中国成年人身高降低与跟骨骨密度的关联分析

申泽薇; 孙至佳; 余灿清; 郭彧; 卞铮; 裴培; 杜怀东; 陈君石; 陈铮鸣; 吕筠; 李立明; 代表中国慢性病前瞻性研究项目协作组

Abstract

申泽薇,孙至佳,余灿清,郭彧,卞铮,裴培,杜怀东,陈君石,陈铮鸣,吕筠,李立明,代表中国慢性病前瞻性研究项目协作组.中国成年人身高降低与跟骨骨密度的关联分析[J].Chinese journal of Epidemiology,2020,41(6):813-818

中国成年人身高降低与跟骨骨密度的关联分析

Association between height loss and calcaneus bone mineral density in Chinese adults

Received:October 05, 2019

DOI：10.3760/cma.j.cn112338-20191005-00716

KeyWord: 身高降低骨密度跟骨队列研究

English Key Word: Height loss Bone mineral density Calcaneus Cohort study

FundProject:国家自然科学基金（91846303）；国家重点研发计划精准医学研究重点专项（2016YFC0900500）；中国香港Kadoorie Charitable基金；英国Wellcome Trust（212946/Z/18/Z，202922/Z/16/Z，104085/Z/14/Z，088158/Z/09/Z）

Author Name	Affiliation	E-mail
Shen Zewei	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Sun Zhijia	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Yu Canqing	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Guo Yu	Chinese Academy of Medical Sciences, Beijing 100730, China
Bian Zheng	Chinese Academy of Medical Sciences, Beijing 100730, China
Pei Pei	Chinese Academy of Medical Sciences, Beijing 100730, China
Du Huaidong	Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
Chen Junshi	China National Center for Food Safety Risk Assessment, Beijing 100022, China
Chen Zhengming	Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
Lyu Jun	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Peking University, Beijing 100191, China	lvjun@bjmu.edu.cn
Li Liming	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
for the China Kadoorie Biobank Collaborative Group

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Abstract:

目的分析身高降低与跟骨骨密度的关联。方法研究对象为参加中国慢性病前瞻性研究第二次重复调查者，此次调查时采用定量超声骨密度仪测定跟骨骨密度。本研究纳入分析24 231人。采用线性回归分析基线至重复调查的身高变化与重复调查时骨密度指标之间的关联。结果基线至重复调查平均间隔时间为（8.0±0.8）年，身高降低≥1.0 cm者占33.0%，≥3.0 cm者占3.7%。控制潜在混杂因素后，身高降低与骨密度水平的关联存在线性趋势（均P<0.001）。身高降低1.0 cm，宽带超声衰减、超声声速和强度指数分别变化-0.79（-0.95～-0.63）、-2.74（-3.35～-2.13）和-1.29（-1.54～-1.04）。与身高稳定者相比，身高降低≥3.0 cm者的宽带超声衰减、超声声速和强度指数的β值（95% CI）依次为-3.29（-4.08～-2.50）、-10.70（-13.66～-7.73）和-5.16（-6.36～-3.96）。亚组分析显示，上述关联在女性、年龄≥55岁和低体力活动者中更为显著。结论身高降低幅度越大，骨密度指标越低。身高作为容易测量的体格指标，应该定期关注其变化情况，以早期发现和预防骨质疏松症等骨骼健康问题。

English Abstract:

Objective To examine the association between height loss and calcaneus bone mineral density (BMD) through data gathered from the China Kadoorie Biobank (CKB). Methods The present study included 24 231 participants who attended the CKB resurvey during 2013-2014, in which calcaneus BMD was measured by quantitative ultrasound method for the first time. Height loss was calculated according to the differences appeared in height measurement between baseline and resurvey. We used linear regression models to estimate the association between height loss and BMD measures. Results The mean interval between baseline and resurvey was (8.0±0.8 ) years. 33.0% of the participants showed a height loss of ≥1.0 cm, and another 3.7% were with height loss of ≥3.0 cm. After adjustment for potential confounders, there was a linear correlation seen between height loss and BMD (P for all linear trend were <0.001). The βs (95%CIs) for each 1.0 cm of height loss were -0.79 (-0.95- -0.63) for broadband ultrasound attenuation (BUA), -2.74 (-3.35- -2.13) for speed of sound (SOS), and -1.29 (-1.54- -1.04) for stiffness index (SI). Compared with participants with stable height, the multivariate-adjusted βs (95%CIs) for those with height loss of ≥3.0 cm were -3.29 (-4.08- -2.50) for BUA, -10.70 (-13.66- -7.73) for SOS, and -5.16 (-6.36- -3.96) for SI, respectively. According to the subgroup analyses, the association of height loss with BMD measures seemed to be more apparent among females, in those aged ≥55 years, and those being less physically active. Conclusions BMD became lower with the increase of height loss. Regular height measurement may contribute to the early diagnosis and prevention of osteoporosis.

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