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目的采用双能X线吸收(DXA)和定量CT(QCT)对比评价北京地区中老年女性骨密度与年龄相关的骨丢失。方法收集北京地区接受腰椎正位及髋部DXA检查(面积骨密度测量)的社区女性10 472名,接受腰椎QCT检查(体积骨密度测量)的女性562名。将接受两种检查的受检者分别按每10岁年龄段分组。计算各组别的平均骨密度,并计算峰值骨密度各组别的骨丢失率,分析骨密度与年龄间的相关性。结果 DXA测量北京地区女性腰椎、股骨颈及全髋部的峰值骨密度均在30~39岁年龄组,40岁以后各部位骨密度开始不同程度减低,至80~94岁组腰椎、股骨颈、全髋部累计骨丢失率分别为21.7%、31.4%和29.5%;QCT测量腰椎松质骨的峰值骨密度在20~29岁组,至80~97岁组累计骨丢失率达58.2%。累计骨丢失率从高到低依次为腰椎松质骨>股骨颈>全髋部>腰椎正位。结论腰椎QCT可较DXA更早、更准确地显示中老年女性的骨丢失情况,对增龄性骨丢失更敏感。
Objective To compare bone mineral density (BMD) and age-related bone loss (BMD) among middle-aged and elderly women in Beijing by using dual energy X-ray absorptiometry (DXA) and quantitative CT (QCT) Methods A total of 10 472 female community residents in Beijing who underwent DXA examination of the lumbar spine and hip (BMD measurement) and 562 women who underwent QCT examination of the lumbar spine (bulk BMD) were collected. Subjects who underwent both examinations were grouped by age group of 10 years. Calculate the average bone mineral density of each group, and calculate the peak bone mineral density of bone loss rate of each group, analysis of bone mineral density and age-related. Results The BMD of lumbar vertebra, femoral neck and total hip of women in Beijing area were all in the 30-39 age group. The bone mineral density of each site began to decrease to varying degrees after 40 years old. The lumbar spine, femoral neck, The total bone loss rate of total hip were 21.7%, 31.4% and 29.5%, respectively. The peak BMD of lumbar cancellous bone measured by QCT was between 20 and 29 years old, and the cumulative bone loss rate reached 58.2% in 80 ~ 97 years old group. The cumulative loss rate of bone from high to low was lumbar cancellous bone> femoral neck> total hip> lumbar spine. Conclusion Lumbar QCT can be earlier than DXA, more accurately show the bone loss in middle-aged and elderly women, more sensitive to age-related bone loss.