| 引用本文： |
-
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]
|
|
| 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 |
