Zhang Yi-Li, Wei Xu, Xie Yan-Ming, Zhu Li-Guo, Gao Jing-Hua, Shen Hao, Chai Yan, Sun Meng-Hua, Zhang Cheng, Sun Kai, Tang Bin, Jiang Jun-Jie, Zhi Ying-Jie, Yu Chen-Chen
Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China.
Zhongguo Gu Shang. 2020 Oct 25;33(10):916-21. doi: 10.12200/j.issn.1003-0034.2020.10.006.
To investigate the relevance ratio of osteoporosis and bone mass of middle aged and elderly people in Beijing communities, in order to understand occurrence and development trend of abnormality of bone mass in high-risk population from community.
Based on the method of cross-sectional investigation, the information data of 1 540 middle-aged and elderly people from 10 communities were collected, including 415 males and 1 125 females, aged from 45 to 80 years old with the average of (63.02±7.15) years old; the height was (161.34±7.24) cm, the weight was (65.90±10.19) kg, body mass index was (25.29±3.32) kg /m2. Bone mineral density (BMD) of lumbar vertebrae (L-L) and both hips were measured by dual energy X ray absorptiometry (DEXA). The differences of bone mineral density and bone mass in different age groups were evaluated, and the relevance ratio of osteoporosis in different parts of the subjects was calculated. Elbow venous blood was collected on an empty stomach, and the gender differences of serum bone metabolic markers were detected and compared.
The level of β-CTX was(0.27±0.12) ng /ml, procollanen type 1 N-terminal propeptide(P1NP) was(51.03± 22.36) ng /ml, 25(OH) D3 was (16.68±6.24) ng /ml, serum calcium was(2.34±0.09) mmol / L, blood phosphorus was (1.43± 0.37) mmol / L, and blood magnesium was (0.94±0.07) mmol / L, alkaline phosphatase was (79.28±20.48) U/ L, parathyroid hormone was (3.09±1.60) pmol / L, osteocalcin was (13.29±6.65) ng /ml. Except for blood magnesium, the other indexes had significant differences between different sex groups(<0.05). Results of T value of bone mineral density and level of bone mass showed that bone mineral density of lumbar vertebrae and both hips fluctuated and decreased with the increase of age, and there were significant differences in level of bone mass among different age groups in women(<0.05), and except lumbar vertebrae in males, there were significant differences in other parts of bone mass among different age groups (<0.05). The relevance ratio of lumbar osteoporosis, left hip osteoporosis, and right hip osteoporosis was 27.89%, 14.80% and 14.47%, respectively.
There are obvious differences in relevance ratio of osteoporosis and low bone mass among different sites. It is suggested that the clinical diagnosis of osteoporosis should be combined with bone mineral density and bone metabolic markers. With the increasing prevalence of osteoporosis among middle aged and elderly people in Beijing community, continuous follow-up research based on community primary health care units could promote early examination, early diagnosis, and early treatment of middle aged and elderly people at high risk of osteoporosis in community.
调查北京社区中老年人骨质疏松症与骨量的相关性，以了解社区高危人群骨量异常的发生及发展趋势。
采用横断面调查方法，收集来自10个社区的1540名中老年人的信息数据，其中男性415名，女性1125名，年龄45至80岁，平均（63.02±7.15）岁；身高（161.34±7.24）cm，体重（65.90±10.19）kg，体重指数（25.29±3.32）kg/m²。采用双能X线吸收法（DEXA）测量腰椎（L-L）和双侧髋部的骨密度（BMD）。评估不同年龄组骨密度和骨量的差异，并计算受试者不同部位骨质疏松症的相关性。空腹采集肘静脉血，检测并比较血清骨代谢标志物的性别差异。
β-CTX水平为（0.27±0.12）ng/ml，Ⅰ型前胶原N端前肽（P1NP）为（51.03±22.36）ng/ml，25（OH）D3为（16.68±6.24）ng/ml，血清钙为（2.34±0.09）mmol/L，血磷为（1.43±0.37）mmol/L，血镁为（0.94±0.07）mmol/L，碱性磷酸酶为（79.28±20.48）U/L，甲状旁腺激素为（3.09±1.60）pmol/L，骨钙素为（13.29±6.65）ng/ml。除血镁外，其他指标在不同性别组间差异有统计学意义（<0.05）。骨密度T值及骨量水平结果显示，腰椎和双侧髋部骨密度随年龄增长波动下降，女性不同年龄组骨量水平差异有统计学意义（<0.05），男性除腰椎外，其他部位骨量在不同年龄组间差异有统计学意义（<0.05）。腰椎骨质疏松症、左侧髋部骨质疏松症和右侧髋部骨质疏松症的相关性分别为27.89%、14.80%和14.47%。
骨质疏松症与低骨量在不同部位的相关性存在明显差异。建议骨质疏松症的临床诊断应结合骨密度和骨代谢标志物。随着北京社区中老年人骨质疏松症患病率的增加，基于社区基层医疗卫生机构的持续随访研究可促进社区骨质疏松症高危中老年人的早检查、早诊断和早治疗。
