社区骨质疏松症高危人群筛查及其影响因素分析
Risk screening of osteoporosis in community residents and its influencing factors
目的 通过对社区骨质疏松症(osteoporosis,OP)高危人群的筛查,分析OP的影响因素.方法 采用多阶段整群抽样法,于江苏省6个城市随机选择6个城区,每个城区再随机抽取3个社区,对社区内40~69岁居民进行问卷调查和身体测量,问卷调查内容包括:基本信息、OP风险评估(采用国际骨质疏松症基金会的1 min测试题)、健康状况、日常生活方式(近12个月).高危人群与相关影响因素间的关系采用非条件Logistic回归分析.结果 共回收有效问卷6577份.男性2069人(31.46%),女性4508人(68.54%).共166例(2.52%)居民自报曾被诊断为OP,男性自报患病率(1.55%)低于女性(2.97%),差异有统计学意义(χ2=11.719,P<0.01),60~69岁人群自报患病率高于40~49岁人群,差异有统计学意义(χ2=44.766,P<0.01).高危人群共3400例(51.70%).男性(OR=1.845),年龄(50~59岁和60~69岁较40~49岁OR=2.171、2.854),文化程度(大专以上学历较小学初中学历,OR=0.517),职业(技术办事人员、商业服务业、农林牧渔等、生产运输业较机关公务员OR=2.289、2.224、2.258和2.552),以及自报慢性病史(OR=1.596)、骨折史(OR=4.061)、身体疼痛史(OR=2.286)、脚抽筋史(OR=1.923)、钙/维生素D摄入(OR=1.357)、增加日照(OR=1.256)、每天步数5000以上(OR=1.336)和体质指数>24.0 kg/m2(OR=1.322)是OP高危的影响因素.结论 40~69岁的人群中,OP高危人群比例较高,性别、年龄、文化程度、职业、不良身体状况和生活方式均是OP高危的影响因素,应加强对社区居民OP筛查,并对OP危险因素进行进一步研究.
更多Objective To explore the influencing factors of high risk osteoporosis (OP) population. Methods Using multi-stage cluster sampling method, 1 district was selected from each of the 6 cities randomly, then 3 communities were selected from each district randomly. Questionnaire investigation and physical examination were applied to community residents aged 40-69 years old. The questionnaire mainly included basic information, OP risk assessment (using the 1 minute test method developed by the International OP Foundation), health status and lifestyle information (recent 12 months). The relationship between high-risk groups and influencing factors was analyzed by unconditional logistic regression. Results Totally 6577 valid questionnaires were collected, 2069 were male (31.46%) and 4508 were female (68.54%). A total of 166 cases (2.52%) were found as self-reported OP patients at the age of 40-69, self-reported rate of male (1.55%) was lower than that of female (2.97%) (χ2=11.719, P<0.01), the rate was higher among people aged 60-69 years than people aged 40-49 (χ2=44.766, P<0.01);3400 cases (52.28%) were found as high-risk individuals,there were more male at higher risk than female (OR=1.845). Among different age groups, the 50-59 and 60-69 years age groups had more high risk people than that of 40-49 years group (with OR=2.171 and OR=2.854 respectively). Comparative analysis was also conducted for the following factors: degree of education [college or above (OR=0.517) compared with primary school or junior middle school], occupation [compared with civil servants, technical management personnel (OR=2.289), business services (OR=2.224), farming/forestry/fishing (OR=2.258) and production/transportation staff (OR=2.552)], self-reported history of chronic disease (OR=1.596), fracture (OR=4.061), body pain (OR=2.286) and foot cramps (OR=1.923), as well as calcium/vitamin D intake (OR=1.357), increased sunlight (OR=1.256), daily walking steps>5000 (OR=1.336) and BMI>24.00 (OR=1.322), they were all related to a increased proportion of high risk population. Conclusion The proportion of OP high-risk groups is higher among people aged 40-69. Gender, age, cultural level, occupation, bad health status and lifestyle changes are closely related to higher OP risk. Community residents OP screening should be continued to further study the risk factors of OP.
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