体重、体脂、骨代谢指标结合OSTA、FRAX评估绝经后女性骨质疏松风险
发布时间：2018-07-24 17:43
【摘要】：目的探讨体重、体脂与绝经后女性骨密度的关系。通过分析骨代谢指标与骨密度的关系以及OSTA、FRAX评估工具识别骨质疏松风险的能力,为绝经后女性骨质疏松症的早期诊断及治疗提供指导。方法选取2014年5月至2014年8月在安徽医科大学第一附属医院体检中心体检的健康绝经后女性131例,平均年龄(63.96±7.60)岁,自然绝经,绝经时间大于1年,平均绝经年限(14.50±8.71)年。采集受试者年龄、身高、体重、腰围、绝经年限、母亲骨折史等资料,计算体重指数(BMI),测定血钙(Ca)、血磷(P)、碱性磷酸酶(ALP)、25羟-维生素D3(25(OH)D3)、雌激素(E2)、骨钙素(BGP)、抗酒石酸酸性磷酸酶(TRACP)等生化指标,采用双能X线骨密度仪检测腰椎L2-4、股骨颈、wards三角、大转子骨密度及全身体脂百分比,结合相关资料,计算出每位受试者亚洲人骨质疏松自我筛查工具(OSTA)指数和骨折风险因子评估工具(不含骨密度模型FRAX)的10年髋部骨折风险(HF)和主要骨质疏松性骨折风险(MO)。依据BMI值24为切点将受试者分为体重正常组和超重及肥胖组,通过t检验比较两组间骨密度、骨代谢指标、骨折风险概率。根据骨密度分为骨质疏松组及非骨质疏松组,通过t检验比较两组间体重、体脂百分比、骨代谢指标、骨折风险概率。运用相关分析探讨骨密度的相关影响因素。分析OSTA、FRAX工具识别骨质疏松风险的ROC曲线特征。结果1.超重及肥胖组的腰椎L2-4骨密度、股骨颈骨密度、大转子骨密度较正常体重组高,而绝经年限较对照组短,差异有统计学意义(均P0.05);两组的年龄、身高、Wards三角骨密度、BGP、TRACP、E2、25(OH)D3、ALP、Ca、P差异无统计学意义。2.骨质疏松组的年龄、绝经年限、BGP、TRACP、ALP较对照组高,而身高、体重、BMI、体脂百分比、E2、25(OH)D3较对照组低,差异有统计学意义(均P0.05)。两组的腰围、ALP、Ca、P差异无统计学意义。3.相关分析显示腰椎L2-4骨密度、股骨颈骨密度、大转子骨密度、Wards三角骨密度与BMI、体脂百分比、体重、OSTA评分、E2呈正相关,与年龄、绝经年限、MO、HF、BGP、TRACP呈负相关,与腰围、25(OH)D3、ALP、Ca、P相关性较弱或无相关性。4.OSTA指数识别骨质疏松风险的ROC曲线下面积为0.754,FRAX工具计算出的HF、MO识别骨质疏松风险的ROC曲线下面积分别为0.890、0.888。结论1.健康的绝经后女性适量增加体重和体脂可以增加骨密度从而早期预防骨质疏松症;2.测定骨代谢指标对骨质疏松症的早期诊断提供指导;3.OSTA及FRAX工具均可用于识别绝经后女性骨质疏松风险,且OSTA简单、经济、易与推广。
[Abstract]:Objective to investigate the relationship between body weight, body fat and bone mineral density in postmenopausal women. The relationship between bone metabolism and bone mineral density (BMD) and the ability of OSTA-FRAX to identify the risk of osteoporosis were analyzed in order to provide guidance for early diagnosis and treatment of osteoporosis in postmenopausal women. Methods 131 postmenopausal women (mean age (63.96 卤7.60) years) who were examined in the physical examination Center of the first affiliated Hospital of Anhui Medical University from May 2014 to August 2014 were selected. The menopausal period was more than one year and the average menopausal period was (14.50 卤8.71) years. The subjects' age, height, weight, waist circumference, menopausal age, history of the mother's fracture and so on were collected. Body mass index (BMI),) was used to measure serum calcium, (Ca), serum phosphorus, (P), (P), alkaline phosphatase (ALP) 25 hydroxy-vitamin D 3 (25 (OH) D 3), estrogen (E2), osteocalcin (BGP), tartrate resistant acid phosphatase (TRACP) and so on. Lumbar spine L2-4 and femoral neck bursa triangle were detected by dual energy X-ray absorptiometry. Bone mineral density of trochanter and percentage of body fat, combined with relevant data, Calculate 10 year hip fracture risk (HF) and major osteoporosis fracture risk (MO). For each Asian self-screening tool (OSTA) index and fracture risk factor assessment tool (excluding bone mineral density model FRAX) The subjects were divided into normal weight group and overweight and obesity group according to the BMI value of 24. Bone mineral density, bone metabolism index and fracture risk probability were compared between the two groups by t test. Bone mineral density was divided into osteoporosis group and non-osteoporosis group. T test was used to compare the weight, percentage of body fat, bone metabolism index and fracture risk probability between the two groups. Correlation analysis was used to investigate the related factors of bone mineral density (BMD). The ROC curve features of OSTA-FRAX tool for identifying osteoporosis risk were analyzed. Result 1. L2-4 bone mineral density (BMD), femoral neck bone density (BMD) and greater trochanter bone density (BMD) in overweight and obese group were higher than those in normal weight group, but the menopausal period was shorter than that in control group (P0.05). There was no significant difference in bone mineral density (BGP) between two groups. The age and menopausal age of Osteoporosis group were higher than that of the control group, but the body height, body weight and body fat percentage were significantly lower than those in the control group (P0.05). There was no significant difference in the waist circumference between the two groups. Correlation analysis showed that lumbar L2-4 bone mineral density, femoral neck bone density, greater trochanter bone mineral density and BMIs, percentage of body fat, weight and OSTA score E _ 2 were positively correlated, but negatively correlated with age, menopausal age and BGPCP. The area under the ROC curve of Osta index to identify the risk of osteoporosis was 0.754m FRAX tool. The area under the ROC curve calculated by FRAX tool was 0.890 卤0.8880.The area under the ROC curve calculated by FRAX tool was 0.890 ~ 0.8880.The area under the ROC curve calculated by FRAX was 0.890 ~ 0.888. Conclusion 1. Healthy postmenopausal women gain weight and body fat in moderation to increase bone mineral density and prevent osteoporosis early. Osta and FRAX tools can be used to identify osteoporosis risk in postmenopausal women, and OSTA is simple, economical, easy and popularized.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R580
，
本文编号：2142155
[Abstract]:Objective to investigate the relationship between body weight, body fat and bone mineral density in postmenopausal women. The relationship between bone metabolism and bone mineral density (BMD) and the ability of OSTA-FRAX to identify the risk of osteoporosis were analyzed in order to provide guidance for early diagnosis and treatment of osteoporosis in postmenopausal women. Methods 131 postmenopausal women (mean age (63.96 卤7.60) years) who were examined in the physical examination Center of the first affiliated Hospital of Anhui Medical University from May 2014 to August 2014 were selected. The menopausal period was more than one year and the average menopausal period was (14.50 卤8.71) years. The subjects' age, height, weight, waist circumference, menopausal age, history of the mother's fracture and so on were collected. Body mass index (BMI),) was used to measure serum calcium, (Ca), serum phosphorus, (P), (P), alkaline phosphatase (ALP) 25 hydroxy-vitamin D 3 (25 (OH) D 3), estrogen (E2), osteocalcin (BGP), tartrate resistant acid phosphatase (TRACP) and so on. Lumbar spine L2-4 and femoral neck bursa triangle were detected by dual energy X-ray absorptiometry. Bone mineral density of trochanter and percentage of body fat, combined with relevant data, Calculate 10 year hip fracture risk (HF) and major osteoporosis fracture risk (MO). For each Asian self-screening tool (OSTA) index and fracture risk factor assessment tool (excluding bone mineral density model FRAX) The subjects were divided into normal weight group and overweight and obesity group according to the BMI value of 24. Bone mineral density, bone metabolism index and fracture risk probability were compared between the two groups by t test. Bone mineral density was divided into osteoporosis group and non-osteoporosis group. T test was used to compare the weight, percentage of body fat, bone metabolism index and fracture risk probability between the two groups. Correlation analysis was used to investigate the related factors of bone mineral density (BMD). The ROC curve features of OSTA-FRAX tool for identifying osteoporosis risk were analyzed. Result 1. L2-4 bone mineral density (BMD), femoral neck bone density (BMD) and greater trochanter bone density (BMD) in overweight and obese group were higher than those in normal weight group, but the menopausal period was shorter than that in control group (P0.05). There was no significant difference in bone mineral density (BGP) between two groups. The age and menopausal age of Osteoporosis group were higher than that of the control group, but the body height, body weight and body fat percentage were significantly lower than those in the control group (P0.05). There was no significant difference in the waist circumference between the two groups. Correlation analysis showed that lumbar L2-4 bone mineral density, femoral neck bone density, greater trochanter bone mineral density and BMIs, percentage of body fat, weight and OSTA score E _ 2 were positively correlated, but negatively correlated with age, menopausal age and BGPCP. The area under the ROC curve of Osta index to identify the risk of osteoporosis was 0.754m FRAX tool. The area under the ROC curve calculated by FRAX tool was 0.890 卤0.8880.The area under the ROC curve calculated by FRAX tool was 0.890 ~ 0.8880.The area under the ROC curve calculated by FRAX was 0.890 ~ 0.888. Conclusion 1. Healthy postmenopausal women gain weight and body fat in moderation to increase bone mineral density and prevent osteoporosis early. Osta and FRAX tools can be used to identify osteoporosis risk in postmenopausal women, and OSTA is simple, economical, easy and popularized.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R580
，
本文编号：2142155
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