Ofluoglu Demet, Gunduz Osman Hakan, Bekirolu Nural, Kul-Panza Evren, Akyuz Gulseren
Physical Medicine and Rehabilitation (PMR), Marmara University School of Medicine, Istanbul, Turkey.
Clin Rheumatol. 2005 Nov;24(6):606-11. doi: 10.1007/s10067-005-1110-0. Epub 2005 Jul 12.
The aim of this study was to determine whether the probability of osteoporosis and osteopenia was affected by the risk factors, physical examination findings, or radiological investigations such as spinal X-rays in postmenopausal women. We assessed risk factors such as use of hormone replacement therapy, physical activity level, calcium intake, smoking, caffeine consumption, long-term immobilization, previous history of fracture, family history of fracture, presence of certain systemic diseases (hyperthyroidism or hyperparathyroidism), or use of medications (corticosteroids or others), physical examinations, and presence of vertebral fractures on spinal X-rays. Patients' bone mineral density (BMD) was evaluated using dual energy X-ray absorptiometry (DXA) in the lumbar spine, and we compared the risk factors between osteopenic and osteoporotic women according to DXA. We evaluated 235 postmenopausal women who attended our osteoporosis outpatient clinic. Those patients were divided into two groups as either osteopenic (n = 67, mean age: 63.1 years) or osteoporotic (n = 168, mean age: 66.2 years) according to WHO criteria. The lumbar spinal (L1-L2) T-score values were -1.5 +/- 0.6 and -3.1 +/- 0.6 in osteopenic and osteoporotic groups, respectively. There were significant differences between the two groups in terms of mean age and lumbar BMD (p = 0.009 and p < 0.001, respectively). We also observed that vertebral tenderness on palpation, back pain, and existing vertebral fracture (fx) were significantly different between the osteopenic and osteoporotic groups (p < 0.05). As a result of the statistical analysis, we found an equation to determine osteopenic and osteoporotic women by using those four factors (age, vertebral tenderness on palpation, back pain, and existing vertebral fx) in multivariate stepwise logistic regression. The equation is as follows: Y (DXA) = -2.9024 + 0.044 (age in year) + 0.819 (vertebral fx) + 0.877 (pain) + 1.136 (vertebral tenderness). We can estimate whether a postmenopausal woman is osteopenic or osteoporotic based on these risk factors by using the stepwise logistic regression equation.
本研究的目的是确定骨质疏松症和骨质减少的概率是否受到绝经后女性的风险因素、体格检查结果或诸如脊柱X光等放射学检查的影响。我们评估了诸如激素替代疗法的使用、身体活动水平、钙摄入量、吸烟、咖啡因摄入量、长期制动、既往骨折史、骨折家族史、某些全身性疾病（甲状腺功能亢进或甲状旁腺功能亢进）的存在或药物（皮质类固醇或其他药物）的使用等风险因素、体格检查以及脊柱X光上椎体骨折的存在情况。使用双能X线吸收法（DXA）评估患者腰椎的骨矿物质密度（BMD），并根据DXA比较骨质减少和骨质疏松女性之间的风险因素。我们评估了235名到我们骨质疏松门诊就诊的绝经后女性。根据世界卫生组织标准，这些患者被分为两组，即骨质减少组（n = 67，平均年龄：63.1岁）或骨质疏松组（n = 168，平均年龄：66.2岁）。骨质减少组和骨质疏松组腰椎（L1-L2）的T值分别为-1.5±0.6和-3.1±0.6。两组在平均年龄和腰椎BMD方面存在显著差异（分别为p = 0.009和p < 0.001）。我们还观察到，骨质减少组和骨质疏松组在触诊时的椎体压痛、背痛和现有的椎体骨折（fx）方面存在显著差异（p < 0.05）。作为统计分析的结果，我们在多变量逐步逻辑回归中找到了一个通过使用这四个因素（年龄、触诊时的椎体压痛、背痛和现有的椎体fx）来确定骨质减少和骨质疏松女性的方程。该方程如下：Y（DXA）= -2.9024 + 0.044（年龄，单位：岁）+ 0.819（椎体fx）+ 0.877（疼痛）+ 1.136（椎体压痛）。通过使用逐步逻辑回归方程，我们可以根据这些风险因素估计一名绝经后女性是骨质减少还是骨质疏松。
