中华骨质疏松和骨矿盐疾病杂志2025，Vol.18Issue(5)：536-542,7.DOI:10.3969/j.issn.1674-2591.2025.05.004
40～60岁女性体检人群腰椎骨密度纵向轨迹分析
Longitudinal trajectory analysis of bone mineral density at lumbar spine in female physical examination population aged between 40 and 60 years
摘要
Abstract
Objective To analyze the dynamic changes in bone mineral density(BMD)at lumbar spine among female participants aged from 40 to 60 years undergoing routine health check-ups during the phase of bone loss,and to in-vestigate the crowd characteristics of different trajectory groups.Methods A cohort of female individuals aged 40-60 years who underwent consecutive health check-ups from January 2018 to September 2023 at the Health Management Center of the First Affiliated Hospital of University of Science and Technology of China were recruited.General information and la-boratory test results were collected.Group-based trajectory modeling was employed to construct and categorize the develop-mental trajectories of BMD over time.Kruskal-Wallis H test was used for univariate analysis to identify the characteristics at different trajectory groups.Multivariable logistic regression analysis was performed to estimate the associations between various trajectory groups and the influencing factors.Results A total of 274 participants were included in the study.Ac-cording to the longitudinal variation of T-scores,the model can be categorized into three groups:the rapid decline group(n=46,16.8%,-3.3≤T≤-1.8),the slow decline group(n=111,40.5%,-2≤T≤-1.1)and the stable group(n=117,42.7%,-1.5≤T≤0.7).Multivariable logistic regression analysis results showed that compared to the stable group,the decreases of BMI(OR=0.89,P=0.038),uric acid(UA,OR=0.99,P＜0.001)and total cholesterol(TC,OR=0.21,P＜0.001)were associated with a rapid BMD decline.The rising of age(OR=1.22,P＜0.001),al-kaline phosphatase(ALP,OR=1.02,P=0.008)and low-density lipoprotein cholesterol(LDL-C,OR=3.31,P=0.003)were also related to rapid BMD decline.The decreases of BMI(OR=0.87,P＜0.001)and TC(OR=0.61,P=0.014)were associated with slow BMD decline and the rising of age(OR=1.12,P＜0.001)was also relevant.Conclusion During the phase of bone loss,BMD at lumbar spine generally exhibits a declining trend,with a faster de-cline observed in individuals with lower baseline T-scores.Factors such as age,LDL-C,ALP,UA,BMI and TC are closely related to BMD decline.Therefore,special attention should be paid to the bone health of women aged over 50 years,with low body weight and TC levels,and high LDL-C and ALP levels.关键词
骨量减少/骨密度/组轨迹模型/体检人群Key words
low bone mass/bone mineral density/group-based trajectory model/health check-up population分类
医药卫生引用本文复制引用
黎雨婷,姚蓓,刘雪晗,刘宇飞,李义娜,杨春梅..40～60岁女性体检人群腰椎骨密度纵向轨迹分析[J].中华骨质疏松和骨矿盐疾病杂志,2025,18(5):536-542,7.基金项目
国家自然科学基金(72404258、72072169) （72404258、72072169）
