Epidemiological Survey Of Osteoporosis And Evaluation Of Different Therapeutic Methods In Qingyunpu District Of Nanchang

Objective:The prevalence and demographic characteristics of osteoporosis?OP?in community residents above 40 years old in Qingyunpu District of Nanchang were investigated,and the risk factors of OP were analyzed.Afterwards,in order to find out the optimal treatment,three different treatments were prospectively observed in these OP patients.Method:A questionnaire was designed for the investigation in 3800 people aged over 40years old in Qingyunpu District of Nanchang in a cross-sectional epidemiological survey.Basic demographic information,family history,past medical history,lifestyle and menstrual information were collected.Also,bone mineral density?BMD?in lumbar spine 1⁴?L1⁴?and the femoral neck was performed by dual energy X-ray absorptiometry,and physical examination was done.In males and females,the prevalence of OP were calculated and the influencing factors of OP were analyzed by univariate logistic regression.Sequential multiple classification logistic stepwise regression analysis was carried out to calculate odd ratio?OR?and confidence interval?CI?.The risk factors and protective factors of OP were respectively analyzed.300 patients who met the diagnostic criteria of OP were chosen and randomly divided into three groups including basic treatment,alendronate and zoledronic acid.The levels of BMD,serum PINP and beta-CTX and the ratio of new brittle fracture were measured regularly in the first month,the twelfth month,the twenty-fourth month and the thirty-sixth month,respectively.Result:1.The prevalence of OP in the residents above 40 years old in Qingyunpu District of Nanchang was 16.77%.The prevalence of OP was 11.12%in males,and22.93%in females.2.In the single factor logistic analysis,it was suggested that age,education level,alcohol consumption,family history,BMI and systolic blood pressure might relate to BMD in males.Next,in the ordinal multiple logistic stepwise regression analysis,it was showed that the elderly and family history of OP were the risk factors for OP in males?p<0.05?,and the higher education level and higher BMI were possible protective factors?p<0.05?.3.In the single factor logistic analysis,it was suggested that BMI,hip circumference,menopause age,age,family history,drinking condition,milk consumption,menopausal status and parity might relate to BMD in females.Next,in the stepwise regression analysis,it was showed that osteoporosis family history,advanced age,prolificacy and menopause were the risk factors for OP in females?p<0.05?,and high BMI,late menopause,frequent consumption of milk were possible protective factors?p<0.05?.4.All of basic treatment,alendronate and zoledronic acid treatment could effectively increase the BMD of the L1⁴ and the femoral neck?p<0.05?,and reduce the serum PINP,beta-CTX,the proportion of new brittle fracture?p<0.05?.5.In the 12^th month,compared with the basic treatment group,the BMD of L1⁴and femoral neck in the alendronate group were increased significantly?p<0.05?,and the serum beta-CTX and new brittle fracture were decreased?p<0.05?.Also,BMD in L1⁴ and femoral neck in the zoledronic acid group were increased significantly?p<0.05?,and the serum PINP,beta-CTX and new brittle fracture were decreased?p<0.05?.Compared with the alendronate group,the serum PINP and new brittle fracture in L1⁴ were decreased significantly?p<0.05?in the zoledronic acid group,but no significant differences were found in the BMD of L1⁴ and femoral neck,and the serum beta-CTX?p>0.05?.5.In the 24^th month,compared with the basic treatment group,the BMD of L1⁴in the alendronate group and the zoledronic acid group increased significantly?p<0.05?,and the serum PINP,beta-CTX and new brittle fracture decreased?p<0.05?.Compared with the alendronate group,the BMD of L1⁴ and femoral neck in the zoledronic acid group increased significantly?p<0.05?,and the serum PINP,beta-CTX and new brittle fracture decreased?p<0.05?.In the basic treatment group,no significant differences were found in lumbar and femoral neck BMD,serum PINP,beta-CTX and new brittle fracture in the 12^th months and the 24^th months?p>0.05?.In alendronate group,compared with the 12^th month,significant differences were discovered in L1⁴ and femoral neck BMD,the serum PINP and new brittle fracture in the 24^th month?p<0.05?,but no significant differences in serum beta-CTX level?p>0.05?.In zoledronic acid group,compared with the 12^th month,significant differences were discovered in L1⁴ and femoral neck BMD,and beta-CTX level in the 24^th month?p<0.05?,but no significant differences in the serum PINP level and new brittle fracture?p>0.05?.6.In the 36^th month,compared with the basic treatment,the BMD of L1⁴ and femoral neck in the alendronate group and the zoledronic acid group were significantly increased?p<0.05?,and the serum PINP,beta-CTX and new brittle fracture were decreased?p<0.05?.,no significant differences were found in the BMD of L1⁴ and femoral neck,serum PINP,beta-CTX and new brittle fracture between the zoledronic acid group and the alendronate group?p>0.05?.In the basic treatment group,no differences were showed in the BMD of L1⁴ and femoral neck,serum PINP,beta-CTX,and new brittle fracture,compared with in the 24^th month.In the alendronate group,compared with in the 24^th month,significant differences were found in the BMD of L1⁴ and femoral neck in the 36^th month?p<0.05?,but no differences in the serum PINP,beta-CTX and new brittle fracture?p>0.05?.In the zoledronic acid group,compared with in the 24^th month,no differences were discovered in the BMD of L1⁴ and femoral neck,serum PINP,beta-CTX,and the new brittle fracture?p>0.05?.7.Higher effectiveness was showed in the alendronate group and the zoledronic than in the basic treatment group?p<0.01?,but no difference between the alendronate group and the zoledronic acid group?p>0.05?.Conclusion:1.The prevalence of OP in the residents aged 40 and above in Qingyunpu District of Nanchang was 16.77%,11.12%in males and 22.93%in females.The prevalence was gradually increased with the age.2.Age and family history of OP were the independent risk factors for OP in males,while higher education level and higher BMI were the protective factors.Family history of OP,age,prolificacy and menopause were the independent risk factors for OP in females,while high BMI,late menopause,and frequent consumption of milk were the protective factors.3.After 12 month short-term therapy,similar effects was showed in the zoledronic acid and alendronate group.Higher BMD and bone turnover both in zoledronic acid and alendronate group were discovered than in the basic treatment.After 24 month middle-term therapy,the effectiveness was better in the zoledronic acid than in the alendronate.After 36 month long-term therapy,no difference in the effectiveness in the zoledronic acid and the alendronate.