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绝经后女性骨质疏松症的危险因素——从初级保健妇科医生的角度来看

Risk Factors for Osteoporosis in Postmenopausal Women - from The Point of View of Primary Care Gynecologist.

作者信息

Franic Damir, Verdenik Ivan

机构信息

Outpatient Clinic for Obstetrics and Gynecology, Celjska cesta 10, 3250Rogaska Slatina, Slovenia.

University Clinical Center Ljubljana, Department for Obstetrics and Gynecology, Zaloska cesta 7, 1000Ljubljana, Slovenia.

出版信息

Zdr Varst. 2018 Jan 5;57(1):33-38. doi: 10.2478/sjph-2018-0005. eCollection 2018 Mar.

Abstract

INTRODUCTION

Osteoporosis is a highly prevalent public health problem with osteoporosis-related fractures that account for high morbidity and mortality. Therefore, prevention strategies and early detection of osteoporosis should be carried out in primary gynaecological care units, so as to substantially reduce the risk of fractures and allow the best treatment option for a particular woman.

METHODS

From 2002 to 2011, we recruited 2956 women. Of the total number of women, we additionally extrapolated 1274 women aged 60-75 years, assumingly, the group of women at higher risk of osteoporosis. Demographic and anthropometrical data as well as the information regarding risk factors for osteoporosis were collected using a questionnaire.

RESULTS

The odds ratio for osteoporosis increased by 8% (p=0.001) with each additional year of life. The OP prevalence increased with age from 24.9% in 60-64 years to 37.4% in 70-75 years. In non-smokers the odds ratio for osteoporosis was 0.424, which was statistically significant (p<0.05). BMI <18.5 increased the odds ratio for osteoporosis by 2 times, which was not statistically significant. In women 60-75 years old (N=1274), the risk of fractures increased with increasing age, considering previous fractures in the last 5 years (p<0.001), hip fracture (p=0.001), wrist fracture (p=0.002) and observed height loss (p<0.001). Hormone therapy (HT) use decreased the prevalence of OP by 25% in comparison with non-users.

CONCLUSION

Primary care gynaecologist with a DXA centre has every opportunity for a holistic approach to the management of postmenopausal women, including the prevention and treatment of postmenopausal osteoporosis.

摘要

引言

骨质疏松症是一个高度普遍的公共卫生问题,与骨质疏松症相关的骨折导致高发病率和死亡率。因此,应在初级妇科保健单位开展骨质疏松症的预防策略和早期检测,以大幅降低骨折风险,并为特定女性提供最佳治疗方案。

方法

2002年至2011年,我们招募了2956名女性。在这些女性总数中,我们额外推断出1274名60 - 75岁的女性,假定这是骨质疏松症风险较高的女性群体。使用问卷收集人口统计学和人体测量数据以及有关骨质疏松症风险因素的信息。

结果

年龄每增加一岁,患骨质疏松症的优势比增加8%(p = 0.001)。骨质疏松症的患病率随年龄增长而增加,从60 - 64岁的24.9%增至70 - 75岁的37.4%。在非吸烟者中,患骨质疏松症的优势比为0.424,具有统计学意义(p < 0.05)。体重指数(BMI)< 18.5使患骨质疏松症的优势比增加2倍,但无统计学意义。在60 - 75岁的女性(N = 1274)中,考虑到过去5年的既往骨折(p < 0.001)、髋部骨折(p = 0.001)、腕部骨折(p = 0.002)以及观察到的身高降低(p < 0.001),骨折风险随年龄增加而增加。与未使用者相比,激素疗法(HT)的使用使骨质疏松症的患病率降低了25%。

结论

配备双能X线吸收仪(DXA)中心的初级保健妇科医生有充分机会对绝经后女性进行全面管理,包括预防和治疗绝经后骨质疏松症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c04/5894367/818eaffbc32c/sjph-57-033-g001.jpg

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