Changes in femur neck bone density in US adults between 1988-1994 and 2005-2008: demographic patterns and possible determinants
Changes in femur neck bone density in US adults between 1988-1994 and 2005-2008: demographic patterns and possible determinants
复制标题
DOI：
10.1007/s00198-011-1623-0
复制
发表时间：
2012-02-01
影响因子：
4
通讯作者：
Shepherd, J. A.
中科院分区：
文献类型：
--
作者：
Looker, A. C.;Melton, L. J., III;Shepherd, J. A.
本分析比较了1988-1994年国家健康与营养调查（NHANES） III和2005-2008年NHANES之间成人股骨颈骨密度（FNBMD）和骨骼决定因素。NHANES 2005-2008的FNBMD高于NHANES III，但调查间差异因年龄、性别和种族/民族而异。老年白人女性的FNBMD改善的可能性最大。最近关于髋部骨折发生率和股骨颈骨质疏松症的数据表明，自20世纪90年代以来，美国老年人的骨骼状况有所改善，但这些变化的解释仍不确定。本研究比较了第三版（NHANES III, 1988-1994）和NHANES 2005-2008之间20岁及以上成年人的平均FNBMD。双能x射线吸收测量系统（NHANES III中的铅笔束，NHANES 2005-2008中的扇形束）用于测量髋部骨密度，并比较了调查之间的几种骨决定因素，以评估它们在解释观察到的FNBMD差异中的潜在作用。NHANES 2005-2008的FNBMD总体上高于NHANES III，但调查间差异因年龄、性别和种族/民族而异。虽然几个组的FNBMD差异足够小（千分之一货币符号3%），可归因于在两次调查中使用不同的双能x射线吸收仪（DXA）系统，但差异的大小和方向的可变性并不支持DXA方法的人为差异作为唯一解释。在老年人中，一些FNBMD决定因素（体型、吸烟、选择的骨骼活性药物、自我报告的健康状况、钙摄入量和咖啡因摄入量）朝着改善骨骼的方向改变，但在2005-2008年，即使在调整了DXA方法或选择的骨骼决定因素后，老年非西班牙裔白人女性的FNBMD仍显着较高。老年白人女性的FNBMD改善的可能性最大，但这一群体改善的原因尚不清楚。
This analysis compares femur neck bone mineral density (FNBMD) and bone determinants in adults between National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and NHANES 2005-2008. FNBMD was higher in NHANES 2005-2008 than in NHANES III, but between-survey differences varied by age, sex, and race/ethnicity. The likelihood that FNBMD has improved appears strongest for older white women.Recent data on hip fracture incidence and femur neck osteoporosis suggest that the skeletal status of older US adults has improved since the 1990s, but the explanation for these changes remains uncertain.The present study compares mean FNBMD of adults ages 20 years and older between the third (NHANES III, 1988-1994) and NHANES 2005-2008. Dual-energy X-ray absorptiometry systems (pencil beam in NHANES III, fan beam in NHANES 2005-2008) were used to measure hip BMD, and several bone determinants are compared between surveys to assess their potential role in explaining observed FNBMD differences.FNBMD was higher overall in NHANES 2005-2008 than in NHANES III, but between-survey differences varied by age, sex, and race/ethnicity. Although FNBMD differences in several groups were small enough (a parts per thousand currency sign3%) to be attributable to use of different dual-energy X-ray absorptiometry (DXA) systems in the two surveys, variability in size and direction of the differences does not support artifactual differences in DXA methodology as the sole explanation. Several FNBMD determinants (body size, smoking, selected bone-active medications, self-reported health status, calcium intake, and caffeine consumption) changed in a bone-improving direction in older adults, but FNBMD in older non-Hispanic white women remained significantly higher in 2005-2008 even after adjusting for DXA methodology or for the selected bone determinants.The likelihood that FNBMD has improved appears strongest for older white women, but the reason for the improvement in this group remains unclear.