| Background: In 2017,the newly added elderly population in China exceeded 10 million for the first time,and the population over 60 years old has reached 240 million,with an average life expectancy of 76.7 years [1].Osteoporosis,as a common and frequently-occurring disease among the elderly,with severe complications such as pain,rickets and fractures,which affect the quality of life of the elderly and endanger public health.Among them,elderly women are more prone to osteoporosis than men,the incidence of Postmenopause Osteoporosis is 40%-50%,and only 13%-22% in men[2].Literature shows that female osteoporosis is closely related to estrogen[3].In addition,menopause,body mass index,physical activity level,fertility and lactation also affect the occurrence and development of osteoporosis.Therefore,we studied the influencing factors of female bone density,hoping to provide certain clinical basis for preventing female osteoporosis and reducing the incidence of fractures.Objective: To analyze the bone mineral density results and general information of 2,282 female in physical examination and outpatient service,and to understand the incidence rate and influencing factors of abnormal bone mass in women of all ages.Exploring the risk factors and protective factors which affected bone mass.Methods: From March 30,2016 to March 30,2018,clinical data of 2,282 women who visited the physical examination center of the second affiliated hospital of Chongqing medical university and the outpatient department of gynaecology were collected.The relationship between age,body mass index,menstruation,birth history and bone density was analyzed by single factor.Based on the international physical activity questionnaire and combined with general information,the questionnaire was made for 70 women,and the influencing factors of abnormal bone density were analyzed by multiple factors regression.Results:1.Among the 2282 cases,489(21.43%)were diagnosed with osteoporosis,901(39.48%)were diagnosed with bone loss,and 892(39.09%)were diagnosed with normal bone mass.(1)Among the women with bone loss,261(28.97%)were diagnosed with bone loss of lumbar spine,155(17.20%)were diagnosed with bone loss of femoral neck,and 485(53.83%)were diagnosed with both bone loss of lumbar spine and femoral neck.Among the women with osteoporosis,289 cases(59.10%,289/489)were diagnosed with osteoporosis in the lumbar spine,48 cases(9.82%,48/489)were diagnosed with osteoporosis in the femoral neck,and 152 cases(31.08%,152/489)were diagnosed with osteoporosis in the lumbar spine and femoral neck.(2)The mean age of the women is 55.60±11.12,and 674 cases(group A)were aged less than 49,458 cases(group B)were aged 50-54,293 cases(group C)were aged 55-59,415 cases(group D)were aged 60-64,and 452 cases(group E)were aged more than 65.In group A,there were 10 cases with osteoporosis,accounting for 1.48%(10/674),and 103 cases with bone loss,accounting for 15.28%(103/674).In group B,there were 58 cases with osteoporosis,accounting for 12.66%(58/458),and 228 cases with bone loss,accounting for 49.78%(228/458).In group C,there were 74 cases with osteoporosis,accounting for 25.25%(74/293),and 152 cases with bone loss,accounting for 51.88%(152/293).In group D,127 cases had osteoporosis,accounting for 30.60%(127/415),and 229 cases had bone loss,accounting for 55.18%(229/415).In group E,there were 221 cases with osteoporosis,accounting for 48.78%(221/452),and 195 cases with bone loss,accounting for 43.05%(195/452).Bone loss and osteoporosis were significantly increased with age(?2=52.501,p<0.001).(3)The average body mass index of the study was 19.45±3.21Kg/M2.According to the body type standard in China,the group with BMI<18.5 Kg/M2 was the thin body type group(group A),the group with body type of 18.5Kg/M2?BMI<24.0Kg/M2 was the normal body type group(group B),and the group with A body type more than 24.0Kg/M2 BMI was the fat and obese body type group(group C).There were 118 cases in group A,among whom osteoporosis accounted for 39.83%(47/118)and decreased bone mass 27.97%(33/118).There were 1332 cases in group B,among whom,osteoporosis accounted for 21.44%(278/1332)and bone loss accounted for 36.41%(488/1332).A total of 832 cases were enrolled in group C,of whom 18.88%(157/832)were osteoporosis cases and 46.15%(384/832)were bone loss cases.The incidence of osteoporosis was significantly different among the three groups(?2=21.894,P<0.05).(4)The average age of postmenopausal women was 48.55±3.42,including 511 perimenopausal women and 555 post-menopausal women.Among the perimenopausal women,there were 9 cases of osteoporosis,accounting for 1.6%(9/511),and 74 cases of bone loss,accounting for 13.74%(74/511).Among the postmenopausal women,116 cases had osteoporosis,accounting for 20.9%(116/555),and 297 cases had decreased bone mass,accounting for 53.51%(297/555).Postmenopausal women were divided into 3 groups with the duration of menopause 5 years,5 to 10 years and the duration more than 10 years(?2=12.482,P<0.05).(5)The menarche ranged from 10 to 19 years old,with an average age of 14.30±2.56;the average pregnancy times was 3.43±2.79.The average birth times was 1.03±0.78.The median age of menarche was 14,the median number of pregnancy times was 3,and the median number of birth times was 1 in the groups with normal bone mass,osteopenia,and osteoporosis.The difference was not statistically significant by rank sum test(P>0.05).2.The questionnaire was based on the international physical activity questionnaire and combined with the physical examination data to make a questionnaire.The questionnaire included the general information of the population: age,height,weight,and body mass index calculated based on height and weight.Menstruation,marriage and child-bearing history: age of menarche,age of first birth,postmenopausal age.Results of physical activity,bone density,follicle stimulating hormone and estrogen.After assigning the binary data,multiple factors regression analysis age(B= 1.527,P=0.044),postmenopausal age(B = 1.808,P = 0.175),body mass index(B=1.361,P=0.410),estrogen(B=3.903,P=0.021),follicle-stimulating hormone(B=2.894,P=0.005),and physical activity(B=2.328,P=0.015),menarche(B=0.614,P=0.562),age,estrogen,follicle-stimulating hormone,physical activity group P>0.05,The difference was statistically significant.Conclusion:1.The incidence of osteoporosis in women increases significantly with age,and the risk of osteoporosis in female with low body mass index is higher.Menopause is an important factor affecting the decrease of bone density in women,and the incidence of osteoporosis increases significantly with the increase of menopause.2.Age,estrogen,follicle stimulating hormone and physical activity were independent influencing factors of bone density,estrogen and physical activity were protective factors of osteoporosis,and follicle stimulating hormone and age were risk factors of osteoporosis. |
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