Pesonen Janne, Sirola Joonas, Tuppurainen Marjo, Jurvelin Jukka, Alhava Esko, Honkanen Risto, Kröger Heikki
Bone and Cartilage Research Unit, Clinical Research Center, University of Kuopio, P.O. Box 1627, 70211, Kuopio, Finland.
Osteoporos Int. 2005 Dec;16(12):1899-906. doi: 10.1007/s00198-005-1958-5. Epub 2005 Jun 16.
Studies regarding high bone mineral density (HBMD) are few. In the population-based Kuopio Osteoporosis Risk Factor and Prevention Study, BMDs of women were measured from 1990-1991 and 1995-1997. The mean age of the 1,873 women studied was 53.5 years at baseline (range 48.0-59.6). In all, 248 women were excluded because of BMD measurement errors or artifacts: 41 from the HBMD group (20.6%) and 207 (12.4%) from the control group. The final study group consisted of 1,551 women, 168 in the HBMD group (baseline lumbar BMD >1.23 g/cm2; femoral BMD >1.01 g/cm2, and 5-year follow-up lumbar BMD >1.21 g/cm2; femoral BMD >0.98 g/cm2, respectively) and 1,383 in the control group. The predictors for HBMD in the multivariate regression analysis were as follows: hormone therapy (HT) during the follow-up from 0.5 to 2 years and for over 2 years (OR 2.06, CI: 1.11-3.81 and OR 2.16, CI 1.43-3.26) and being overweight (BMI from 25 kg/m2 to 30 kg/m2, and BMI >30 kg/m2) at baseline (OR 2.84, CI: 1.82-4.42; OR 5.94, CI: 3.47-10.16, respectively). High physical activity while 11-18 years of age was associated with HBMD (OR 1.69, CI: 1.17-2.45). Parity predicted HBMD so that after one to two births the OR was 2.66 (CI: 1.03-6.88) and 3.03 (CI: 1.16-7.90) after three or more births. Menopause was negatively associated with HBMD (OR 0.57, CI 0.38-0.85). There were more premenopausal women in the HBMD group (53.9 vs. 34.6%, P <0.001). The HBMD group showed fewer fractures. In conclusion, being overweight, parity, HT use, premenopause and high physical activity in adolescence seemed to be predictors for persistently high BMD in early postmenopausal women. We suggest that the fracture risk is low in these women, and thus they are neither primary candidates for BMD screening nor for osteoporosis medication.
关于高骨矿物质密度（HBMD）的研究较少。在基于人群的库奥皮奥骨质疏松症危险因素与预防研究中，于1990 - 1991年和1995 - 1997年对女性的骨密度进行了测量。所研究的1873名女性的平均年龄在基线时为53.5岁（范围48.0 - 59.6岁）。共有248名女性因骨密度测量误差或伪影被排除：41名来自HBMD组（20.6%），207名（12.4%）来自对照组。最终研究组由1551名女性组成，HBMD组有168名（基线腰椎骨密度>1.23 g/cm²；股骨骨密度>1.01 g/cm²，5年随访腰椎骨密度>1.21 g/cm²；股骨骨密度>0.98 g/cm²），对照组有1383名。多因素回归分析中HBMD的预测因素如下：随访0.5至2年及超过2年期间的激素治疗（HT）（比值比2.06，置信区间：1.11 - 3.81和比值比2.16，置信区间1.43 - 3.26）以及基线时超重（体重指数从25 kg/m²至30 kg/m²，体重指数>30 kg/m²）（比值比分别为2.84，置信区间：1.82 - 4.42；比值比5.94，置信区间：3.47 - 10.16）。11至18岁时高体力活动与HBMD相关（比值比1.69，置信区间：1.17 - 2.45）。产次可预测HBMD，一至两次分娩后的比值比为2.66（置信区间：1.03 - 6.88），三次或更多次分娩后的比值比为3.03（置信区间：1.16 - 7.90）。绝经与HBMD呈负相关（比值比0.57，置信区间0.38 - 0.85）。HBMD组中绝经前女性更多（53.9%对34.6%，P <0.001）。HBMD组骨折较少。总之，超重、产次、HT使用、绝经前状态以及青春期高体力活动似乎是绝经后早期女性持续高骨密度的预测因素。我们认为这些女性骨折风险较低，因此她们既不是骨密度筛查的主要对象，也不是骨质疏松症药物治疗的主要对象。
