美国多民族人群骨密度呈下降趋势：对 2005-2014 年连续 NHANES 数据分析。
Decreasing trend of bone mineral density in US multiethnic population: analysis of continuous NHANES 2005-2014.
机构信息
Nevada Institute of Personalized Medicine, University of Nevada, Las Vegas, 4505 Maryland Parkway, Las Vegas, NV, 89154-4009, USA.
Department of Environmental and Occupational Health, School of Community Health Sciences, University of Nevada, Las Vegas, 4505 Maryland Parkway, Las Vegas, NV, 89154-4009, USA.
出版信息
Osteoporos Int. 2018 Nov;29(11):2437-2446. doi: 10.1007/s00198-018-4648-9. Epub 2018 Aug 8.
UNLABELLED
Studies examining recent bone mineral density (BMD) trends in the US population are limited. In our study, we found that age-adjusted mean BMD among US men and women was stable from 2005 to 2010, but then declined in 2013-2014. We also explored factors associated with decreasing BMD in recent years.
INTRODUCTION
Osteoporosis prevalence in the USA declined between 1988 and 2006, while the declining trend in hip fracture may have plateaued in 2013-2014. We aimed to examine whether there has been a corresponding change in BMD trajectory for the US population.
METHODS
Continuous National Health and Nutrition Examination Survey (NHANES) data from 2005-2006 to 2013-2014 were analyzed to examine BMD trends among US men and women aged 30 years and older and among different race/ethnicity subgroups. ANOVA and Bonferroni adjustments were used to examine the differences in mean BMD, and multiple linear regressions adjusting for potential confounding effects were employed to examine BMD trends.
RESULTS
After age standardization, the mean BMD of the femur neck for the first three NHANES cycles was stable (all p > 0.1) in both men and women, but significantly decreased in 2013-2014, from 0.864 g/cm to 0.846 g/cm (p = 0.0025) in men and from 0.789 to 0.771 g/cm (p = 0.03) in women. The overall mean femur neck BMD in 2013-2014 was significantly lower than that in earlier survey cycles in both men and women, even after adjusting for multiple covariates, including age, race, physical activity, previous fracture, BMI, and other variables. Similar results were observed in subgroup analyses of race and sensitivity analyses.
CONCLUSIONS
Age-adjusted mean BMD decreased in 2013-2014 in both men and women, and this significant decrease was also observed in sensitivity and subgroup analyses. The decreased BMD in 2013-2014 still remained significant even after being adjusted for multiple potentially confounding effects.
未加标签
关于美国人口近期骨密度（BMD）趋势的研究有限。在我们的研究中，我们发现美国男性和女性的年龄调整平均 BMD 在 2005 年至 2010 年期间保持稳定，但在 2013-2014 年期间有所下降。我们还探讨了近年来与 BMD 下降相关的因素。
引言
1988 年至 2006 年期间，美国骨质疏松症的患病率下降，而髋部骨折的下降趋势可能在 2013-2014 年趋于平稳。我们旨在研究美国人群的 BMD 轨迹是否发生了相应变化。
方法
分析了 2005-2006 年至 2013-2014 年期间的连续全国健康和营养调查（NHANES）数据，以检查 30 岁及以上美国男性和女性以及不同种族/族裔亚组的 BMD 趋势。使用方差分析和 Bonferroni 调整来检查平均 BMD 的差异，并使用调整潜在混杂效应的多元线性回归来检查 BMD 趋势。
结果
在年龄标准化后，前三个 NHANES 周期股骨颈的平均 BMD 在男性和女性中均保持稳定（所有 p 值均>0.1），但在 2013-2014 年显著下降，从 0.864 g/cm 降至 0.846 g/cm（p=0.0025）在男性和从 0.789 降至 0.771 g/cm（p=0.03）在女性。即使在调整了年龄、种族、体力活动、既往骨折、BMI 和其他变量等多个协变量后，2013-2014 年男性和女性的整体平均股骨颈 BMD 仍明显低于早期调查周期。在种族和敏感性分析的亚组分析中也观察到了类似的结果。
结论
2013-2014 年男性和女性的年龄调整平均 BMD 下降，在敏感性和亚组分析中也观察到了这一下降。即使在调整了多个潜在混杂效应后，2013-2014 年的 BMD 下降仍然显著。
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