Looker A C, Orwoll E S, Johnston C C, Lindsay R L, Wahner H W, Dunn W L, Calvo M S, Harris T B, Heyse S P
Division of Health Examination Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.
J Bone Miner Res. 1997 Nov;12(11):1761-8. doi: 10.1359/jbmr.1997.12.11.1761.
Most estimates of osteoporosis in older U.S. adults have been based on its occurrence in white women, even though it is known to affect men and minority women. In the present study, we used dual-energy X-ray absorptiometry measurements of femoral bone mineral density (BMD) from the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) to estimate the overall scope of the disease in the older U.S. population. Specifically, we estimate prevalences of low femoral BMD in women 50 years and older and explore different approaches for defining low BMD in older men in that age range. Low BMD levels were defined in accordance with an approach proposed by an expert panel of the World Health Organization and used BMD data from 382 non-Hispanic white (NHW) men or 409 NHW women ages 20-29 years from the NHANES III dataset. For women, estimates indicate 13-18%, or 4-6 million, have osteoporosis (i.e., BMD > 2.5 standard deviations [SD] below the mean of young NHW women) and 37-50%, or 13-17 million, have osteopenia (BMD between 1 and 2.5 SD below the mean of young NHW women). For men, these numbers depend on the gender of the reference group used to define cutoff values. When based on male cutoffs, 3-6% (1-2-million) of men have osteoporosis and 28-47% (8-13 million) have osteopenia; when based on female cutoffs, 1-4% (280,000-1 million) have osteoporosis and 15-33% (4-9 million) have osteopenia. Most of the older U.S. adults with low femur BMD are women, but, regardless of which cutoffs are used, the number of men is substantial.
对于美国老年成年人骨质疏松症的大多数估计都是基于白人女性的发病情况，尽管已知该疾病会影响男性和少数族裔女性。在本研究中，我们使用了第三次全国健康和营养检查调查（NHANES III，1988 - 1994年）中股骨骨矿物质密度（BMD）的双能X线吸收测定数据，来估计美国老年人群中该疾病的总体范围。具体而言，我们估计了50岁及以上女性股骨低骨密度的患病率，并探索了在该年龄范围内定义老年男性低骨密度的不同方法。低骨密度水平是根据世界卫生组织专家小组提出的方法定义的，并使用了NHANES III数据集中382名年龄在20 - 29岁的非西班牙裔白人（NHW）男性或409名NHW女性的骨密度数据。对于女性，估计表明13% - 18%（即400万 - 600万）患有骨质疏松症（即骨密度比年轻NHW女性的平均值低2.5个标准差[SD]以上），37% - 50%（即1300万 - 1700万）患有骨量减少（骨密度比年轻NHW女性的平均值低1至2.5个标准差）。对于男性，这些数字取决于用于定义临界值的参考组的性别。基于男性临界值时，3% - 6%（100万 - 200万）的男性患有骨质疏松症，28% - 47%（800万 - 1300万）患有骨量减少；基于女性临界值时，1% - 4%（28万 - 100万）患有骨质疏松症，15% - 33%（400万 - 900万）患有骨量减少。美国大多数股骨骨密度低的老年成年人是女性，但无论使用哪种临界值，男性的数量都相当可观。
