云南省大理州白族人群骨質(zhì)疏松癥流行病學(xué)調(diào)查及相關(guān)影響因素研究分析
發(fā)布時間：2018-08-22 19:30
【摘要】：目的：1.通過定量超聲技術(shù)測定云南省大理州白族人群跟骨骨量參數(shù),建立峰值骨量數(shù)據(jù)庫并探討其變化規(guī)律。2.調(diào)查云南省大理州白族骨質(zhì)疏松癥的患病率并探討相關(guān)危險因素。3.驗證OSTA系統(tǒng)是否適用于目標人群的骨質(zhì)疏松癥自我診斷及預(yù)測,為云南省白族骨質(zhì)疏松癥的自我篩查提供參考依據(jù)。4.測定云南省大理州白族40歲以上人群血清骨代謝標志物,了解其變化規(guī)律。方法：1.采用整群抽樣法,抽取云南省大理州劍川縣白族人群200例,其中男性57例,女性143例,年齡從23歲～87歲,并按10歲為一年齡段,將人群分為7組。進行跟骨定量超聲檢測(包括跟骨BMD值、T值、SI值)、基本體征測量、骨質(zhì)疏松相關(guān)因素問卷調(diào)查,整合并量化檢測及調(diào)查結(jié)果后進行統(tǒng)計分析。2.采用隨機抽樣法,抽取云南省大理州白族40歲以上人群103人,年齡40～87歲,按年齡段分為5組,用ELISA法檢測25-(OH)Vit D3、甲狀旁腺激素PTH、骨鈣素BGP及降鈣素CT,并對檢測結(jié)果進行統(tǒng)計分析。結(jié)果：1.云南省大理州白族人群男女BMD峰值均出現(xiàn)于20～29歲年齡段。男性SI峰值處于20～29歲；女性的SI峰值則出現(xiàn)在30～39歲。峰值過后BMD及SI均開始下降,女性于50～59歲、60～69歲兩個年齡段BMD、SI的丟失最為迅速。2.總體骨質(zhì)疏松癥患病率PR總體為9.5%,其中男性骨質(zhì)疏松癥患病率PR男性：3.5%,女性骨質(zhì)疏松癥患病率PR女性：11.89%。女性于70～79歲、80-89歲患病率最高,且相對于其他年齡段具有統(tǒng)計學(xué)差異。年齡、女性孕、產(chǎn)次與骨量變化呈負相關(guān)關(guān)系,身高、體重與骨量變化呈正相關(guān)關(guān)系；脆性骨折在Logistic回歸分析中優(yōu)勢比為11.86,系云南省大理州白族人群骨質(zhì)疏松癥發(fā)病的高危因素。3.OSTA風(fēng)險等級與OP患病率存在正相關(guān)關(guān)系。OSTA等級的ROC曲線下面積AUC顯示OSTA等級對受試人群骨質(zhì)疏松癥有預(yù)測價值。4.大理州白族40歲以上人群平均25-(OH)Vit D含量為：14.51ng/ml,平均PTH為：46.50pg/ml,平均BGP為：8.10ng/ml,平均PCT為：17.20pg/ml;其中,隨年齡的增長,25-(OH)Vit D含量呈現(xiàn)下降趨勢,60～69歲年齡段男性及女性25-(OH)Vit D含量下降最為明顯；PTH含量隨年齡增長出現(xiàn)上升趨勢,且25-(OH)Vit D血清含量與PTH血清含量呈的負相關(guān)關(guān)系。25-(OH)Vit D含量與BMD、SI對比后無統(tǒng)計學(xué)意義,但通過與T值對比后發(fā)現(xiàn)25-(OH)Vit D含量與T值呈正相關(guān)關(guān)系。CT與BGP兩項檢測結(jié)果與年齡、BMD、SI、T值進行對比后未發(fā)現(xiàn)有統(tǒng)計學(xué)意義。結(jié)論：1.云南省大理州白族人群峰值骨量出現(xiàn)在20～29歲年齡段,與全國大部分地區(qū)一致,但骨量均值低于低海拔的平原及沿海地區(qū)；峰值年齡過后BMD開始逐漸下降,50～59歲、60-69歲兩個年齡段丟失最為迅速,因此,預(yù)防骨量丟失的重點應(yīng)放在50～69歲之間。2.骨質(zhì)疏松癥患病率低于全國水平,與沿海等經(jīng)濟發(fā)達地區(qū)相比較低；男性患病率最高為50～59歲,女性患病率最高為70～79歲、80～89歲兩個年齡段,因此,白族骨質(zhì)疏松癥及并發(fā)癥防治重點應(yīng)放在上述年齡段。年齡、女性孕、產(chǎn)次與BMD變化呈負相關(guān)關(guān)系,身高、體重與BMD變化呈正相關(guān)關(guān)系；脆性骨折系云南省大理州劍川縣白族人群骨質(zhì)疏松癥發(fā)病的重要相關(guān)因素,出現(xiàn)脆性骨折后應(yīng)注意骨質(zhì)疏松癥的防范。3.OSTA系統(tǒng)與云南省大理州白族人群骨質(zhì)疏松患病情況之間具有良好的相關(guān)性及統(tǒng)計學(xué)意義,是適用于該地區(qū)該民族骨質(zhì)疏松癥自我檢測的有效工具。4.大理州劍川縣白族人群血清25-(OH)Vit D3含量與年齡呈負相關(guān)關(guān)系(于60～69歲年齡段下降最為迅速),與跟骨T值成正相關(guān)關(guān)系；血清PTH含量與年齡成正相關(guān)關(guān)系,與血清25-(OH)Vit D3含量呈負相關(guān)關(guān)系；血清骨鈣素BGP、降鈣素CT與年齡、BMD、T值以及其他兩項血清骨代謝物對比后無明顯統(tǒng)計學(xué)意義。對大理州劍川縣白族人群進行血清25-(OH)Vit D3以及PTH含量的檢測對該民族骨質(zhì)疏松癥患病情況有一定的指導(dǎo)意義。
[Abstract]:Objective: 1. To determine the calcaneal bone mass parameters of Bai ethnic group in Dali Prefecture of Yunnan Province by quantitative ultrasound, establish a peak bone mass database and explore its changing regularity. 2. To investigate the prevalence of osteoporosis in Bai ethnic group in Dali Prefecture of Yunnan Province and explore the related risk factors. The serum bone metabolic markers of the Bai nationality over 40 years old in Dali Prefecture of Yunnan Province were determined to understand the regularity of their changes. Methods: 1. 200 cases of Bai nationality in Jianchuan County, Dali Prefecture, Yunnan Province were selected by cluster sampling, including 57 males and 143 females. The population was divided into seven groups according to age from 23 to 87. Quantitative ultrasound examination of calcaneus (including BMD, T, SI), basic signs measurement, questionnaire survey of osteoporosis related factors were carried out. The results were integrated and quantified and analyzed statistically. 2. A random sampling method was used to select 40 Bai nationality from Dali Prefecture, Yunnan Province. 103 people over the age of 40-87 were divided into 5 groups according to their age. 25-(OH) Vit D3, parathyroid hormone PTH, osteocalcin BGP and calcitonin CT were detected by ELISA, and the results were statistically analyzed. Results: 1. BMD peaks of both men and women in Dali Bai nationality of Yunnan Province were in the age range of 20-29 years. After the peak, BMD and SI began to decrease, and the loss of SI was the fastest in women aged 50-59 and 60-69. 2. The overall prevalence of osteoporosis was 9.5%. The prevalence of osteoporosis was 3.5% in males and 11.89% in females. The prevalence rate of fragile fracture was the highest in women aged 70-79, and the difference was statistically significant between 80-89 and other age groups. The area under the ROC curve of OSTA showed that OSTA had predictive value for osteoporosis. 4. The average content of 25 - (OH) Vit D was 14.51ng/ml, and the average PTH was 46.50pg/ml, and the average BGP was 8.10n/ml. The average PCT was 17.20 pg/ml. The content of 25-(OH) Vit D decreased with age, and the content of 25-(OH) Vit D decreased most significantly in males and females aged 60-69. The content of PTH increased with age, and the serum content of 25-(OH) Vit D was negatively correlated with that of PTH. There was no significant difference between MD and SI, but there was a positive correlation between 25-(OH) Vit D and T. There was no significant difference between CT and BGP in BMD, SI and T. Conclusion: 1. The peak bone mass of Bai nationality in Dali Prefecture of Yunnan Province appeared in the age range of 20-29 years, which was the same as most of the country. BMD began to decrease gradually after the peak age, and the loss was most rapid in the two age groups of 50-59 and 60-69. Therefore, the focus of preventing bone loss should be placed between 50-69 years old. 2. The prevalence of osteoporosis is lower than the national level, and coastal and other economically developed areas. The highest morbidity rate of men is 50-59 years old, the highest morbidity rate of women is 70-79 years old, 80-89 years old two age groups, therefore, the prevention and treatment of osteoporosis and complications of the Bai nationality should focus on the above age groups. Osteoporosis is an important risk factor for the occurrence of osteoporosis in Bai nationality in Jianchuan County, Dali Prefecture, Yunnan Province. We should pay attention to the prevention of osteoporosis after fragile fracture. 3. There is a good correlation and statistical significance between OSTA system and the prevalence of osteoporosis in Bai nationality in Dali Prefecture, Yunnan Province. 4. Serum 25 - (OH) Vit D3 levels were negatively correlated with age (the lowest was in the 60-69 age group), and positively correlated with calcaneal T value; serum PTH levels were positively correlated with age, and negatively correlated with serum 25 - (OH) Vit D3 levels; serum bone marrow was positively correlated with calcaneal T value; serum PTH levels were negatively correlated with serum 25 - (OH) Vit D3 levels. Calcitonin BGP, calcitonin CT and age, BMD, T value and other two serum bone metabolites were not statistically significant. The serum 25 - (OH) Vit D3 and PTH levels of Bai nationality in Jianchuan County, Dali Prefecture were measured to have certain guiding significance for the prevalence of osteoporosis in this nationality.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R580
本文編號：2198090
[Abstract]:Objective: 1. To determine the calcaneal bone mass parameters of Bai ethnic group in Dali Prefecture of Yunnan Province by quantitative ultrasound, establish a peak bone mass database and explore its changing regularity. 2. To investigate the prevalence of osteoporosis in Bai ethnic group in Dali Prefecture of Yunnan Province and explore the related risk factors. The serum bone metabolic markers of the Bai nationality over 40 years old in Dali Prefecture of Yunnan Province were determined to understand the regularity of their changes. Methods: 1. 200 cases of Bai nationality in Jianchuan County, Dali Prefecture, Yunnan Province were selected by cluster sampling, including 57 males and 143 females. The population was divided into seven groups according to age from 23 to 87. Quantitative ultrasound examination of calcaneus (including BMD, T, SI), basic signs measurement, questionnaire survey of osteoporosis related factors were carried out. The results were integrated and quantified and analyzed statistically. 2. A random sampling method was used to select 40 Bai nationality from Dali Prefecture, Yunnan Province. 103 people over the age of 40-87 were divided into 5 groups according to their age. 25-(OH) Vit D3, parathyroid hormone PTH, osteocalcin BGP and calcitonin CT were detected by ELISA, and the results were statistically analyzed. Results: 1. BMD peaks of both men and women in Dali Bai nationality of Yunnan Province were in the age range of 20-29 years. After the peak, BMD and SI began to decrease, and the loss of SI was the fastest in women aged 50-59 and 60-69. 2. The overall prevalence of osteoporosis was 9.5%. The prevalence of osteoporosis was 3.5% in males and 11.89% in females. The prevalence rate of fragile fracture was the highest in women aged 70-79, and the difference was statistically significant between 80-89 and other age groups. The area under the ROC curve of OSTA showed that OSTA had predictive value for osteoporosis. 4. The average content of 25 - (OH) Vit D was 14.51ng/ml, and the average PTH was 46.50pg/ml, and the average BGP was 8.10n/ml. The average PCT was 17.20 pg/ml. The content of 25-(OH) Vit D decreased with age, and the content of 25-(OH) Vit D decreased most significantly in males and females aged 60-69. The content of PTH increased with age, and the serum content of 25-(OH) Vit D was negatively correlated with that of PTH. There was no significant difference between MD and SI, but there was a positive correlation between 25-(OH) Vit D and T. There was no significant difference between CT and BGP in BMD, SI and T. Conclusion: 1. The peak bone mass of Bai nationality in Dali Prefecture of Yunnan Province appeared in the age range of 20-29 years, which was the same as most of the country. BMD began to decrease gradually after the peak age, and the loss was most rapid in the two age groups of 50-59 and 60-69. Therefore, the focus of preventing bone loss should be placed between 50-69 years old. 2. The prevalence of osteoporosis is lower than the national level, and coastal and other economically developed areas. The highest morbidity rate of men is 50-59 years old, the highest morbidity rate of women is 70-79 years old, 80-89 years old two age groups, therefore, the prevention and treatment of osteoporosis and complications of the Bai nationality should focus on the above age groups. Osteoporosis is an important risk factor for the occurrence of osteoporosis in Bai nationality in Jianchuan County, Dali Prefecture, Yunnan Province. We should pay attention to the prevention of osteoporosis after fragile fracture. 3. There is a good correlation and statistical significance between OSTA system and the prevalence of osteoporosis in Bai nationality in Dali Prefecture, Yunnan Province. 4. Serum 25 - (OH) Vit D3 levels were negatively correlated with age (the lowest was in the 60-69 age group), and positively correlated with calcaneal T value; serum PTH levels were positively correlated with age, and negatively correlated with serum 25 - (OH) Vit D3 levels; serum bone marrow was positively correlated with calcaneal T value; serum PTH levels were negatively correlated with serum 25 - (OH) Vit D3 levels. Calcitonin BGP, calcitonin CT and age, BMD, T value and other two serum bone metabolites were not statistically significant. The serum 25 - (OH) Vit D3 and PTH levels of Bai nationality in Jianchuan County, Dali Prefecture were measured to have certain guiding significance for the prevalence of osteoporosis in this nationality.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R580
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，本文編號：2198090
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