摘要
目的:通过建立青岛地区正常成年女性骨密度(BMD)参考数据库及不同厂家双能X线吸收法骨密度仪(DXA)之间的数据换算关系,比较青岛与长沙地区成年女性BMD差异及影响因素,以期达到数据共享的目的。
方法:采用Challenger型DXA测量青岛地区868例25-83岁女性参考人群的腰椎(L2-L4)侧位和左侧髋部(股骨颈、大转子、Ward三角区)6个骨骼区域的BMD,用8种回归模型拟合健康成年女性人群BMD随年龄的变化,找出最佳拟合的方程建立数据库并与长沙地区已建立的数据库(采用Holigic QDR4500型DXA)进行比较。同时选择25-35岁健康成年女性30人分别在Chal lenger及Holigic QDR4500型DXA上扫描,经过直线相关与回归分析分别计算出腰椎(L2-L4)正位和左侧髋部(股骨颈、大转子、Ward三角区)6个骨骼区域的BMD换算公式,比较校正以后两地区骨密度数据库差异。
结果:1、青岛地区正常成年女性6个骨骼区域BMD随年龄变化,不同部位骨峰值(PBMD)出现的时间不同,腰椎在25-29岁,髋部在40-44岁,而长沙地区均在30-34岁。2、用三次回归模型拟合程度优于其他回归模型,拟合曲线的决定系数(?)为0.21±0.09(P<0.001)。3、Challenger与Holigic QDR4500型DXA之间的骨密度测定数据显著相关,存在线性关系。4、校正之前,青岛地区女性髋部BMD几乎无一例外地高于长沙地区;校正之后,两地区骨密度无显著性差别。
结论:1.不同地域之间的PBMD出现的年龄不同,有必要建立适合当地人群的BMD参考数据库。2.BMD测定受很多因素影响,除地域、性别、生活习惯和BMI外,DXA仪器本身也是很重要的影响因素。
Objective Establishing the bone mineral density(BMD) reference databases of multiple skeletal regions in women in Qingdao and then to compare the differences of the BMD databases from Qingdao and Changsha area in China by calculating the fomulus of the varied type dual-energy X-ray absorptiometries(DXAs).The aim is to find the way which could share the different databases from the varied type DXAs.
Method BMD was measured by Challenger(DXA,DMS Co.France) at skeletal regions of supine normotopia spine,left hip(femoral neck、greater trochanter and ward's triangle) in 868 healthy women aged 25-83years in Qingdao.BMD of skeletal regions with age-related changes were found to fit in whole of eight kinds of regression models.Best model equations of fitting was found and the reference databases were established,then to be compared with that in Changsha area where BMD was measured by Hologic QDR 4500(DXA,America).Meanwhile,30 healthy women aged 25-35 were selected and had their BMD measured by the different DXAs(Challenge and Hologic) at skeletal regions above mentioned.Then we found the emendation formulus from the two varied DXAs by linear correlation and regression analysis,and compared the different BMD databases from Qingdao and Changsha areas respectly.
Results 1.BMD reference databases changed with aging and the peak BMD of lumbar spine and hip in Qingdao appeared at 25-29 and 40-44years old groups respectively,while Changsha at 30-34years old groups.2.The BMD reference databases were established by cubic regression equation,which was better fitted with age-related change as compared with other regression models.The coefficients of determination(R~2) of fitting curve were 0.21±0.09(P<0.001).3.BMD measured by Challenger and Hologic QDR 4500 were predominantely correlated,and there exists linear relationship.4.There is significant difference of BMD between both areas,especially in the hip regions Qingdao women are higher than Changsha area before data emendation.In fact the BMD databases of the both areas showed no significant difference after emendation.
Conclusion 1.It is necessary to establish the local reference database of BMD for the PBMD age were different in different areas.2.The effectors of measuring BMD include region,diary habits,sex, BMI,especially the types of the measuring equipments.
Postgraduate student:Qiu-LingWang(endocrinology and metabolism) Directed by Prof.Nai-LongYang
引文
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