中国全科医学 ›› 2023, Vol. 26 ›› Issue (22): 2778-2784.DOI: 10.12114/j.issn.1007-9572.2022.0171

• 论著·中老年人群健康研究 • 上一篇    下一篇

社区老年人骨质疏松患病情况及全科防控策略

孟凡1,*(), 董敏洁1, 郭瑾1, 许松涛1, 严薇1, 顾俊1, 陈忆蓉1, 杨乘1, 王军1, 夏丽芳1, 陈俊1, 富灵杰2   

  1. 1.200001 上海市黄浦区外滩社区卫生服务中心
    2.200011 上海市第九人民医院骨科
  • 收稿日期:2022-05-15 修回日期:2022-11-13 出版日期:2023-08-05 发布日期:2023-05-11
  • 通讯作者: 孟凡

  • 作者贡献: 孟凡负责研究设计、论文撰写;董敏洁、郭瑾、许松涛、严薇、顾俊参与设计,辅助研究;陈忆蓉、杨乘、王军、夏丽芳、陈俊、富灵杰收集与分析数据。
  • 基金资助:
    2020年黄浦区卫生健康委员会、黄浦区科学技术委员会科研项目(HLM202034); 上海交通大学医学院附属第九人民医院重大创新孵化项目(JYJC201809)

Osteoporosis in Community-dwelling Elderly People: Prevalence and Associated Prevention and Control Strategies in General Practice

MENG Fan1,*(), DONG Minjie1, GUO Jin1, XU Songtao1, YAN Wei1, GU Jun1, CHEN Yirong1, YANG Cheng1, WANG Jun1, XIA Lifang1, CHEN Jun1, FU Lingjie2   

  1. 1. Huangpu District Waitan Community Health Service Center, Shanghai 200001, China
    2. Department of Orthopedics, Shanghai Ninth People's Hospital, Shanghai 200011, China
  • Received:2022-05-15 Revised:2022-11-13 Published:2023-08-05 Online:2023-05-11
  • Contact: MENG Fan

摘要: 背景 骨质疏松人群逐渐增多,社区低骨量人群也日益增长,给社区开展骨质疏松防治工作带来严峻挑战。 目的 摸清社区开展骨质疏松防治工作时相关的基础条件,包括纳入骨质疏松防治对象基本流程与成本、防治对象现患情况与危险因素分布情况,为全科团队制定精准防控措施提供证据支持。 方法 于2021年5—8月,在上海市外滩社区选取门诊就诊人群和老年体检人群322例为研究对象,采用问卷调查法收集调查对象一般情况、骨密度测试结果、骨质疏松危险因素情况。 结果 本社区骨质疏松防治对象纳入成本为57.344元/人。322例研究对象中,27例(8.4%)骨量正常,157例(48.8%)为低骨量,138例(42.8%)为骨质疏松,骨密度异常率达91.6%(低骨量+骨质疏松)。骨量正常、低骨量、骨质疏松人群性别、BMI比较,差异有统计学意义(P<0.05)。骨量正常、低骨量、骨质疏松人群平均骨密度值为(-0.72±0.27)、(-1.88±0.38)、(-3.17±0.53)AU/mm3。运动习惯上,骨量正常、低骨量、骨质疏松组几乎不运动者占比分别为37.0%(10/27)、49.7%(78/157)、64.5%(89/138);运动强度上,骨量正常、低骨量、骨质疏松组运动强度为适中者占比分别为74.1%(20/27)、79.6%(125/157)、80.4%(111/138)。三组其他骨质疏松高危因素,如手术史、吸烟史、过敏史和疾病史方面差别不大。饮食习惯上,骨量正常、低骨量、骨质疏松组没有太大差异;48.8%(157/322)的人群从不饮用啤酒、白酒及红酒,32.0%(103/322)的人群咖啡饮用频率为4~6次/周,31.4%(101/322)的人群腌菜/熏酱类摄入频率为4~6次/周。 结论 社区骨质疏松防治对象入组周期短、所花成本低,社区是开展防治工作和临床研究工作的优势场所。社区老年人运动和饮食习惯不容乐观,全科团队应基于精确数据,精准引导社区居民短时间内迅速改善膳食结构,建立运动习惯,主动管控骨质疏松发病进程。

关键词: 骨质疏松, 老年人, 低骨量, 饮食, 运动, 生活方式, 社区卫生服务, 健康促进

Abstract:

Background

The continuous increase in numbers of people with osteoporosis, and individuals with low bone mass in the community, brings severe challenges to the prevention and treatment of osteoporosis in the community.

Objective

To investigate the basic conditions related to the prevention and control of osteoporosis in communities, including the basic process and cost of enrolling the target population, and the prevalence and risk factors of osteoporosis in the target population, so as to provide evidence for supporting a general practice team to develop precise osteoporosis prevention and control measures.

Methods

This study selected 322 cases (including outpatient patients and older physical examinees) from Waitan Community Health Service Center, Shanghai from May to August 2021. General information, bone density test results and risk factors of osteoporosis were collected by a questionnaire.

Results

The cost of enrolling the target population in the community was 57.344 yuan per person. Among the 322 cases, 27 (8.4%) had normal bone mass, 157 (48.8%) had low bone mass, and 138 (42.8%) had osteoporosis. The prevalence of bone density abnormalities (low bone mass and osteoporosis) reached 91.6%. There were statistically significant differences in gender ratio and BMI among normal bone mass, low bone mass and osteoporosis groups (P<0.05). The average bone mineral density (BMD) values of normal bone mass, low bone mass and osteoporosis groups were (-0.72±0.27) AU/mm3, (-1.88±0.38) AU/mm3, and (-3.17±0.53) AU/mm3, respectively. In terms of exercise habits, the prevalence of individuals doing little exercise in normal bone mass, low bone mass and osteoporosis groups was 37.0% (10/27), 49.7% (78/157) and 64.5% (89/138), respectively. In terms of exercise intensity, the prevalence of individuals exercising at moderate-intensity in normal bone mass, low bone mass and osteoporosis groups was 74.1% (20/27), 79.6% (125/157) and 80.4% (111/138), respectively. Three groups had no significant differences in the other osteoporosis risk factors, such as surgical treatment history, smoking history, allergy history and disease history. There was also no significant intergroup difference in dietary habits. Of all cases, 48.8% (157/322) never drank beer, liquor and red wine, 32.0% (103/322) drank coffee 4-6 times per week, and 31.4% (101/322) ate pickled vegetables, smoked foods, or sauces 4-6 times per week.

Conclusion

The community is a favorable setting for conducting prevention, treatment and clinically research programs regarding osteoporosis owing to short participant enrollment period and low cost. As the exercise and eating habits of the elderly in the community are unhealthy, the general practice team should accurately guide them to rapidly improve their dietary structure and develop a healthy exercise habit according to their own status, by which the onset and progression of osteoporosis can be proactively controlled.

Key words: Osteoporosis, Aged, Low bone mass, Diet, Movement, Lifestyle, Community health services, Health promotion