고관절부, 요추부, 원위 요골에서의 골밀도에 따른 골다공증 진단의 일치도
Coincidence of Diagnosis of Osteoporosis at the Site of Proximal Femur, Lumbar Spine and Distal Radius
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목적: 골밀도에 영향을 미칠 수 있는 요소를 갖지 않는 골다공증 진단을 받은 여자 환자들을 대상으로 부위별 골밀도를 측정하여 그 상관관계를 알아보고자 한다. 대상 및 방법: 2006년 1월에서 2007년 1월까지 이중에너지 X-선 흡수 계측법를 이용하여 골다공증으로 진단 받은 여자 환자 200명을 대상으로 하였다. 고관절부(대퇴경부,Ward 삼각, 대전자부), 요추체 전후면(L1-4), 원위 요골 부위의 골밀도를 측정하여 부위별, 연령대별 골밀도와 골다공증 진단의 일치도를 평가하였다. 결과: 부위별 평균 골밀도는 wards 삼각(-2.93±0.95), 원위요골 중간부위(-2.95±1.21)에서 가장 낮았고, 부위별 진단진단에 있어 고관절-요추의 경우 37%, 고관절-원위요골의 경우 34%, 요추-원위 요골의 경우 38%의 불일치도를 보였다. 연령대의 증가에 따라 골밀도의 감소 소견을 보여주었으며 특히 60대와 70대 사이에서 골밀도의 두드러진 감소 소견을 보였다. 결론: 한국여성의 골밀도 측정시 고관절부, 요추부, 그리고 원위 요골에서 상당한 진단 불일치율을 주어 각각의 부위에서의 골다공증으로 인한 골절 예방을 위해서는 고관절부, 요추부, 원위 요골 모두의 골밀도 측정이 불가피할 것으로 보인다.
Abstract
Purpose: The purpose of this study is to evaluate correlation according to sites measured from women diagnosed with osteoporosis without other factors influencing osteoporosis. Materials and Methods: Two hundred patients diagnosed with osteoporosis using dual-energy X-ray absorptiometry from January 2006 to January 2007 were evaluated. All patients were measured at the hip joint (Femur neck, Ward triangle, and great trochanter), lumbar spine body (L1-4), and distal radius. Results of measurements were then evaluated for determination of coincidence. Results: Mean bone mineral density was lowest at Ward’s triangle(-2.93±0.95) and radius midshaft(-2.95±1.21). The rate of disconcordance between hip joint and lumbar spine was 37%, between hip joint and distal radius, 34%, and, between the lumbar spine and distal radius, 38%. With increase in age, a greater decrease in bone mineral density was observed, and markedly decreased bone mineral density was observed between the ages of 60 and 70-years. Conclusion: Rate of disconcordance of bone mineral density among hip joint, lumbar spine, and distal radius was significant. To prevent further fracture, all sites (hip joint, lumbar spine, and distal radius) must inevitably be measured.
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