| Objective:The prevalence and risk of Osteoporosis(OP) as well as bone mineral density(BMD) in nonselected female population are still unclear. It's of far reaching cilinical importance to understand the prevalence and risk of the nonselected female population with OP in different disorder groups.The study is to know the changes of BMD with age in nonselected female population, the differences in the prevalence of osteoporosis in different disease groups and the risk of OP compared with physical examination population.Methods:Clinical BMD data of 11983 female cases, measured in the room of bone mineral density, aged between 35-89 years, collected from 2000 to 2008 year were analysed retrospectively.4605 cases of healthy person were specified as group 1,3110 cases of patient with Type 2 diabetes as group 2,1938 cases of patient with joint and lower back pain as group 3, 644 cases with suspect OP and/or fracture as group4,463 cases with Limbs weakness and/or hypothyrodism as group 5,271 cases with hyperthyroidism as group 6,952 cases with other diseases as group 7.All the subjects were tested BMD, weight as well as height by designated doctors.Previous medical history was inquired and detailedly filled form. BA, BMC and aBMD in L-spine (L1-L4) and Left Hip(including Femoral neck, Trochanter, Intertrochanter, Total region) were measured by using dual-energy X-ray ab-sorptiometry (DXA) with a Hologic Delphi A, estimated vBMD in lumbar spine and femoral neck. All groups were stratified by 10-year age groups, and BMD, mean of BA, BMC, aBMD and vBMD of each group were calculated at various skeletal regions, to find the differences among disease groups and age groups.The best-fit regression model was used to describe the changes of BMD curve in different disease groups with age. According to the WHO diagnostic criteria, the peak value of aBMD or vBMD lower than 2.5SD(T value<-2.5) was diagnosed as OP.Compared with healthy group,the risk of suffering OP of each disease group was calculated.Results:(1)In this retrospective review, there was difference in the number of case, average age and average years since last menstrual period of each disease group. Among them, group 4 had the oldest average age, group 6 was the lowest in all average age, average weight, BMI and duration since menopause. The average BMC in anteroposterior lumbar spine from group1 to group 7 was 47.0±10.6g,45.6±10.3g,43.3±10.5g,36.9±9.24g, 46.0±10.6g,49.2±11.0g and 44.6±10.9g respectively; group 4 had the lowest while group 6 had the most. The average BMC of the femoral neck was 3.28±0.612g,3.09±0.617g,3.00±0.629g,2.62±0.520g, 3.24±0.644g,3.34±0.627g and 3.07±0.667g respectively; group 4 was lowest in all groups. The average BMC of the Total region was 25.0±4.83g,24.0±5.17g,23.5±5.15g,20.6±4.69g,24.3±5.05g, 25.1±4.90g and 24.1±5.58g respectively; group 4 was lower than other groups too.The average aBMD in anteroposterior lumbar spine from group 1 to group 7 was 0.848±0.152g/cm2,0.818±0.145g/cm2, 0.786±0.155g/cm2,0.683±0.140g/cm2,0.842±0.150g/cm2, 0.869±0.152g/cm2 and 0.808±0.155g/cm2 respectively; group 4 had the lowest while group 6 had the highest. The average aBMD in the femoral neck was 0.705±0.123g/cm2,0.657±0.124g/cm2,0.638±0.127g/cm2, 0.556±0.104g/cm2,0.704±0.130g/cm2,0.709±0.119g/cm2 and 0.651±0.133g/cm2 respectively; group 4 was the lowest and group 3 took second place compare with other groups. The average aBMD in the total region was 0.781±0.132g/cm2,0.744±0.139g/cm2,0.724±0.142g/cm2, 0.631±0.129g/cm2,0.771±0.135g/cm2,0.777±0.130g/cm2 and 0.739±0.150g/cm2 respectively; group 4 and group 3 were also lower than other groups.(2) The relationships between aBMD, vBMD and age in anteroposterior lumbar spine, femoral neck, total region were analysed by cubic regression model which was the best-fit model.The fitted curves of BMD in group 4 was significantly lower than other groups.The fitted curves of aBMD in anteroposterior lumbar spine of group2 was significantly higher than other groups.The fitted curve of aBMD and vBMD in Neck of group 1,group 2 and group 5 was in a higher level. The fitted curve of BMD in femoral neck of group 3,group 6 and group 7 was in a middle level and significantly lower than group 1,group 2 and group 5,significantly higher than group 4.The fitted curve of BMD in total region of group 4 was in the lowest level, while group 6 significantly was higher than group 4,but significantly had lower than group 1 and group 2 and group 3 and group 5.(3)The average prevalence rate of OP was 19.9±7.8% in different bone areas.The positive detection rate of aBMD and vBMD in anteroposterior lumbar spine were 32.9% and 27.9% respectively, which was significantly higher than other areas. The positive detection rate of aBMD and vBMD in femoral neck was 20.9% and 12.2% respectively while aBMD in Total region was 15.6%. The positive detection rate of aBMD in anteroposterior lumbar spine and femoral neck was significantly higher than vBMD of themselves.Diagnosis OP by aBMD and vBMD in anteroposterior lumbar spine, aBMD and vBMD in femoral neck, aBMD in trochanter, aBMD in Inter-trochanter and aBMD in total region, the detection rate from group 1 to group 7 was 12.9±7.5%, 20.3±7.3%,26.1±9.1%,51.1±13.0%,13.8±6.9%,11.3±5.5%,23.2±7.1%, group 4 had highest while group 6 had the lowest. Compared with the healthy group, the risk of OP(OR,95%CI) in anteroposterior lumbar spine and femoral neck was 1.37(1.27-1.59) and 2.07(1.86-2.39) in group 2, 1.97(1.79-2.25)and 2.95(2.63-3.42) in group 3,7.06(6.06-8.46)and 9.12(7.86-10.8) in group 4,1.03(0.87-1.35) and 1.08(0.72-1.36) in group 5,0.74(0.53-1.02) and 0.84(0.58-1.12) in group 6,1.57(1.40-1.96) and 2.62(2.28-3.20) in group 7. The risk of group 4 was about 7-9 times of the healthy group. The risk of group 2,group 3and group 7 increased significantly while the risk of group 6 was decresed significantlyConclusions:The study reveales that the variation laws of BMD of the nonselected female population with different disorders.The difference of detection rates among each disease group as well as every bone area is compared, so the risk is compared between the healthy group and disease groups. This study provides important reference data for knowing the change of bone mineral content and the prevalence of osteoporosis in non-selective female population, it has great significance for clinical diagnosis and evaluation of osteoporosis.
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