The results obtained from this study are important data for public health policy: maximizing bone mass throughout life as well as detection of important risk factors is essential.
确定泰国绝经前后女性骨质疏松症和骨质减少症的年龄别患病率及年龄调整患病率。
这是一项描述性研究，纳入了1935名年龄在40至80岁之间的泰国女性，采用多阶段抽样从该国六个代表性省份随机选取分层样本。招募后，所有女性由训练有素的访谈员使用结构化问卷进行访谈。使用双能光子吸收仪测量腰椎1-4和非优势髋部的骨密度（BMD）。研究人员经过培训并实现标准化；定期测量观察者间和观察者内的差异。每个BMD结果均由专家重新检查。使用泰国和西方标准BMD值确定骨质疏松症和骨质减少症的年龄别患病率。采用年龄调整直接法计算骨质减少症和骨质疏松症的年龄调整患病率。
根据泰国BMD参考标准，泰国女性骨质疏松症的年龄别患病率随年龄增长而逐渐上升，70岁后超过50%。骨质疏松症的年龄调整患病率也逐渐上升。腰椎、股骨颈和粗隆间的年龄调整患病率分别为19.8%、13.6%和10%。骨质疏松症的年龄调整患病率表明了该疾病在人群或国家中的总体情况。在我们的研究中，使用西方BMD参考标准会导致亚洲国家人群中骨质疏松症的患病率被误导性地高估。
计算骨质减少症和骨质疏松症的年龄调整患病率对于了解泰国女性该问题的总体情况很重要。这将使我们能够预测骨质疏松症等可预防慢性病的社会经济影响。本研究获得的结果是公共卫生政策的重要数据：终生最大化骨量以及检测重要危险因素至关重要。
