CAJ | 학술논문

目的探讨高龄老年男性和女性骨健康状况差异。方法将2004年5月至2008年10月在复旦大学附属华东医院进行双能X线骨密度仪测定骨密度（ bone mineral density ， BMD）≥60岁及以上的老年男性1227例和女性1637例纳入本研究，按每10岁为1个年龄段分组，比较各组腰椎、髋部骨密度和骨生化指标及骨折发生率。结果（1） BMD：年龄≥90岁男性组髋部各部位骨密度、男性80～89岁组、70～79岁组、60～69岁组腰椎与髋部均明显高于同年龄组女性骨密度，差异有统计学意义（ P均＜0.05）。（2）骨折发生率：至少1次骨折的发生率60～69岁组、70～79岁组、80～89岁组女性均明显高于同年龄男性组，差异有统计学意义（P均＜0.05）。（3）骨生物化学标志物：60～69岁组、70～79岁组血清骨钙素（osteocalcin， BGP）、尿骨吸收标志物Ⅰ型胶原羧基端肽／肌酐（ carboxy terminal peptide of type Ⅰ collagen／crea， CTX／cr）、尿吡啶啉／肌酐（pyridinoline／crea， Pyd／Cr）、尿脱氧吡啶啉／肌酐（deoxypyridinoline／crea， D-Pyd／Cr）均明显高于同年龄男性组，差异有统计学意义（ P均＜0.05）。80～89岁组女性尿Pyd／Cr、 D-Pyd／Cr均明显高于同年龄段男性，差异有统计学意义（ P＜0.05）。结论性别影响高龄老人骨密度和骨折发生率，性别对高龄老人骨代谢标志物有影响。
목적탐토고령노년남성화녀성골건강상황차이。방법장2004년5월지2008년10월재복단대학부속화동의원진행쌍능X선골밀도의측정골밀도（ bone mineral density ， BMD）≥60세급이상적노년남성1227례화녀성1637례납입본연구，안매10세위1개년령단분조，비교각조요추、관부골밀도화골생화지표급골절발생솔。결과（1） BMD：년령≥90세남성조관부각부위골밀도、남성80～89세조、70～79세조、60～69세조요추여관부균명현고우동년령조녀성골밀도，차이유통계학의의（ P균＜0.05）。（2）골절발생솔：지소1차골절적발생솔60～69세조、70～79세조、80～89세조녀성균명현고우동년령남성조，차이유통계학의의（P균＜0.05）。（3）골생물화학표지물：60～69세조、70～79세조혈청골개소（osteocalcin， BGP）、뇨골흡수표지물Ⅰ형효원최기단태／기항（ carboxy terminal peptide of type Ⅰ collagen／crea， CTX／cr）、뇨필정람／기항（pyridinoline／crea， Pyd／Cr）、뇨탈양필정람／기항（deoxypyridinoline／crea， D-Pyd／Cr）균명현고우동년령남성조，차이유통계학의의（ P균＜0.05）。80～89세조녀성뇨Pyd／Cr、 D-Pyd／Cr균명현고우동년령단남성，차이유통계학의의（ P＜0.05）。결론성별영향고령노인골밀도화골절발생솔，성별대고령노인골대사표지물유영향。
Objective To investgate the differences of bone health between old men and women .Methods From May 2004 to October 2008, bone mineral density (BMD) of 1 227 old men and 1 637 old women were measured by ho-logic dephiA dual energy X-ray absorptiometry ( DXEA) and bone turnover markers were determined .All data were com-pared and statistically analyzed between each group which were devided by every ten years .Results (1) BMD: There were significant significant increases in BMD of hip at age≥90 years and BMD of the lumbar vertebral , at age 80-89 , 70-79, 60-69 year-old of men compared with those of women (P<0.05).(2) Fracture incidence: There were sig-nificant increases in fracture incidences at age 60-69 , 70-79 , 80-89 year-old of women compared with those of men (P<0.05).(3) Bone turnover marker:There were significant increases in serum BGP values at the age of 60-69, 70-79 year-old of women compared with those of men ( P<0.05 ) .There were significant increases in urine carboxy ter-minal peptide of type I collagen /crea ( CTX/Cr ) , pyridinoline/crea ( Pyd/cr ) , deoxypyridinoline/crea ( D-Pyd/Cr ) levels at age 60-69 , 70-79 year-old of women compared with those of men ( P<0.05 ) .There were significant in-creased Pyd/cr, D-Pyd /Cr in arine values at the age 80-89 year-old of women compared with those of men .Conclu-sion There was significant increased in BMD in aged men compared with those of aged women .The risk of fracture was significantly increased in aged women compared with those of men .There were significant increases in bone turnover markers levels in old women compared with those of men .These gender-and age factors need to be considered for the pre-vention and management of osteoporosis .These results demonstrated the effects of gender on BMD , the risk of fracture, and bone turnover markers in aged men and women .