目的:骨质疏松（Osteoporosis,OP）是常见的老年性疾病,尤其绝经后妇女发病率高。据统计我国50～60岁妇女约30%患绝经后OP,60岁以上妇女的患病率约为30%-50%,老年男性的OP患病率约20%-30%。据报道,至2025年,全球将有300万人罹患骨质疏松性股骨颈骨折,因此它已经成为严重威胁人类健康的疾病之一。遗传、饮食营养、生活习惯、某些疾病、生殖周期与激素水平、运动等多种因素可能对中老年女性的骨量产生影响,进而影响中老年女性的骨健康状况和生活质量。阐明上述这些影响因素与中老年女性骨量之间的相互关系将有助于中老年女性骨质疏松的预防和治疗。因此,本研究通过骨矿物质密度（Bone mass density,BMD）实验室检测和有针对性的问卷调查,旨在阐明影响中老年女性骨量的核心因素有哪些,及其相互关系的紧密程度。材料方法:北京市235名中老年女性参加了本研究,平均年龄55.7±4.4岁,平均体重61.5±8.9kg。受试者参与2项实验室检测:1.跟骨骨强度检测;2.全身和右侧股骨颈BMD检测;参与1项问卷调查。调查问卷针对调查对象的运动、月经周期、以钙为核心的饮食营养、生活习惯、骨折（脆性骨折）骨病史等几个方面展开。为了寻找与中老年女性骨量变化关系比较紧密的因素,首先对中老年女性的BMD与量化的相关因素进行相关性分析。根据相关情况及专业知识,筛选其中相关系数较高的,有显著性的影响因素。然后在BMD与选中的各影响因素之间进行Logistic回归,并根据这些影响因子对BMD的作用大小进行排序,最终找出影响中老年女性BMD的核心风险因素,并根据它们作用大小排出先后顺序。结果:受试者右股骨颈BMD变化与年龄、闭经年限之间表现出负相关关系,相关系数分别是r=-0.219,P<0.01和r=-0.292,P<0.01;而与体重、右侧跟骨骨强度呈现正相关关系,相关系数是r=0.220,P<0.01和r=0.384,P<0.01。经过Logistic回归,影响受试者右股骨颈BMD的六个核心影响因素的排列顺序是闭经年限、体重、身高下降、脆性骨折史、规律运动和营养品补充。结论:影响中老年女性骨量的因素是多种多样的。按照重要性由大到小的顺序,影响中老年女性骨量的因素依次是闭经年限、体重、身高下降、脆性骨折史、规律运动和营养品补充。
The objective of the study was to define whether there is an association of bone mineral density（BMD）with fracture in the senior patients with type 2 diabetes（T2DM）.Ninety-four patients with long-lasting T2DM were...
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The objective of the study was to define whether there is an association of bone mineral density（BMD）with fracture in the senior patients with type 2 diabetes（T2DM）.Ninety-four patients with long-lasting T2DM were enrolled and followed up for 7 years with yearly recording HbAC,fracture events and so *** spine areal BMD（aBMD）were measured by dual-energy X-ray absorptiometry（DEXA）at enrolling time as baseline（0 year）and then the 3and7year,*** the 7year,lumbar spineaBMD was also compared with the trabecular volumetric BMD（vBMD）,measured by quantitative computed tomography（QCT）,for these T2DM patients and 20 age-and body-mass-index-matched healthy *** to baseline the aBMD in these diabetic patients was significantly decreased in an age-dependent manner（P<0.05）although there was no statistical difference between the 3and 7years（P>0.05）.There were 13 cases of diabetic patients with *** diabetes with fracture,diabetes without fracture and control group,there was no significant difference for lumbar spine aBMD,measured by DEXA,which was lowest in diabetes with fracture（P>0.05）;however,there was a significant decrease in lumbar spine vBMD,measured by QCT,in diabetes with fracture compared to that in diabetes without fracture（P<0.05）.Stepwise multiple regression analysis did not reveal a significant association between lumbar spine aBMD and HbAlc（P>0.05）.These results suggest that lumbar spine aBMD in elderly patients with T2DM was age-dependent declined,similar to that in normal people,and the decline of the aBMD was not associated with HbA1c *** lumbar spine vBMD,but not aBMD,was significantly lower in diabetic patients with fracture than that in diabetic patients without fracture,indicating a better association between fracture and lumbar spine vBMD than lumbar spine aBMD.
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