Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China.
Department of Orthopaedics, Honghui Hospital, Xi'an Jiao Tong University, Xi'an, 710000, China.
Osteoporos Int. 2022 Nov;33(11):2347-2355. doi: 10.1007/s00198-022-06498-5. Epub 2022 Jul 14.
The association between socioeconomic status (SES) and bone mineral density (BMD) in men remains controversial. We showed that SES was positively associated with BMD in American men. Confounding factors like race/ethnicity and age could affect the association.
Based on the data from the National Health and Nutrition Examination Survey (NHANES), 2011-2020, this article aims to investigate the association of SES (poverty income ratio (PIR) and education level) with the BMD in American men.
We evaluated the association of SES with BMD in 4446 men aged ≥ 20 years (mean age, 41.0 ± 13.4 years) from the NHANES 2011-2020. BMD was measured by dual-energy X-ray absorptiometry (DXA) at the lumbar spine. We used multivariate linear regression models to examine the relationship between SES and total spine BMD, adjusted for a large range of confounding factors.
Compared with other PIR quarters, individuals in the highest quarter of PIR were more likely to be older and white and had fewer smoking or drinking behaviors. After adjusting for race/ethnicity, age, drinking and smoking behavior, body mass index (BMI), total protein, serum calcium, serum uric acid, cholesterol, serum phosphorus, and blood urea nitrogen, PIR was positively correlated with total spine BMD (β = 0.004 95% CI: 0.001-0.007, P = 0.006). Individuals with the highest degree (college degree or above) had a 0.057 g/cm greater BMD than that of the lowest degree (less than 9th grade) (β = 0.057 95% CI: 0.037-0.077, P < 0.001).
Our study indicates that SES was positively associated with the lumbar BMD among American men. Clinicians, healthcare providers, and policymakers should consider the unequal SES of men when implementing osteoporosis prevention and treatment strategies.
社会经济地位（SES）与男性骨密度（BMD）之间的关系仍存在争议。我们表明，SES 与美国男性的 BMD 呈正相关。种族/民族和年龄等混杂因素可能会影响这种关联。
基于 2011-2020 年全国健康与营养调查（NHANES）的数据，本文旨在探讨 SES（贫困收入比（PIR）和教育水平）与美国男性 BMD 的关系。
我们评估了 SES 与 4446 名年龄≥20 岁（平均年龄 41.0±13.4 岁）的 NHANES 2011-2020 年男性 BMD 的关系。BMD 通过双能 X 射线吸收法（DXA）在腰椎处测量。我们使用多元线性回归模型来检验 SES 与总脊柱 BMD 之间的关系，同时调整了大量混杂因素。
与其他 PIR 季度相比，PIR 最高季度的个体更有可能年龄较大且为白人，且吸烟或饮酒行为较少。在调整了种族/民族、年龄、饮酒和吸烟行为、体重指数（BMI）、总蛋白、血清钙、血清尿酸、胆固醇、血清磷和血尿素氮后，PIR 与总脊柱 BMD 呈正相关（β=0.004，95%CI：0.001-0.007，P=0.006）。最高学历（大学及以上）的个体 BMD 比最低学历（9 年级以下）高 0.057 g/cm（β=0.057，95%CI：0.037-0.077，P<0.001）。
我们的研究表明，SES 与美国男性的腰椎 BMD 呈正相关。临床医生、医疗保健提供者和政策制定者在实施骨质疏松症预防和治疗策略时，应考虑男性 SES 的不平等。
