怒江州怒族中老年人群骨质疏松患病率调查及相关影响因素的分析

发布时间：2019-04-23 17:42

【摘要】：目的:1.通过定量超声技术测定云南省怒江州地区怒族中老年人群跟骨骨密度参数,探讨其变化规律。2.调查云南省怒江州怒族中老年人群骨质疏松症患病率,同时探讨与其相关危险因素。3.评价OSTA系统在怒江州怒族中老年人群骨质疏松症自我诊断及预测中的价值。4.测定云南省怒江州怒族中老年人群血清骨代谢标志物,了解其变化规律并评价其在预测骨质疏松发生方面的价值。方法:采用现代流行病学分层随机抽样法,于云南省怒江州福贡县匹河怒族乡,选取当地怒族40岁以上年龄人群,共140人,以10岁为一年龄组,测定其基本生理体征、跟骨骨密度,同时以问卷的形式了解包括其日常生活、作息习惯、生育生产史等信息。选取以上受试者中108例进行血清β-CTX、BGP、BALP、PINP测定。将所得数据用spss21.0进行统计分析。结果:1.云南省怒江州怒族中老年人群女性群体SI值呈现逐年递减趋势,60-69年龄段SI丢失率最高,达到16.63%,且有统计学意义,50-59、70-79岁年龄段及整体不同性别间SI值有差异且有统计学意义,男性SI值大于女性。2.整体人群OP患病率为100%,女性患病率为10.70%,男性为7.1%。男性女性患病率均随年龄增加而身高。其中总体及女性60-69岁、70-79岁患病率高于其他年龄段。身高、OSTA指数、体重与T值、SI值、Z值呈正相关;总体人群的年龄及女性产次与T值、Z值、SI值呈负相关。3.OSTA风险等级与该地区OP患病率呈正相关,OSTA风险等级越高,则OP患病率也就更高。OSTA风险指数的ROC曲线下面积女性为0.875;总体的AUC为0.852。OSTA指数怒族中老年人群总体及女性人群在OP预测准确性上价值较高,准确性好。4.怒江州怒族中老年人群β-CTX、BGP与T值呈负相关关系;女性β-CTX、BGP、BALP与T值呈负相关。怒江州怒族女性中患OP人群BALP、BGP值大于未患人群。结论:1.云南省怒江州怒族中老年人群骨强度指数SI随着年龄逐步降低,女性降低速度快于男性,女性SI丢失率在60-69岁达高峰,预防的重点应位于此年龄层。2.云南省怒江州怒族中老年人群OP患病率低于全国水平;人群总体及女性患病高峰在60-69岁、70-79岁,并且与SI丢失高峰重合,男性患病率比较分散,提示应按性别分别设立防治重点年龄段,以达到最好效果。3.云南省怒江州怒族中老年人群女性骨量与年龄、产次呈负相关,与孕次、初潮年龄及绝经年龄无相关关系;总体人群骨量与体重、身高呈正相关。经常食用豆制品、出行时多选择步行均能降低怒族OP发病率。4.在检测条件极度缺乏时,尤其对于怒江州怒族群体,OSTA系统是怒族进行骨质疏松自我检测的良好工具。5.怒江州怒族中老年人群女性β-CTX、BGP、BALP与T值呈负相关关系;怒江州怒族中老年女性op主要为高骨转换型,当血BALP、BGP升高应警惕骨松发生。
[Abstract]:Purpose: 1. Calcaneal bone mineral density (BMD) was measured by quantitative ultrasound technique in Nujiang Prefecture, Yunnan Province, and the changes of calcaneal bone mineral density were discussed. 2. To investigate the prevalence of osteoporosis in the middle-aged and elderly population of Nujiang Prefecture, Yunnan Province, and to explore the related risk factors. To evaluate the value of OSTA system in self-diagnosis and prediction of osteoporosis in Nujiang Nuzu middle-aged and elderly population. 4. The serum bone metabolism markers were determined in Nujiang nationality middle-aged and aged people in Nujiang Prefecture of Yunnan Province to understand their changes and evaluate their value in predicting the occurrence of osteoporosis. Methods: using modern epidemiological stratified random sampling method, 140 people over 40 years old were selected from Pinghe Nu Township, Fugong County, Nujiang Prefecture, Yunnan Province. The basic physiological signs were measured with 10 years old as one-year-old group. Calcaneal bone mineral density, including daily life, rest habits, birth and production history, and so on in the form of questionnaires. Serum 尾-CTX,BGP,BALP,PINP was measured in 108 of the above subjects. The data were analyzed by spss21.0. Results: 1. In Nujiang Prefecture, Yunnan Province, the SI value of female population in the middle-aged and old age groups was decreasing year by year, and the loss rate of SI was the highest in 60-69 age group, reaching 16.63%, and there was statistical significance. There were significant differences in SI values between the age group and the whole sex in 50-59, 70-79 years old, and the SI value of male was higher than that of female, and the SI value of male was higher than that of female. The prevalence of OP was 100% in the population, 10.70% in females and 7.1% in males. The prevalence rate of male and female all increased with age and height. The prevalence rate of 60 years old and 70 years old women was higher than that of other age groups. Height, OSTA index and weight were positively correlated with T value, SI value and Z value. There was a negative correlation between age and female labor and T value, Z value and SI value. 3. Osta risk grade was positively correlated with the prevalence of OP in this area, and the higher the risk grade of OSTA was, the higher the risk grade of Osta was. The prevalence of OP was also higher. The area under the ROC curve of Osta risk index was 0.875 for females. The overall AUC for the 0.852.OSTA index of the middle-aged and elderly Nu population and the female population in the OP prediction accuracy is higher, the accuracy is good. 4. There was a negative correlation between 尾-CTX,BGP and T value in Nujiang Nu nationality, and a negative correlation between 尾-CTX,BGP,BALP and T value in female. The value of BALP, BGP in Nujiang Nu nationality women with OP was higher than that in non-Nu nationality women. Conclusions: 1. The bone strength index (SI) of the middle-aged and old-aged population in Nujiang Prefecture of Yunnan Province decreased gradually with the age, and the rate of SI loss in female was higher than that in male, and the rate of loss of BMD in female reached the peak at the age of 60 to 69. The emphasis of prevention should be in this age group. The prevalence of OP was lower in the middle-aged and aged people of Nujiang nationality in Yunnan province than in the whole country. The prevalence peak of population and female was 60 / 69 years old and 70 / 79 years old, and coincided with the peak of SI loss. The male prevalence rate was dispersed, suggesting that the key age groups for prevention and control should be set up according to sex, in order to achieve the best effect. 3. There was a negative correlation between bone mass and age and birth, but no correlation between bone mass and pregnancy, menarche age and menopause age, but a positive correlation between bone mass and body weight and height in the population of Nujiang Prefecture, Yunnan Province. Frequent consumption of soy products, walking when traveling can reduce the incidence of OP in the Nu ethnic group. 4. When testing conditions are extremely lacking, especially for Nujiang Nu population, OSTA system is a good tool for self-detection of osteoporosis in Nujiang. 5. There was a negative correlation between 尾-CTX,BGP,BALP and T value in the middle-aged and old-aged women of Nujiang Nu nationality, and the op of Nujiang Nu nationality middle-aged and elderly women was mainly of high bone turnover type, so the occurrence of bone loosening should be alerted when the blood BALP,BGP increased.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R580

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