安苗苗,金鹰,赖俊,双倩,朱焱,许海娜,冉利梅
AN Miaomiao,JIN Ying,LAI Jun,SHUANG Qian,ZHU Yan,XU Haina,RAN Limei

• 1:贵州医科大学公共卫生学院预防医学与妇幼保健学系
• 2:贵州医科大学附属医院健康管理中心

摘要(Abstract)：

目的 探讨贵阳市50岁及以上体检人群中骨质疏松症（OP）的检出率和影响因素。方法 选取贵阳市年龄≥50岁的男性（n=1 209）和自然停经超过12个月（绝经后）女性（n=838）健康体检者，收集年龄、性别、血压、身高、体质量、体质量指数（BMI）等一般情况；抽取被检者晨间空腹静脉血5 mL，采用全自动生化分析仪检测总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、尿酸（SUA）、同型半胱氨酸（Hcy）等生化指标；采用双能X线骨密度仪（DXA）检测被检者的骨密度（BMD）并分级（正常BMD、骨量减少及OP）；采用无序多分类logistic回归分析健康体检者发生OP的影响因素。结果 绝经后中老年女性OP检出率高于中老年男性（χ~2=208.637,P<0.05），年龄≥70岁组健康体检者OP检出率高于年龄50～59岁组和60～69岁组（χ~2=63.698,P<0.05）；骨量减少组和OP组被检者身高、体质量、BMI、舒张压、TC、TG、SUA、HDL-C及LDL-C水平比较，差异均有统计学意义（P<0.05）;logistic回归分析结果显示，年龄、舒张压（OR=1.073、1.020,P<0.05）是被检者OP发生的危险因素，体质量和SUA(OR=0.728、0.998,P<0.05)是OP的保护因素。结论 贵阳市50岁及以上体检人群中绝经后女性OP检出率高于男性，年龄及舒张压是该人群OP发生的危险因素，尿酸水平及体质量是OP的保护因素。
Objective To explore the detection rate and influencing factors of osteoporosis(OP) in people aged ≥50 in Guiyang.Methods Men older ≥50 years old(n= 1 209) in Guiyang and women who had stopped for physical check-ups for more than 12 months(n= 838)were selected, and general data such as age, gender, blood pressure, height, body quality, and body quality index(BMI) were collected. The morning 5 mL fasting venous blood was extracted by a fully automated biochemical analyzer for total cholesterol( TC), triglyceride( TG), high-density lipoprotein cholesterol( HDL-C), low-density lipoprotein cholesterol( LDL-C), uric acid( SUA), and homocycysteine(Hcy). Bone density( BMD) was measured using a double-energy X linear bone densitometer(DXA) and graded(normal BMD, bone mass reduced and OP). The factors of OP were analyzed according to the disorder multi-classified logistic regression.Results The OP detection rate was higher in postmenopausal middle-aged and elderly women than in middle-aged and elderly men（χ~2= 208. 637,P< 0. 05）. The OP detection rate was higher in subjects greater than or equal to 70 years than in the group of 50-59 and 60-69 years old（χ~2= 63. 698,P< 0. 05）. The height, body mass, BMI, diastolic blood pressure, TC, TG, SUA, HDL-C, and LDL-C levels were compared in the reduced bone mass and OP groups, and the differences were all statistically significant(P< 0. 05).logistic regression analysis revealed that age, diastolic blood pressure(OR= 1. 073,1. 020;P< 0. 05)were risk factors for the occurrence of OP in the subjects, and body mass and SUA(OR= 0. 728,0. 998;P< 0. 05) were protective factors for OP.Conclusion The OP detection rate of postmenopausal middle-aged and older women in Guiyang is higher than that of middle-aged and elderly men. Age and diastolic blood pressure are the risk factors for OP occurrence in this population,and uric acid level and body quality are the protective factors of OP.

关键词(KeyWords)： 骨密度;骨质疏松;尿酸;绝经后女性;中老年男性;影响因素
bone mineral density (BMD);osteoporosis (OP);uric acid;postmenopausal women;middle-aged and elderly male;influencing factors

Abstract:

Keywords:

基金项目(Foundation): 贵州省卫生健康委科学技术基金（gzwjkj20191214）

作者(Author): 安苗苗,金鹰,赖俊,双倩,朱焱,许海娜,冉利梅
AN Miaomiao,JIN Ying,LAI Jun,SHUANG Qian,ZHU Yan,XU Haina,RAN Limei

DOI: 10.19367/j.cnki.2096-8388.2022.03.004

参考文献(References)：

• [1]胡伟雄，林涌鹏，饶思远，等．814例绝经后女性初潮年龄、绝经年龄及月经维持年限与骨质疏松症相关性研究[J]．中国骨质疏松杂志，2020,26(9):1257-1261.
• [2] CHEN P, LI Z, HU Y. Prevalence of osteoporosis in China:a meta-analysis and systematic review[J]. BMC Public Health,2016,16:1039.
• [3]罗令，孙晓峰，皮丕喆，等．近10年来我国中老年人群骨质疏松症患病率的荟萃分析[J]．中国骨质疏松杂志，2018,24(11):1415-1420.
• [4]申丹妮，宋飞鹏，胥毅，等．能谱CT与双能X线吸收法对骨密度测定的相关性研究[J]．中国药物与临床，2020,20(8):1276-1278.
• [5]中华医学会骨质疏松和骨矿盐疾病分会．原发性骨质疏松症诊疗指南（2017）[J]．中国实用内科杂志，2018,38(2):127-150.
• [6]杨红英，李虹，刘璐，等．绝经后女性骨密度与维生素D和高密度脂蛋白水平相关性研究[J]．中国骨质疏松杂志，2019, 25(2):193-197.
• [7]何俊勇，何礼霞，王佑娟，等．男性体检人群骨密度调查及其影响因素分析[J]．实用医院临床杂志，2018,15(3):78-80.
• [8]李刚，李崇银，周文，等．西南地区春季及其各月降水的气候特征分析[J]．气候与环境研究，2020,25(6):575-587.
• [9] THOMPSON M,AITKEN D A,OTAHAL P,et al. The relationship between cumulative lifetime ultraviolet radiation exposure, bone mineral density, falls risk and fractures in older adults[J]. Osteoporosis International, 2017, 28(7):2061-2068.
• [10]MRINALI S,SATHEES B,CHANDR A. The critical role of estrogen in menopausal osteoporosis[J]. Menapoz Osteoporozunda?strojenin Kritik Rolü，2017, 7(4):418-427.
• [11]罗薇，刘珍，刘海丹，等．北京地区3 859名体检人群骨密度调查及骨量异常患病率分析[J]．中国骨质疏松杂志，2020,26(5):719-722.
• [12]倪乙洪，王正博，刘权，等．细胞衰老在老年骨质疏松症防治中的研究进展[J]．中国骨质疏松杂志，2020,26(8):1207-1211.
• [13]SHEN X, CHEN X,HUANG J,et al. Age-dependent role of SIRT6 in jawbone via regulating senescence and autophagy of bone marrow stromal cells[J]. Journal of Molecular Histology, 2020,51(1):67-76.
• [14] DOMAZETOVIC V, MARCUCCI G, IANTOMAS T, et al. Oxidative stress in bone remodeling:role of antioxidants[J]. Clin Cases Miner Bone Metab, 2017,14:209-216.
• [15]GKASTARIS K, GOULIS D G, POTOUPNIS M, et al.Obesity, osteoporosis and bone metabolism[J]. Musculoskelet Neuronal Interact, 2020,20(3):372-381.
• [16]聂义珍，燕巍，闫朝岐．不同类型肥胖与骨质疏松症的研究[J]．中国骨质疏松杂志，2017, 23(5):580-584.
• [17]NAKAMURA Y,NAKANO M,SUZUKI T, et al. Two adipocytokines, leptin and adiponectin, independently predict osteoporotic fracture risk at different bone sites in postmenopausal women[J]. Bone, 2020, 137:115-404.
• [18]陈宇宁，魏鹏，施毕旻，等．绝经后女性H型高血压合并骨质疏松症患者骨代谢标志物及炎性因子的变化研究[J]．中国全科医学，2018,21(32):3951-3955.
• [19]余萍萍，何丽，王斯瑶，等．不同性别骨密度与血脂、血糖、血压的相关性研究[J]．重庆医学，2018,47(23):3077-3080.
• [20] CHAI H,GE J, LI L,et al. Hypertension is associated with osteoporosis:a case-control study in Chinese postmenopausal women[J]. BMC Musculoskelet Disord,2021,22(1):253.
• [21]NAKATANI T,PARTRIDGE N C. MEF2C interacts with c-FOS in PTH-stimulated mmp13 gene expression in osteoblastic cells[J]. Endocrinology, 2017,158(11):3778-3791.
• [22]王海燕，孟祥晖．老年患者骨密度与血尿酸相关性分析[J]．中国临床保健杂志，2020,23(1):122-124.
• [23] MADLAlA H P,MAARMAN G J,OJUKA E. Uric acid and transforming growth factor in fructose-induced production of reactive oxygen species in skeletal muscle[J].Nutrition Reviews,2016,74:259-266.
• [24]查敏，杨乃龙，李玲，等．绝经后女性及老年男性骨密度与血尿酸的相关性[J]．中华骨质疏松和骨矿盐疾病杂志，2018,11(4):359-364.
• [25]PIRRO M, MANNARINO M R, BIANCONI V, et al. Uric acid and bone mineral density in postmenopausal osteoporotic women:the link lies within the fat[J]. Osteoporos International, 2017, 28:973-981.
• [26]陈婵．维生素D、维生素B12和同型半胱氨酸水平与绝经后女性骨密度的相关性研究[J]．中国骨质疏松杂志，2019, 25(2):189-192.

文章评论(Comment)：