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骨质疏松的影响因素研究

Affect Factors of Osteoporosis

作者: 专业:体育教育训练学 导师:郭海英 年度:2010 学位:硕士  院校: 浙江师范大学

Keywords

Osteoporosis, Impact factor, Body Composition, Exercise

        目的:通过调查研究分析,探索影响人体骨质疏松的相关因素,从不同方面提出预防和改善骨质疏松的措施和建议,旨在降低骨质疏松症的发生率和提高人们的生活质量。方法:本研究利用美国GE跟骨超声骨密度测量仪及Inbody 3.0人体成份分析仪随机对浙江省的600位居民分别进行跟骨定量超声参数及身体成份的测定,并对这些人群进行问卷调查,内容包括:性别、年龄、运动情况、妇科情况(月经初潮年龄、停经年龄、初产年龄)、是否吸烟、是否喝酒等。对获得的数据进行单方差分析和Logistic回归分析。结果:男女的骨强度值(STI)和T值的峰值都出现在30~39岁,其中男性:STI=111.04±12.00,T=0.68±1.00;女:STI=103.63±8.21,T=0.44±1.06.随着年龄的增加,STI和T值都呈下降的趋势,到60岁以上时,低于其他4个年龄段的值,男性:STI=86.64±12.30,T=-0.96±1.32;女性:STI=75.90±9.67,T=-1.42±1.08。女性在每个年龄段的STI和T值都低于男性,并存在非常显著的差异。女性的初潮时间、初产时间和绝经都会影响女性的Z值。高血压、糖尿病患者的Z值明显低于正常人,但高血脂对Z值影响不大。参加运动者的Z值比不参加运动者高,且存在显著差异,但当每周运动次数大于3次时,Z值低于第周运动1-3次的人群。少量饮酒者的Z值高于不饮酒者以及中量和大量饮酒者,且存在显著的差异。当吸烟量每天超过10支且吸烟年限超过10年的吸烟者的Z值低于不吸烟者和少量吸烟者的值,且存在显著的差异。补充维生素D者比不补充维生素D者的Z值高,日常出行走路或骑车者的Z值比以车为代步工具者高,且存在显著的差异。通过Logistic回归分析,进入男性骨强度影响因素回归方程的是年龄、是否参加体育锻炼和右下肢水分含量;进入女性骨强度影响因素回归方程的是年龄、是否绝经、是否参加体育锻炼、疾病和是否补充维生素D。结论:(1)随着年龄的增长,骨质疏松的发生率增加,女性在各年龄阶段骨质疏松的发生率均高于男性。(2)女性初潮过晚或初产过早都会降低骨峰值量,绝经后女性的骨量明显低于绝经前。(3)高血压、糖尿病会导致骨量降低,而高血脂与骨量没有相关联系。(4)体育锻炼会提高骨量,减少骨质疏松的发生率,但要控制合理的运动负荷;有关运动项目与骨量的关系有待进一步研究。(5)日常生活习惯中吸烟和饮酒是导致骨质疏松的危险因素之一,出行方式以走路或骑车为主有利于提高骨密度,促进钙的补充和吸收对预防骨质疏松起到积极的作用。(6)增加肌肉含量对提高男女骨量都有积极的作用,相对较高的脂肪含量对维持女性骨量有积极的作用。(7)本研究中对男性骨质疏松发病率有显著性相关的因素依次是年龄、体育锻炼和右下肢水分含量;对女性骨质疏松发病率有显著性相关的因素依次为年龄、绝经、体育锻炼、疾病和维生素D的补充。
    Objective:Through investigation and research and analysis, explore the impact of human factors related to osteoporosis, made from different aspects of osteoporosis prevention and improvement measures and recommendations aimed at reducing the incidence of osteoporosis and improve people’s quality of life.Methods:In this study, Adopted the United States GE heel ultrasound bone density measuring instrument and Inbody 3.0 human composition analysis instrument, we measured respectively calcaneus ultrasound bone mineral density for 600 residents in Hangzhou, Anji, Linhai, and Yuhuan of Zhejiang Province.Besides, we performed questionnaire survey for these groups, including gender, age, physical conditions, gynecological conditions (age of menarche, menopause age, primiparous age), smoking or not, drinking or not, etc. Then we made univariate analysis and Logistic regression analysis for the obtained data.Results:The peak values of bone strength Index (STI) and T of the wrinkly men and women all appear in the 30 to 39 years old. The STI and T of men is 111.04±12.00 and 0.68±1.00 respectively, and that of women is 103.63±8.21 and 0.44±1.06 respectively. Along with aging, the STI and T show decreasing trend. The STI and T reach a minimum value above the age of 60 compared with the other four age groups. In this condition, the STI and T of men is 86.64±12.30 and -0.96±1.32 respectively, and that of women is 75.90±9.67 and -1.42±1.08 respectively.The STI and T of women is lower than that of men in each age group, and the difference is every significant. The menarche age, primiparous time and menopause all affect the Z value of women. The Z value of hypertension and diabetic patients are lower than that of normal, and the difference is significant. However, the effect of hyperlipidemia on the Z value is not obvious.The Z value of is higher than that of out of the physical exerciser, and the difference is significant. But the Z value will decrease when exercise time is more than 3 every month. The Z value of basketball player is higher than that of walker, and the difference is significant.The Z value of low doses of Alcohol is higher than that of moderate and heavy doses of Alcohol, and the difference is significant. The Z value of smokers who have smoking more than ten years and smoke ten cigarettes every day is higher than that of non-smokers and milder smokers, and the difference is significant. The Z value of Vitamin D supplementation group is higher than the group without Vitamin D supplementation, and the difference is significant.The Z value of walker and cycler is higher than the driver group, and the difference is significant.Through Logistic regression analysis, it is concluded that age, regular physical activity and water content in right lower extremity were the major factors for men, and age, menopause, regular physical activity, illness and Vitamin D supplementation were the major factors for women.Conclusion:(1) The risk of osteoporosis increases with aging in the wrinkly people, among which the risk in women is higher than that in men.(2) It will reduce women’s peak bone mass if the menarche is too late or the primiparity is too early. Due to hormonal reasons, women’s bone mass in postmenopausal is lower than in pre-menopausal.(3)Hypertension and diabetes can reduce bone mass, while the influence of hyperlipidemia on bone mass has no significant difference.(4)Physical exercise can increase bone mass and reduce the incidence of osteoporosis. However, the amount of exercise should be appropriate. The comprehensive items is the best choice.(5) Smoking and drinking are risk factors for osteoporosis in daily life, while walking or bicycle riding can enhance bone mineral density, and supplying adequate calcium can prevent osteoporosis.(6)Muscle content of lower extremity have a positive role in promoting bone mass of men and women. Fat content has a positive role on women’s bone mass, but has no significant effect on men.(7) The factors that affect significantly the incidence of osteoporosis in men are age, physical exercise, and water content of right lower extremity. The factors that affect significantly the incidence of osteoporosis in women are age, age, menopause, regular physical activity, illness and Vitamin D supplementation
        

骨质疏松的影响因素研究

摘要3-5
ABSTRACT5-6
目录7-9
符号说明9-10
1 前言10-11
2 文献综述11-20
    2.1 骨质疏松概述11
    2.2 骨质疏松的研究现状11-13
        2.2.1 骨质疏松的测量方法11-12
        2.2.2 超声骨密度测试仪的评价指标12-13
    2.3 骨质疏松的影响因素13-20
        2.3.1 年龄13
        2.3.2 性别13-14
        2.3.3 种族和遗传14
        2.3.4 身体成分14-15
        2.3.5 激素和调节因子15-16
        2.3.6 疾病16
        2.3.7 运动16-18
        2.3.8 营养因素18
        2.3.9 吸烟和饮酒18-20
3 研究对象与方法20-23
    3.1 研究对象20
    3.2 研究方法20-23
        3.3.1 骨密度测量法20-21
        3.3.2 人体成分测试法21-22
        3.3.3 问卷调查法22
        3.3.4 数量统计法22-23
4 研究结果23-37
    4.1 影响骨质疏松的相关因素23-34
        4.1.1 年龄对骨密度和骨强度的影响23-24
        4.1.2 性别对骨密度和骨强度的影响24-25
        4.1.3 初潮年龄对女性Z值的影响25-26
        4.1.4 初产年龄对女性Z值的影响26
        4.1.5 绝经对女性Z值的影响26-27
        4.1.6 疾病对Z值的影响27-28
        4.1.7 运动次数对Z值的影响28-29
        4.1.8 不同运动方式对Z值的影响29
        4.1.9 饮酒对Z值的影响29-30
        4.1.10 吸烟对Z值的影响30-31
        4.1.11 补充维生素D对Z值的影响31-32
        4.1.12 日常出行方式对Z值的影响32
        4.1.13 身体成分对骨质疏松的影响32-34
    4.2 影响因素与骨质疏松发病率的1ogistic回归结果34-37
5 分析与讨论37-44
    5.1 骨质疏松的影响因素分析37-42
        5.1.1 年龄对骨质疏松的影响37
        5.1.2 性别对骨质疏松的影响37
        5.1.3 女性初潮、初产年龄以及绝经对女性骨质疏松的影响37-39
        5.1.4 疾病对骨质疏松的影响39
        5.1.5 运动对骨质疏松的影响39-40
        5.1.6 饮酒和吸烟对骨质疏松的影响40-41
        5.1.7 营养和出行方式对骨质疏松的影响41
        5.1.8 身体成份对骨质疏松的影响41-42
    5.2 影响因素与骨质疏松发病率的1ogistic回归分析42-44
6 研究结论44-45
参考文献45-50
附录 影响骨质疏松的因素分析问卷调查表50-51
攻读学位期间取得的研究成果51-52
致谢52-53
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