Bone Mineral Density and Correlation Factor Analysis in Normal Taiwanese Children

臺灣正常兒童的骨密度及相關因素的分析

徐山靜(San-Ging Shu)

《Acta Paediatrica Taiwanica》 48卷6期 (2007/12) Pp. 323-327

https://doi.org/10.7097/APT.200712.0323

摘要

背景，本研究之目的在建立臺灣正常兒童腰椎骨密度(BMD)的正常參考範圍，並分析BMD與各變項之相關性，及找出迴歸公式；作爲病態時的評估標準。
方法：257位正常身高由各學校徵求來的健康兒童，4-18歲，男孩132位，女孩125位，自願參與本研究並由父母之簽同意書後加入。每人測量身高(stadiometer)、體重、血壓、理學檢查根據Tanner分期（包括女孩的乳房／男孩的陰莖，及兩者的陰毛；SMR），及骨齡（Greulich & Pyle方法）。腰椎骨密度評估採用本院Lunar DPX-L。統計以SPSS, Pearson's, correlation、stepwise linear regression作分析。
結果：BMD隨變項增加而增加。相關性由高降低於男孩依序爲：體重、骨齡、身高、SMR及年齡，女孩依序爲：SMR、身高、體重、骨齡及年齡。性別間除身高於14-18歲有統計差異，其他變項均未達統計學意義。迴歸公式男孩：ŷ=0.391+0.005974年＋0.006654體＋0.04207青春期，女孩：ŷ=0.409+0.0007142年＋0.007287體重＋0.05999青春期。
結論：本研究提供臺灣正常兒童腰錐的BMD做參考。除體重、身高、青春期、年齡外，骨齡也高度相關，血壓呈中度相關性。男女差別未達統計意義。

關鍵字

骨齡 ； 骨密度 ； 雙能量X光吸收測定法

並列摘要

Background: Our aim was to establish reference data and linear regression equations for lumbar bone mineral density (BMD) in normal Taiwanese children. Several influencing factors of lumbar BMD were investigated.
Methods: Two hundred fifty-seven healthy children were recruited from schools, 136 boys and 121 girls, aged 4-18 years were enrolled on a voluntary basis with written consent. Their height, weight, blood pressure, puberty stage, bone age and lumbar BMD (L2-4) by dual energy x-ray absorptiometry (DEXA) were measured. Data were analyzed using Pearson correlation and stepwise regression tests.
Results: All measurements increased with age. Prior to age 8, there was no gender difference. Parameters such as height, weight, and bone age (BA) in girls surpassed boys between ages 8-13 without statistical significance (p≥0.05). This was reversed subsequently after age 14 in height (p＜0.05). BMD difference had the same trend but was not statistically significant either. The influencing power of puberty stage and bone age over BMD was almost equal to or higher than that of height and weight. All the other factors correlated with BMD to variable powers. Multiple linear regression equations for boys and girls were formulated.
Conclusions: BMD reference data is provided and can be used to monitor childhood pathological conditions. However, BMD in those with abnormal bone age or pubertal development could need modifications to ensure accuracy.

並列關鍵字

bone age ； bone mineral density ； dual energy X-ray absorptiometry