McKnight A, Steele K, Mills K, Gilchrist C, Taggart H
Department of General Practice, Queen's University Belfast.
Br J Gen Pract. 1995 Jun;45(395):317-20.
Interest in the prevention of osteoporosis is increasing and thus there is a need for an acceptable osteoporosis prevention programme in general practice.
A study was undertaken to identify a cohort of middle-aged women attending a general practice who would be eligible for a longitudinal study looking at bone mineral density, osteoporosis and the effectiveness of hormone replacement therapy. This study aimed to describe the relationship between medical and lifestyle risk factors for osteoporosis and the initial bone density measurements in this group of women.
A health visitor administered a questionnaire to women aged between 48 and 52 years registered with a Belfast general practice. The main outcome measures were menopausal status, presence of medical and lifestyle risk factors and bone mineral density measurements.
A total of 358 women our of 472 (76%) took part in the study which was conducted in 1991 and 1992. A highly significant difference was found between the mean bone mineral density of premenopausal, menopausal and postmenopausal women within the narrow study age range, postmenopausal women having the lowest bone mineral density. A significant relationship was found between body mass index and bone mineral density, a greater bone mineral density being found among women with a higher body mass index. Risk factors such as smoking and sedentary lifestyle were common (reported by approximately one third of respondents) but a poor relationship was found between these two and all the other risk factors and bone mineral density in this age group.
Risk of osteoporosis cannot be identified by the presence of risk factors in women aged between 48 and 52 years. In terms of a current prevention strategy for general practice it would be better to take a population-based approach except for those women known to be at high risk of osteoporosis: women with early menopause or those who have had an oophorectomy.
对骨质疏松症预防的关注度日益提高，因此在全科医疗中需要一个可接受的骨质疏松症预防方案。
开展一项研究，以确定一组在全科医疗就诊的中年女性，她们符合一项纵向研究的条件，该研究旨在观察骨矿物质密度、骨质疏松症以及激素替代疗法的有效性。本研究旨在描述该组女性中骨质疏松症的医学和生活方式风险因素与初始骨密度测量值之间的关系。
一名健康访视员向在贝尔法斯特一家全科医疗注册的48至52岁女性发放问卷。主要观察指标为绝经状态、医学和生活方式风险因素的存在情况以及骨矿物质密度测量值。
1991年和1992年进行的这项研究中，472名女性中有358名（76%）参与。在狭窄的研究年龄范围内，绝经前、绝经中和绝经后女性的平均骨矿物质密度存在高度显著差异，绝经后女性的骨矿物质密度最低。发现体重指数与骨矿物质密度之间存在显著关系，体重指数较高的女性骨矿物质密度更高。吸烟和久坐不动的生活方式等风险因素很常见（约三分之一的受访者报告有这些情况），但在这个年龄组中，这两者以及所有其他风险因素与骨矿物质密度之间的关系并不密切。
48至52岁女性中，不能通过风险因素的存在来识别骨质疏松症风险。就目前全科医疗的预防策略而言，除了已知骨质疏松症高风险的女性（早绝经女性或已接受卵巢切除术的女性）外，采用基于人群的方法可能更好。
