| BackgroundEpidemiological investigations related to Bone mass in the elderly show that Bone Mineral Density(BMD)tests usually have high incidence of osteoporosis,high incidence of Osteo Porotic fractures(OPF),as well as low incidence of medical diagnosis prior to occurrence of obvious diseases,as known as "Three high and one low".With the serious aging trend in the world,bone mass abnormality has become a common concern in many countries.An epidemiological survey in 2019 shows that the situation of abnormal bone mass among the elderly population in China is already quite severe.The resulting OPF imposes a huge economic burden of disease on individuals,families and society.However,due to the insidiousness of the disease and the lack of awareness of both doctors and patients,residents’ awareness of the prevention and treatment of abnormal bone mass is not strong,and the health education,treatment and follow-up work of community public health departments are not in place.Therefore,the use of simple screening tools to expand the prevention and control range of Osteo Prosis(OP),move the prevention threshold to the population with abnormal bone mass and those at high risk of fracture,and carry out pre-disease prevention and control are of great significance for the implementation of the "Healthy China 2030" strategy.ObjectiveThis study conducted field investigation in a community in kaifeng,a city with severe aging,aiming to screen the high-risk population and key population with abnormal bone mass,discuss the status quo and influencing factors of abnormal bone mass in residents under gender stratification,assess the risk of fracture,and put forward targeted Suggestions on community public health prevention and treatment.MethodsThis study was a cross-sectional study.The convenience sampling method was adopted to select the middle-aged and elderly residents of a community in kaifeng city as the target population.In the investigation,ultrasonic bone mineral density(BMD)was used to measure the non-dominant radial bone density of the hands of the survey subjects.Questionnaire was used to carry out field investigation,and data collected from 10 indicators in 3 dimensions were analyzed to analyze the influencing factors of bone mass abnormality in different genders.The fracture risk assessment tool(FRAX)was used to calculate the individual fracture risk probability,including the main body parts(spine,wrist,ribs,etc.)and the risk probability of hip fracture.Epidata3.0 was used to establish a database and input data.SPSS22.0 statistical analysis software was used for data analysis:(1)in the descriptive analysis of data,numerical variables conforming to normal distribution was described by mean ± standard deviation,and non-normal distribution of numerical variables was expressed by median(lower quartile to upper quartile).Description of classification variable rate and composition ratio;(2)in the analysis of parameter estimation and hypothesis test,q-q graph was used to test the normal distribution of data.If the measured value of the observed object was normally distributed,t-test or one-way analysis of variance was used;if the measured value of the observed object was normally distributed,mann-whitney U test or kruscal-wallis rank sum test was used.Classification variables were tested by Pearson chi-square.Test level α=0.05;(3)the influencing factors of abnormal bone mass and high risk of fracture were analyzed by binary Logistic regression;(4)ROC curve was used to investigate the degree of coincidence between bone mass and fracture risk in the elderly population and the predictive effect of age on fracture risk in the elderly population.Results(1)A total of 700 respondents were surveyed,of which 285 were males,accounting for 40.7% and415 were females,accounting for 59.3%.There were 106 men and 309 women with abnormal bone mass,accounting for 37.2% and 74.5% respectively.The high risk of fracture in men and women were 37 and 156,accounting for 13% and 37.6% respectively.(2)Analysis of influencing factors of abnormal bone mass in the elderly: taking calcium tablets,moderate intensity exercise and sleeping time of > 8h/d were protective factors to maintain bone mass in men;Taking calcium tablets and sleeping for > 8h/ day were protective factors for abnormal bone mass in female subjects.(3)Analysis of influencing factors of fracture risk in the elderly: age,smoking and drinking were risk factors of fracture risk in males,and BMI was its protective factor.Age was a risk factor for women at high risk of fracture.BMI,history of hip fracture in parents,moderate intensity exercise and walking habits were protective factors for women at high risk of fracture.(4)In the elderly population in the community,the degree of anastomosis between those with abnormal bone mass and those with high risk of fracture screened by ultrasonic bone mineral density analyzer and fracture risk assessment tool was not high.This suggests low sensitivity to predicting fracture risk based on bone mass.If the two complement each other,it may play a role in the screening of OP and OPF high-risk population to check for loopholes.Age has a good prediction effect on the risk of fracture(the area under the curve of male and female age and the risk of fracture was 0.676 and 0.835 respectively).According to the approximate equal index calculated by the coordinates of the curve,the critical age for the risk of fracture of male subjects was 68.5 years old.The critical age for women at high risk of fracture was70.5 years.Conclusion(1)The incidence of abnormal bone mass and high risk of fracture among middle-aged and elderly residents in kaifeng community is high.(2)The bone mass of the elderly in the community was affected by sleep duration,and the fracture risk was affected by BMI.The factors affecting bone mass and fracture risk were not identical under gender stratification.(3)Ultrasound bone mineral density measurement parallel fracture risk assessment was conducive to comprehensive screening of high-risk groups of OP and OPF.Policy Suggestions(1)Abnormal bone mass requires universal prevention;(2)Standardize community management and promote the national awareness of bone health;(3)Strengthen the capacity building of community-level services and improve the ability of prevention and control and guidance;(4)Formulate targeted service policies and carry out systematic management for high-risk and key groups of OP and OPF. |
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