文章摘要
汤淑女,尹香君,余卫,崔露,李志新,崔丽嘉,王临虹,夏维波.中国40岁及以上绝经后女性骨质疏松症患病率及其影响因素研究[J].中华流行病学杂志,2022,43(4):509-516
中国40岁及以上绝经后女性骨质疏松症患病率及其影响因素研究
Prevalence of osteoporosis and related factors in postmenopausal women aged 40 and above in China
收稿日期:2021-08-26  出版日期:2022-04-16
DOI:10.3760/cma.j.cn112338-20210826-00680
中文关键词: 骨质疏松症|绝经后女性|患病率|危险因素
英文关键词: Osteoporosis|Postmenopausal women|Prevalence|Related factor
基金项目:中央转移支付重大公共卫生项目;中国红十字基金会
作者单位E-mail
汤淑女 中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050  
尹香君 中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050  
余卫 中国医学科学院北京协和医学院北京协和医院放射科, 北京 100730  
崔露 中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050  
李志新 中国疾病预防控制中心妇幼保健中心, 北京 100081  
崔丽嘉 中国医学科学院北京协和医学院北京协和医院内分泌科, 北京 100730  
王临虹 中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京 100050 wanglinhong@ncncd.chinacdc.cn 
夏维波 中国医学科学院北京协和医学院北京协和医院内分泌科, 北京 100730 xiaweibo8301@163.com 
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中文摘要:
      目的 了解我国≥40岁绝经后女性骨质疏松症患病率及其影响因素,为我国骨质疏松症防控工作提供科学依据。方法 本研究数据来自2018年中国骨质疏松症流行病学调查,覆盖全国11个省(直辖市)44个县(区),通过问卷调查、体格检查收集调查对象相关变量,并采用双能X线吸收法测量腰椎和股骨近端骨密度。应用复杂抽样加权估计我国≥40岁绝经后女性骨质疏松症患病率及其95%CI并分析其影响因素。结果 纳入分析5 728人,中国≥40岁绝经后女性骨质疏松症患病率为32.5%(95%CI:30.3%~34.7%)。其中,40~、50~、60~、70~、≥80岁绝经后女性骨质疏松症患病率为16.0%(95%CI:4.5%~27.5%)、18.4%(95%CI:15.9%~20.8%)、37.5%(95%CI:34.5%~40.4%)、52.9%(95%CI:47.5%~58.3%)和68.0%(95%CI:55.9%~80.1%);文盲或小学以下文化程度和家庭人均年收入<10 000元人群骨质疏松症患病率较高(P<0.001),分别为47.2%(95%CI:43.0%~51.3%)和40.3%(95%CI:36.9%~43.7%);农村[35.1%(95%CI:32.0%~38.1%)]高于城市(P<0.001);低体重、正常体重、超重、肥胖人群骨质疏松症患病率分别为69.9%(95%CI:59.0%~80.8%)、42.2%(95%CI:38.7%~45.7%)、24.2%(95%CI:21.3%~27.1%)和14.6%(95%CI:11.1%~18.0%)。月经维持年限≤30年和绝经年限≥11年骨质疏松症患病率相对较高(P<0.001),分别为46.1%(95%CI:40.8%~51.3%)和48.2%(95%CI:45.0%~51.3%)。多因素logistic回归分析结果显示,年龄≥60岁、文盲或小学以下文化程度、家庭人均年收入<10 000元、低体重、月经维持年限≤30年、绝经年限≥11年绝经后女性骨质疏松症患病风险高。结论 我国≥40岁绝经后女性骨质疏松症患病率较高,且在不同社会经济地位组间存在差异,应有效开展重点人群骨质疏松症防控工作。
英文摘要:
      Objective To understand the prevalence of osteoporosis and related factors in postmenopausal women aged ≥ 40 years in China and provide scientific evidence for osteoporosis prevention and control. Methods Data of this study were from the 2018 China Osteoporosis Epidemiological Survey, covering 44 counties (districts) in 11 provinces in China. Related variables were collected by questionnaire survey and physical measurement, and the BMD of lumbar spine and proximal femur was measured by dual-energy X-ray absorption method. The prevalence of osteoporosis and its 95%CI in postmenopausal women aged ≥ 40 years were estimated with complex sampling weights. Results A total of 5 728 postmenopausal women aged ≥ 40 years were included in the analysis and the prevalence of osteoporosis was 32.5% (95%CI:30.3%-34.7%). The prevalence of osteoporosis in postmenopausal women aged 40-49 years, 50-59 years, 60-69 years, 70-79 years, and ≥ 80 years were 16.0% (95%CI:4.5%-27.5%), 18.4% (95%CI:15.9%-20.8%), 37.5% (95%CI:34.5%-40.4%), 52.9% (95%CI:47.5%-58.3%), and 68.0% (95%CI:55.9%-80.1%) respectively. The prevalence of osteoporosis was higher (P<0.001) in those with education level of primary school or below (47.2%, 95%CI:43.0%-51.3%) and in those with individual annual income less than 10 000 Yuan, (40.3%, 95%CI:36.9%-43.7%). The prevalence of osteoporosis was 35.1% in rural areas (95%CI:32.0%-38.1%), which was higher than that in urban areas (P<0.001). The prevalence of osteoporosis in low weight, normal weight, overweight and obese groups were 69.9% (95%CI:59.0%-80.8%), 42.2% (95%CI:38.7%-45.7%), 24.2% (95%CI:21.3%-27.1%) and 14.6% (95%CI:11.1%-18.0%), respectively. The prevalence of osteoporosis in those with menstrual maintenance years ≤ 30 years and in those with menopause years ≥ 11 years were 46.1% (95%CI:40.8%-51.3%) and 48.2% (95%CI:45.0%-51.3%), respectively. Multivariate logistic analysis showed that age ≥ 60 years, education level of primary school or below, annual household income per capita less than 10 000 Yuan, low body weight, menstrual maintenance years ≤ 30 years, menopause years ≥ 11 years were risk factors of osteoporosis in postmenopausal women in China. Conclusions The prevalence of osteoporosis was high in postmenopausal women aged ≥ 40 years in China, and there were differences in osteoporosis prevalence among different socioeconomic groups. Effective interventions should be taken for the prevention and control of osteoporosis in key groups in the future.
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