初潮及绝经年龄等因素与绝经后骨质疏松症发病的关系

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目的探讨初潮年龄和绝经年龄、生育次数及哺乳时间与绝经后骨质疏松症发病的关系。方法1999年5月至2003年4月,对已绝经的1472例妇女进行骨密度测定,并对不同月经初潮年龄、绝经年龄、生育次数及哺乳时间妇女的骨质疏松症发生率及骨密度进行分析比较。骨质疏松症的诊断标准为骨密度值低于或等于正常年轻妇女平均骨密度峰值减去2.5个标准差。结果1472例中,共发生骨质疏松症861例,发生率为58.5%。其中绝经年限为1~10年、初潮年龄≥17岁者336例,发生骨质疏松症119例(35.4%);初潮年龄≤13岁者276例,发生骨质疏松症75例(27.2%)。1472例妇女中,初潮年龄11~13岁者,腰椎骨密度为(0.83±0.16)g/cm2;14~16岁者为(0.82±0.16)g/cm2;17~19岁者为(0.80±0.14)g/cm2;初潮年龄11~13岁者与17~19岁者比较,差异有统计学意义(P<0.05)。1472例妇女中,年龄为55~65岁、绝经年龄≤48岁者156例,发生骨质疏松症98例(62.8%);绝经年龄≥54岁者80例,发生骨质疏松症33例(41.3%),两者比较,差异有统计学意义(P<0.01)。1472例妇女中,生育次数≥4次者225例,腰椎、大转子及W ard三角区骨密度分别为(0.76±0.16)、(0.49±0.10)及(0.38±0.19)g/cm2;生育次数≤1次者475例,分别为(0.85±0.15)、(0.57±0.10)及(0.52±0.11)g/cm2,两者各部位骨密度比较,差异均有统计学意义(P<0.05)。1472例妇女中,哺乳时间≥36个月者249例,腰椎、W ard三角区骨密度分别为(0.76±0.16)及(0.40±0.10)g/m2;哺乳时间≤6个月者418例分别为(0.83±0.17)及(0.48±0.12)g/m2,两者各部位骨密度比较,差异均有统计学意义(P<0.05)。结论月经初潮时间晚及绝经时间早的妇女,骨质疏松症的发生率高;生育次数多,哺乳时间长的妇女的骨密度低于生育次数少、哺乳时间短的妇女。 Objective To investigate the relationship between menarche age and menopause age, number of birth and lactation time and the incidence of postmenopausal osteoporosis. Methods From May 1999 to April 2003, the bone mineral density (BMD) of 1472 women who had been in menopause was measured. The incidence of osteoporosis and bone mineral density in women with different menarche age, menopause age, number of births and breastfeeding time analyse and compare. The diagnostic criteria for osteoporosis are bone mineral density values ​​less than or equal to 2.5 standard deviations from the average peak bone mineral density for normal young women. Results A total of 861 cases of osteoporosis occurred in 1472 cases, the incidence was 58.5%. There were 336 cases of osteoporosis (n = 119) (35.4%), 276 cases of menarche ≤13 years old, and 75 cases (27.2%) of osteoporosis occurred during the menopause period of 1 ~ 10 years. . Among 1472 women, the lumbar spine BMD was (0.83 ± 0.16) g / cm2 for menarche aged from 11 to 13 years old; (0.82 ± 0.16) g / cm2 for aged 14-16 years; (0.80 ± 0.14) g / cm2. There was a significant difference between menarche age of 11-13 years and 17-19 years old (P <0.05). Of the 1472 women, 156 were aged 55 to 65 years, 98 (62.8%) had osteoporosis, 80 had menopause, and 33 had osteoporosis 41.3%), the difference between the two was statistically significant (P <0.01). Among 1472 women, there were 225 cases with more than 4 times of fertility. The BMD of lumbar vertebrae, greater trochanter and W ard triangle were (0.76 ± 0.16), (0.49 ± 0.10) and (0.38 ± 0.19) g / ≤1 times, 475 cases were (0.85 ± 0.15), (0.57 ± 0.10) and (0.52 ± 0.11) g / cm2 respectively. There was significant difference in BMD between the two groups (P <0.05). There were 249 cases of lactation time≥36 months among 1472 women, and the BMD of lumbar vertebra and W ard triangle were (0.76 ± 0.16) and (0.40 ± 0.10) g / m2 respectively; 418 cases of lactation time ≤6 months (0.83 ± 0.17) and (0.48 ± 0.12) g / m2 respectively. There was significant difference in BMD between the two groups (P <0.05). Conclusions Women with late menarche and early menopause have a high incidence of osteoporosis. Women with more births and longer lactation time have lower BMD than those with fewer births and shorter lactation time.
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