丽江地区纳西族人群骨质疏松症流行病学调查及相关影响因素分析

发布时间：2018-03-08 10:20

本文选题：云南省丽江市纳西族　切入点：跟骨定量超声　出处：《昆明医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：1.测定云南省丽江纳西族人群跟骨定量超声参数,创建跟骨超声骨量数据库。2.探讨云南省丽江地域纳西族骨质疏松症的发病率和危险因素。3.测定云南省丽江地域纳西族人群血清骨代四项谢标志物,了解其变化规律。方法：采用整群抽样法,抽取云南省丽江市纳西族人口102例,年龄40～90岁,其中男性42人,女性60人,并按10岁区间划分为一年龄段,将人群分为五组。上述每组人群均进行跟骨定量超声检测,基本体征测量,骨质疏松相关要素问卷调查；用ELISA法检测血清骨代谢物标志(25-(OH)D、PTH、BGP、CT),对调查结果进行统计学分析。结果：1.云南省丽江市纳西族被调查人群BMD男女性均于45-50岁达到峰值骨量,峰值骨量高于全国其他地域,男女性峰值骨量无统计学差异性,以后随着年龄的增长而降低,且女性下降速率较男性快,以50岁最明显。跟骨定量超声SI,跟骨T值,跟骨BMD值,男性以45～52岁最高,女性以40～49岁最高,之后均迅速下降,男女性均于80岁以后骨量达到最低。其中,女性骨量降低较快的时间段为绝经期后3-5年,说明女性骨质疏松与绝经密切相关,绝经后女性骨量丢失较绝经前多。2.人群身高、体重、年龄、腰围、臀围、BMI等与跟骨定量超声T值及OSTA有相关性,呈现明显的增龄性改变；吸烟,饮酒者骨密度显著低于不吸烟者,骨质疏松症与饮酒量呈正相关关系；环境因素是重要因素,日照时间、劳动量、饮食生活与人群骨密度高低密切相关。3.共检测云南省丽江市纳西族人群102人,按照诊断标准,患病人数为5人,其中男性总人数1人患病4人,女性总人数60人,患病4人；总发病率为4.9%,男性发病率2.4%,女性发病率6.7%。随着年龄的增加发病率升高,71-80岁年龄组发病率最高,为20.0%,差异有显著性。40-50岁,50-60岁,60-70岁年龄组发病率为0。70-80岁年龄组女性发病率高于男性,差异无显著性。4.云南省丽江市纳西族被调查人群血清25-(OH)D值与年龄成负相关,血清PTH与年龄成正相关。BGP、CT与年龄无相关性。有可能说明云南省丽江市纳西族人群随着年龄的增加,骨质疏松风险增加。结论：1.云南省丽江市纳西族,被调查人群骨质疏松发病率,低于全国其他地域,峰值骨量可能高于全国其他地域。2.人群身高、体重、年龄、腰围、臀围、BMI等与跟骨定量超声T值及OSTA有相关性,呈现明显的增龄性改变；吸烟,饮酒者骨密度显著低于不吸烟者,骨质疏松症与饮酒量呈正相关关系；环境因素是重要因素,日照时间、劳动量、饮食生活与人群骨密度高低密切相关。3.云南省丽江市纳西族被调查人群,骨质疏松发病率随年龄的增加而逐年增加,男女性均以70-80岁年龄组发病率最多。这与年龄增长,机体功能减退,女性以绝经后雌激素水平下降,男性以劳动量下降等因素有关。4.有可能说明云南省丽江市纳西族人群随着年龄的增加,骨质疏松风险增加。
[Abstract]:Objective 1. To determine the quantitative ultrasonic parameters of calcaneus in Naxi nationality of Lijiang, Yunnan Province. To explore the incidence and risk factors of osteoporosis in Naxi nationality in Lijiang area of Yunnan Province. 3. To determine the four markers of bone replacement in serum of Naxi nationality in Lijiang area of Yunnan Province. Methods: 102 Naxi population of Lijiang City, Yunnan Province were selected by cluster sampling method. The population was 40 ~ 90 years old, including 42 males and 60 females, and was divided into one age group according to the age range of 10 years. The population was divided into five groups. Each group was examined by quantitative ultrasound of calcaneus, basic signs, osteoporosis related factors questionnaire; The ELISA method was used to detect the serum bone metabolite marker 25-OHH, PTHH, BGP, and the results were statistically analyzed. Results: 1. The peak bone mass of BMD was reached between 45 and 50 years old in Naxi nationality in Lijiang, Yunnan Province, and the peak bone mass was higher than that in other regions of China. There was no statistical difference in peak bone mass between men and women, and the rate of decline was faster in women than in men, especially in 50 years old. Calcaneal quantitative ultrasound, calcaneal T value, calcaneal BMD value were the highest in male patients at 4552 years old. The female bone mass was the highest in 40 or 49 years old, then declined rapidly, and the bone mass of both men and women reached the lowest after 80 years old. The period of female bone mass decrease was 3-5 years after menopause, indicating that female osteoporosis is closely related to menopause. The loss of bone mass in postmenopausal women was higher than that before menopause. The height, weight, age, waist circumference and hip circumference were correlated with calcaneal quantitative ultrasound T value and OSTA. Bone mineral density (BMD) of drinkers was significantly lower than that of non-smokers, osteoporosis was positively correlated with alcohol consumption, environmental factors were important factors, sunshine time, labor volume, A total of 102 Naxi people in Lijiang City, Yunnan Province were detected. According to the diagnostic criteria, the number of patients was 5, of which 4 were male, 60 were female and 4 were sick. With the increase of age, the incidence rate of 71-80 age group was the highest (20.0%). The difference was significant. The incidence rate of women aged from 0.70 to 80 years old was higher than that of men, and the incidence rate was 0.70-80 years old in the age group of 50-60 years and 60-70 years old, the incidence of which was 0.70-80 years old. There was no significant difference between serum PTH and age. 4. There was no significant correlation between serum PTH and age in Naxi nationality in Lijiang, Yunnan Province. It may be suggested that the age of Naxi population in Lijiang City of Yunnan Province increased with age, and there was no significant correlation between serum PTH and age, which suggested that the age of Naxi nationality in Lijiang City of Yunnan Province was higher than that of Naxi ethnic group in Lijiang City, Yunnan Province. The risk of osteoporosis is increased. Conclusion 1. The incidence of osteoporosis in Naxi nationality in Lijiang City, Yunnan Province, is lower than that in other regions of the country, and the peak bone mass may be higher than that in other regions of the country. 2. Population height, weight, age, waist circumference, Hip circumference and OSTA were correlated with calcaneal quantitative ultrasound T value and OSTA, the BMD of smoking drinkers was significantly lower than that of non-smokers, osteoporosis was positively correlated with alcohol consumption, environmental factors were important factors. Sunshine time, labor, dietary life and bone mineral density were closely related. 3. The incidence of osteoporosis increased year by year with the increase of age in the investigated population of Naxi nationality in Lijiang City, Yunnan Province. Both sexes had the highest incidence in the 70-80 age group. This was associated with the increase of age, the decline of body function, and the decrease of estrogen levels in postmenopausal women. It may indicate that the risk of osteoporosis increases with the increase of age in the Naxi ethnic group in Lijiang, Yunnan Province.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R580

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