일개병원 건강 성인 남성의 요추, 대퇴부의 골밀도 특징
Bone Mineral Density of Lumbar Spine and Femur in Healthy Korean Men
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연구배경 남성 골다공증 환자가 점점 증가추세에 있으며 골절에 의한 이환율과 사망률이 여성보다 높다. 그러나 남성의 골밀도에 대한 연구는 매우 부족한 실정이며 특히 국내 남성 골밀도에 대한 연구는 거의 없었다. 따라서 정상 성인 남성의 연령별 부위별 골밀도 분포양상과 요추 대퇴의 골밀도 차이에 대해서 알아보고 임상에 적용하고자 한다. 방 법 2000년 1월부터 2008년 5월까지 일개 대학병원 검진센터에서 골밀도 검사를 시행하였던 남자 중 전신질환이나 골절이 없는 정상 성인 남성 314명을 대상으로 키, 몸무게, 부위별 골밀도를 DEXA로 측정하였다. 결 과 전체 대상자의 골밀도는 제1요추 1.003±0.160, 제2요추 1.086±0.175, 제3요추 1.137±0.182, 제4요추 1.180±0.193, 대퇴 경부0.935±0.133, 워드 삼각 0.740±0.163, 전자부 0.819±0.113 이었다. 연령별에 따른 제2요추, 대퇴 전체의 골밀도는 음의 상관관계를 보였으며 연령이 증가함에 따라 골감소증, 골다공증의 유병률이 증가하였다. 요추와 대퇴의 골밀도 불일치율은 43.9%였다. 흡연 남성의 제3, 제4 요추 골밀도는 감소하였다. 결 론 연령이 증가함에 따라 제2요추, 대퇴 전체의 골밀도는 감소하였다. 제1, 3, 4 요추는 연령에 따른 상관관계를 보이지 않았는데 이는 골극에 의한 결과로 여겨지며 남성이 여성에 비해 요추 골극이 현저한 것으로 생각된다. 골다공증의 유병율은 연령에 따라 증가하였으며 70대가 60.9%로 가장 높았다. 대퇴 요추 골밀도 불일치율은 43.9%였으며 연령이 증가함에 따라 대퇴 진단율이 높아 70대 이상 남성은 골밀도 검사를 실시하고 연령이 증가할수록 대퇴부위의 골밀도를 중시해야 할 것이다. 흡연자의 요추 골밀도는 감소하였다.
Abstract
Background With the prevalence of osteoporosis in men increasing, the mortality and morbidity of fractures is higher than in women. But there are only a few studies about BMD in Korean men. In this study, we measured BMD at the lumbar spine and the femur to find the differences and discordance rate between these sites with age. Methods From January 2000 to May 2008, we measured height, weight and BMD of different skeletal sites by DEXA in 314 subjects seen at one hospital. The subjects had no history of diseases and fractures. Factors affecting BMD were analyzed via ANOVA, Chi square test and Pearson Correlation. Results The BMDs of L1, L2, L3, L4, femur neck, Ward’striangle and trochanter were 1.003±0.160, 1.086±0.175, 1.137±0.182, 1.180±0.193, 0.935±0.133, 0.740±0.163 and 0.819±0.113, respectively. The prevalence of osteopenia and osteoporosis increased with age. L2 spine and femur (any site) showed negative correlations with age. The discordance rate between lumbar spine and femur was 43.9%. The BMDs of L3 and L4 spine were low in men who smoked. Conclusions The BMDs of L2 spine and all sites of femur decreased with age, but other lumbar vertebrae showed no correlations because of higher osteophytes in men. The prevalence of osteoporosis was highest for men in their 70s. Diagnostic rate by femur increased with age. Thus, we conclude that it might be useful to check BMD in men in their 70s, and to monitor BMD of femur with increasing age. The BMD of lumbar spine was low in smoking men.
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