Ooms M E, Lips P, Van Lingen A, Valkenburg H A
Institute for Research in Extramural Medicine (EMGO-Institute), Vrije Universiteit, Amsterdam.
J Bone Miner Res. 1993 Jun;8(6):669-75. doi: 10.1002/jbmr.5650080604.
Bone mineral density (BMD) and risk factors for osteoporosis were assessed in 348 apparently healthy women over 70 years of age (mean 82.3 years). BMD was measured at both hips and the dominant distal radius. With stepwise multiple regression the best determinants of BMD, selected from anthropometric measurements, age, and years since menopause, were body weight and years since menopause (R2 between 0.07 and 0.20, p < 0.001). Risk and protective factors for osteoporosis were analyzed as indicator variables by multiple regression and corrected for confounding by age, years since menopause, and body weight. Significantly lower BMD at the hip was found in participants with impaired mobility (-5%) and users of loop diuretics (-5%). Use of thiazide(like) diuretics did not influence BMD significantly at any site. Users of oral corticosteroids had a significantly lower BMD at the hip and the distal radius (range -9.1 to -24.3%). Participants with a history of Colles' fracture (n = 56) had a significantly lower BMD at the other radius (-12.9%). The mean calcium intake from dairy products was high (mean 921 mg/day), only 11% having an intake below 500 mg. A relation of calcium intake with BMD could not be detected at any measurement site. We conclude that BMD cannot be adequately predicted in elderly women. Risk factors for low BMD in the elderly are low body weight, high number of years since menopause, impaired mobility, and use of loop diuretics and oral corticosteroids. Calcium intake was not a risk factor in this study, but the number of individuals on a low calcium intake was small.
对348名70岁以上（平均82.3岁）看似健康的女性进行了骨密度（BMD）及骨质疏松风险因素评估。测量了双侧髋部和优势侧桡骨远端的骨密度。通过逐步多元回归分析，从人体测量指标、年龄及绝经年限中选出的骨密度最佳决定因素为体重和绝经年限（R2在0.07至0.20之间，p<0.001）。通过多元回归将骨质疏松的风险和保护因素作为指示变量进行分析，并对年龄、绝经年限和体重的混杂因素进行校正。发现活动能力受损的参与者（-5%）和使用襻利尿剂的参与者（-5%）髋部骨密度显著降低。使用噻嗪类（或类似物）利尿剂在任何部位均未对骨密度产生显著影响。口服皮质类固醇使用者髋部和桡骨远端骨密度显著降低（范围为-9.1%至-24.3%）。有Colles骨折病史的参与者（n=56）另一侧桡骨骨密度显著降低（-12.9%）。乳制品的平均钙摄入量较高（平均921毫克/天），只有11%的人摄入量低于500毫克。在任何测量部位均未检测到钙摄入量与骨密度之间的关系。我们得出结论，老年女性的骨密度无法得到充分预测。老年女性骨密度低的风险因素包括体重低、绝经年限长、活动能力受损以及使用襻利尿剂和口服皮质类固醇。在本研究中，钙摄入量不是一个风险因素，但钙摄入量低的个体数量较少。
