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  • 刘培培,温宇华,张丽亚,等.上海市普陀区中老年人群骨质疏松患病率和治疗现状横断面研究[J].同济大学学报(医学版),2021,42(1):35-41.    [点击复制]
  • LIU Pei-pei,WEN Yu-hua,ZHANG Li-ya,et al.Cross-sectional study on prevalence and treatment of osteoporosis among middle-aged and elderly people in Putuo District of Shanghai[J].同济大学学报(医学版),2021,42(1):35-41.   [点击复制]
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上海市普陀区中老年人群骨质疏松患病率和治疗现状横断面研究
刘培培,温宇华,张丽亚,张晓亚,李慧娟,顾逸群,王健新,邝海东,宋利格
0
(同济大学附属同济医院内分泌代谢科,上海200065; 同济大学医学院骨质疏松和代谢性骨病研究所,上海200065;上海市普陀区甘泉社区街道卫生服务中心,上海200065;上海市普陀区宜川社区街道卫生服务中心,上海200065)
摘要:
目的了解上海市普陀区中老年人群骨质疏松症(osteoporosis, OP)的患病率及抗骨质疏松治疗方案的使用情况,并探讨骨密度(bone mineral density, BMD)与椎体压缩性骨折(osteoporosis vertebra compressed fracture, OVCF)、髋部骨折、所有部位骨折和FRAX软件评估的骨折发生风险的相关性。方法2019年6月—2019年11月在上海市普陀区选取甘泉和宜川2个社区,通过面对面问卷调查获取研究对象的基本资料,并对1098例55~85岁研究对象进行BMD测量和胸腰椎X线侧位的摄片。基于脆性骨折的OP诊断标准,将上述研究对象分为7组。A组: 髋部脆性骨折史;B组: 椎体脆性骨折史及形态学椎体骨折;C组: A+B;D组: 骨密度T-值≤-2.5;E组: 低骨量(-2.5<T-值<-1.0)合并肱骨近端、骨盆或前臂远端脆性骨折;F组: 低骨量;G组: 骨量正常。结果在1098名调查对象中,OP总患病率为56.1%,其中女性占64.8%,男性占43.7%。较55~69岁女性相比,70~85岁女性中A组、B组、C组、D组的发生率明显升高(P<0.05),而G组的发生率明显降低(P<0.05)。较55~69岁男性相比,70~85岁男性中D组、F组的发生率明显增加(P<0.05),而G组的发生率明显降低(P<0.05)。在OP患者中,应用抗骨质疏松药物治疗者仅占2.92%(18/616)。单纯补充钙剂者占5.84%(36/616),联合钙剂、维生素D及其类似物者占8.11%(50/616)。在中老年人群中,骨密度T-值≤-2.5合并椎体压缩性骨折的发生率最高(男性35.2%、女性22.1%)。在55~69岁女性中,骨密度越低,椎体压缩性骨折的发生率越高(P<0.05)。然而在55~85岁男性中,较-2.5<T-值<-1.0相比,T-值≥-1.0合并椎体压缩性骨折的发生率更高(P<0.05)。结论上海市普陀区中老年人OP患病率高,骨密度与OVCF的发生呈负相关、与髋部骨折无相关性,且多数OP患者未进行正规抗骨质疏松药物治疗。因此在中老年人群中常规筛查骨密度、加强宣教对预防老年人群骨折具有重要社会价值。
关键词:  骨密度  骨质疏松  椎体压缩性骨折  骨健康补充剂  中老年人
DOI:10.12289/j.issn.1008-0392.20439
投稿时间:2020-10-15
基金项目:上海市卫生和计划生育委员会临床研究专项(201840217);上海申康医院发展中心临床科技创新项目(SHDC2018X10);同济大学附属同济医院临床培育项目(ITJ(ZD)1904)
Cross-sectional study on prevalence and treatment of osteoporosis among middle-aged and elderly people in Putuo District of Shanghai
LIU Pei-pei,WEN Yu-hua,ZHANG Li-ya,ZHANG Xiao-ya,LI Hui-juan,GU Yi-qun,WANG Jian-xin,KUANG Hai-dong,SONG Li-ge
(Dept.of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China; Institute of Osteoporosis and Metabolic Bone Diseases, Tongji University School of Medicine, Shanghai 200065;Ganquan Community Health Service Center of Putuo District, Shanghai 200065, China;Yichuan Community Health Service Center of Putuo District, Shanghai 200065, China)
Abstract:
ObjectiveTo investigate the prevalence of osteoporosis (OP) and its treatment among middle-aged and elderly people in Putuo District of Shanghai. MethodsA cross-sectional survey was conducted among 1098 residents aged 55-85 years in Ganquan and Yichuan communities of Shanghai Putuo District from June to November 2019. The basic data of the subjects were obtained by face-to-face questionnaire survey; the bone mineral density (BMD) was measured and lateral X-ray films of thoracolumbar spine were taken. The participants were divided into seven groups: group A with history of hip fracture; group B with history of vertebral fracture and morphological vertebral fracture; group C with history hip and vertebral fractures; group D with T-score of bone mineral density ≤-2.5; group E with low bone mass (-2.5<T-score<-1.0) combined with proximal humerus, pelvis or distal forearm fractures; group F with low bone mass; and group G with normal bone mass. ResultsThe prevalence of OP was 56.1%; among OP subjects 64.8% were females and 43.7% were males. Compared with women aged 55-69, the proportions of group A, group B, group C, group D in 70-85 years-old women were significantly higher (P<0.05), while the proportion of group G was significantly lower (P<0.05). Compared with men aged 55-69, the proportions of group D and group F were significantly increased (P<0.05), while the proportion of group G was significantly lower (P<0.05). In OP patients, only 2.92% (18/616) were treated with anti-osteoporosis drugs,84% (36/616) were supplemented with calcium alone, and 8.11% (50/616) took combination of calcium, vitamin D and their analogues. The incidence of vertebral compression fracture was the highest in subjects with T-score≤-2.5 (male 35.2%, female 22.1%). In 55-69 years-old women, the incidence of vertebral compression fractures was negatively correlated with BMD (P<0.05). However, compared with -2.5
Key words:  bone mineral density  osteoporosis  vertebra compressed fractures  bone health supplements  middle-aged and elderly people

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