台灣某一健檢機構中老年男性低骨量相關因素探討

Factors Associated with Low Bone Mass in Middle-aged and Elderly Men Receiving Health Check-ups in Taiwan

背景及目的：20%以上男性終其一生會面臨骨質疏鬆相關的骨折風險，且男性骨折後造成的殘障與第一年內死亡率均較女性為高。台灣在男性骨質疏鬆症研究上甚少。本研究分析台灣男性的低骨量相關盛行率並分析其風險因子。
方法：自2010至2012年收集某一健檢機構50歲以上男性，同時接受腰椎與股骨頸雙能量X光吸收儀檢查者納入分析，若T值<-1.0則定義為低骨量。
結果：總共收集280位男性，平均年齡為59.3±6.3歲，身體質量指數平均為24.8±2.6 kg/m2。腰椎低骨量的盛行率有70人(25.0%)，股骨頸低骨量的盛行率有177人(63.2%)。進一步以邏輯斯複迴歸分析後顯示，腰椎低骨量的負相關因子有身體質量指數（勝算比：0.8；95%信賴區間：0.71- 0.91）和高教育程度（勝算比：0.52; 95%信賴區間：0.28-0.99）；股骨頸低骨量的正相關因子有年齡（勝算比：1.07; 95%信賴區間：1.01-1.12）、每天吸菸者（勝算比：2.69; 95%信賴區間：1.13-6.39），而負相關因子有身體質量指數（勝算比：0.87; 95%信賴區間： 0.77-0.97）和高教育程度（勝算比：0.52; 95%信賴區間：0.28-0.94）。
結論：腰椎與股骨頸低骨量之可改變的風險因子是身體質量指數與吸菸，應可做為未來預防男性低骨量的公衛政策之參考。

Background: It is estimated that approximately 20% of men aged over 50 years will experience an osteoporosis-related fracture, and the rate of the fracture’s leading to disability or even death in the first year is higher in men than in women. However, few studies in Taiwan focus on osteoporosis in men. The study accordingly aimed to to investigate the relative risk factors for low bone mass in middle-aged and elderly men in Taiwan.
Methods: Men aged 50 and over and receiving health examinations between 2010 and 2012 at a health examination center in Taipei were enrolled. Low bone mass was defined as T-score <-1.0 by dual-energy x-ray absorptiometry (DXA) examination. Multiple logistic regression analysis was conducted to estimate the odds ratios of related factors.
Results: A total of 280 men were enrolled in this study, and the prevalences of low bone mass of lumbar spine and femoral neck were 25.0% and 63.2%, respectively. Multiple logistic regression analysis identified a correlation between BMI (OR: 0.8; 95% CI: 0.71- 0.91), high education level (>12 years) (OR: 0.52; 95% CI: 0.28-0.99) and low bone mass of lumbar spine. On the other hand, risk factors associated with low bone mass of femoral neck included age (OR: 1.07; 95% CI: 1.01-1.12), BMI (OR: 0.87; 95% CI: 0.77-0.97), smoking everyday (OR: 2.69; 95% CI: 1.13-6.39), and high education level (>12 years) (OR: 0.52; 95% CI: 0.28-0.94) were correlated with low bone mass of femoral neck.
Conclusions: Smoking and lower BMI are the risk factors of low bone mass in men, a finding that has policy implications in Taiwan.