۳۹۹ ﺍﻭﺳﺘﺌﻮﭘﺮﻭﺯ ﺩﺭ ﻣﺮﺩﺍﻥ ﺭﻭﺳﺘﺎﻫﺎﻱ ﻓﺎﺭﺱ ﺩﻛﺘﺮ ﺍﻣﻴﺮ ﺁﺩﻳﻨﻪﭘﻮﺭ ﻭ ﻫﻤﻜﺎﺭﺍﻥ ﺭﺍ ﺩﺭ ﻣﺮﺩﺍﻥT-score ﻭBMD ﺟﻤﻊﺑﻨﺪﻱ ﺍﻃﻼﻋﺎﺕ، ﻣﻨﺒﻊ ﺑﺮﺧﻮﺭﺩ ﻣﻨﺎﺳﺐ ﺑﺎ ﭘﻮﮐﻲ ﺍﺳﺘﺨﻮﺍﻥ ﺑﺎﻳﺪ ﺍﺯ ﺗﻤﺎﻡ ﻋﻠﺖﻫﺎ ﻭﺭﻭﺳﺘﺎﻳﻲ ﺍﻳﺮﺍﻧﻲ ﻣﻲﺗﻮﺍﻥ ﺗﻌﻴﻴﻦ ﻛﺮﺩ ﻭ ﺍﺯ ﺧﻄﺮﻫﺎﻱ ﻧﺎﺷﻲ ﺍﺯ ، ﺍﺳﺘﻔﺎﺩﻩT-Score ﻋﻮﺍﻣﻞ ﻣﺆﺛﺮ ﺩﺭ ﻭﻗﻮﻉ ﺷﮑﺴﺘﮕﻲ، ﻧﻪ ﻓﻘﻂ .ﺍﻳﻦ ﺑﻴﻤﺎﺭﻱ ﺟﻠﻮﮔﻴﺮﻱ ﻧﻤﻮﺩ ﮐﺮﺩ. ﻫﻢﭼﻨﻴﻦ، ﺑﻪ ﻋﻠﺖ ﺍﻳﻦ ﮐﻪ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻣﻌﻴﺎﺭ ﻣﺤﻠﻲ ﻳﺎﺩﺭ ﻣﺠﻤﻮﻉ ﺑﺮ ﺍﺳﺎﺱ ﻳﺎﻓﺘﻪﻫﺎﻱ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ، ﻣﻤﻜﻦ ﺍﺳﺖ ﺗﺸﺨﻴﺺ، ﺑﻴﺸﺘﺮ ﻳﺎ ﮐﻤﺘﺮ ﺍﺯ ﺣﺪ ﻭﺍﻗﻌﻲWHO ﺑﺮﺍﻱ ﺑﺮﺭﺳﻲ ﭘﻮﮐﻲWHO ﻣﻌﻴﺎﺭﻫﺎﻱ ﻣﺤﻠﻲ ﻳﺎ ﻣﻌﻴﺎﺭﻫﺎﻱ ،ﮔﺰﺍﺭﺵ ﺷﻮﺩ، ﻭ ﻫﺰﻳﻨﻪﻫﺎﻱ ﺑﺨﺶ ﺩﺭﻣﺎﻥ ﺳﻨﮕﻴﻦﺗﺮ ﮔﺮﺩﺩﺍﺳﺘﺨﻮﺍﻥ، ﻣﻤﻜﻦ ﺍﺳﺖ ﻧﺘﺎﻳﺞ ﻣﺘﻔﺎﻭﺗﻲ ﺩﺭ ﺷﻴﻮﻉ ﺍﻳﻦ ﺑﻴﻤﺎﺭﻱ ﺑﻨﺎﺑﺮﺍﻳﻦ ﻫﻴﭻ ﻣﺪﺭﮎ ﻗﺎﻧﻊﮐﻨﻨﺪﻩﺍﻱ ﻭﺟﻮﺩ ﻧﺪﺍﺭﺩ ﮐﻪ ﺗﻌﻴﻴﻦ ﻛﻨﺪﺩﺍﺷﺘﻪ ﺑﺎﺷﺪ. ﺑﻨﺎﺑﺮﺍﻳﻦ، ﺑﺮﺭﺳﻲﻫﺎﻱ ﺁﻳﻨﺪﻩﻧﮕﺮ ﺩﺭﺑﺎﺭﻩﻱ ﺍﺣﺘﻤﺎﻝ T-Score ﺧﻄﺮ ﺷﮑﺴﺘﮕﻲ ﺩﺭ ﺟﻮﺍﻣﻊ ﺭﻭﺳﺘﺎﻳﻲ ﺑﺎ ﮐﺪﺍﻡ .ﺷﮑﺴﺘﮕﻲ ﺍﺳﺘﺨﻮﺍﻥ ﺑﺎ ﺩﻭ ﻣﻌﻴﺎﺭ ﻧﺎﻣﺒﺮﺩﻩ ﺗﻮﺻﻴﻪ ﻣﻲﺷﻮﺩ ﻫﻢﺧﻮﺍﻧﻲ ﺩﺍﺭﺩ ﻭ ﺗﻨﻬﺎ ﺑﺎ ﻣﻄﺎﻟﻌﻪﻫﺎﻱ ﺁﻳﻨﺪﻩﻧﮕﺮ ﺩﺭ ﻣﻮﺭﺩ ﻭﻗﻮﻉ ۲۴،۲۵ﺳﭙﺎﺳﮕﺰﺍﺭﻱ: ﺍﺯ ﻫﻤﻪﻱ ﺍﻓﺮﺍﺩﻱ ﻛﻪ ﺩﺭ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺷﺮﻛﺖ ﻛﺮﺩﻧﺪ ﻭ ﻻﺯﻡ ﺑﻪ .ﺷﮑﺴﺘﮕﻲﻫﺎ ﻣﻲﺗﻮﺍﻥ ﺑﻪ ﻧﺘﻴﺠﻪﻱ ﺩﻟﺨﻮﺍﻩ ﺭﺳﻴﺪﻫﻢﭼﻨﻴﻦ ﺍﺯ ﻛﺎﺭﻛﻨﺎﻥ ﻣﺮﻛﺰ ﺗﺤﻘﻴﻘﺎﺕ ﻏﺪﺩ ﺩﺭﻭﻥﺭﻳﺰ ﻭ ﻣﺘﺎﺑﻮﻟﻴﺴﻢ ﺫﮐﺮ ﺍﺳﺖ ﺩﺭ ﺍﻳﻦ ﭘﮋﻭﻫﺶ ﻓﻘﻂ ﺟﻤﻌﻴﺖ ﻣﺤﺪﻭﺩﻱ ﺍﺯ ﻳﻚﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ ﭘﺰﺷﻜﻲ ﺷﻴﺮﺍﺯ ﻭ ﺍﺯ ﺧﺎﻧﻢ ﺩﻛﺘﺮ ﻣﺮﺿﻴﻪ ﺑﺨﺸﺎﻳﺶ ﻣﻨﻄﻘﻪﻱ ﺭﻭﺳﺘﺎﻳﻲ ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺖ ﻭ ﺑﺮﺍﻱﻛﺮﻡ، ﺧﺎﻧﻢ ﺩﻛﺘﺮ ﻫﻠﻦ ﻃﺎﻫﺮﻱ ﻭ ﺧﺎﻧﻢ ﺯﻫﺮﺍ ﮊﻭﻟﻴﺪﻩﭘﻮﺭ ﺗﺸﻜﺮ ﻭ ﺑﻬﺮﻩﺑﺮﺩﺍﺭﻱ ﺳﻮﺩﻣﻨﺪ ﺍﺯ ﺍﻳﻦ ﻣﻌﻴﺎﺭﻫﺎ ﻻﺯﻡ ﺍﺳﺖ ﻣﻄﺎﻟﻌﻪﻫﺎﻱ .ﻗﺪﺭﺩﺍﻧﻲ ﻣﻲﻧﻤﺎﻳﻴﻢ ﺑﻴﺸﺘﺮﻱ ﺩﺭ ﺳﺎﻳﺮ ﻣﻨﻄﻘﻪﻫﺎﻱ ﺭﻭﺳﺘﺎﻳﻲ ﺍﻳﺮﺍﻥ ﺍﻧﺠﺎﻡ ﺷﻮﺩ ﺑﺎ 11. Wang Y, Tao Y, Hyman ME, Li J, Chen Y. References Osteoporosis in China. Osteoporos Int 2009; 20: 1651-62. 1. NOF, National Osteoporosis Foundation. Clin- 12. Looker AC, Waner HW, Dunn WL, Calvo MS, ician’s Guide to Prevention and Treatment of Harris TB, Heyse SP, et al. Update data on Osteoporosis. Washington, DC, NOF, 2009. proximal femur bone mineral levels of US adults. 2. IOF, International Osteoporosis Foundation. Diag- Osteoporos Int 1998; 8: 468-89. nosis of Osteoporosis. 13. Meyer HE, Berntsen GK, Søgaard AJ, Lang- 3. Gordana M. Osteoporosis in men. Journal of the hammer A, Schei B, Fønnebø V, et al. Higher Royal Society of Medicine 2001; 94: 620-3. bone mineral density in rural compared with urban 4. Khosla S. Update in male Osteoporosis. J Clin dwellers: the NOREPOS study. Am J Epidemiol Endocrinol Metab 2010; 95: 3-10. 2004; 160: 1039-46. 5. Ott SM. Osteoporosis in men. N Engl J Med 2008; 14. Kemper HC, Twisk JW, van Mechelen W, Post 359: 868. GB, Roos JC, Lips P. A fifteen-year longitudinal 6. Johnell O, Kanis JA. An estimate of the worl- study in young adults on the relation of physical dwide prevalence and disability associated with activity and fitness with the development of the osteoporotic fractures. Osteoporos Int 2006; 17: bone mass: The Amsterdam Growth And Health 1726–33. Longitudinal Study. Bone 2000; 27: 847-53. 7. Omrani GR, Massoompour SM, Hamidi A, 15. Pongchaiyakul C, Nguyen TV, Kosulwat V, Mardanifard HA, Taghavi SM, Talezadeh P, et al. Rojroongwasinkul N, Charoenkiatkul S, Eisman Bone mineral density in the normal Iranian JA, et al. Effects of physical activity and dietary population: a comparison with American reference calcium intake on bone mineral density and date. Arch Osteoporosis 2006; 1: 29-35. osteoporosis risk in a rural Thai population. 8. Larijani B, Moayyeri A, Keshtkar AA, Hossein- Osteoporos Int 2004; 15: 807-13. Nezhad A, Soltani A, Bahrami A, et al. Peak bone 16. Tan LJ, Lei SF, Chen XD, Liu MY, Guo YF, Xu mass of Iranian population: the Iranian Multic- H, et al. Establishment of peak bone mineral enter Osteoporosis Study. J Clin Densitom 2006; density in Southern Chinese males and its 9: 367-74. comparisons with other males from different 9. Ardawi MS, Maimany AA, Bahksh TM, Nasrat regions of China. J Bone Miner Metab 2007; 25: HA, Milaat WA, Al-Raddadi RM. Bone mineral 114-21. density of the spine and femur in healthy Saudis. 17. Huang QY, Kung AW. Genetics of osteoporosis. Osteoporos Int 2005; 16: 43-55. Mol Genet Metab 2006; 88: 295-306. 10. Wu XP, Liao EY, Zhang H, Dai RC, Shan PF, 18. Ferrari S. Human genetics of osteoporosis. Best Cao XZ, et al. Determination of age-specific bone Pract Res Clin Endocrinol Metab 2008; 22: 723- mineral density and comparison of diagnosis and 35. prevalence of primary osteoporosis in Chinese 19. Broussard DL, Magnus JH .Risk assessment and women based on both Chinese and World Health screening for low bone mineral density in a multi- Organization criteria. J Bone Miner Metab 2004; ethnic population of women and men: does one 22: 382–91. approach fit all?. Osteoporos Int 2004; 15: 349– 60.
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453/Iranian Journal of Endocrinology and Metabolism Vol 12 No.4 November 2010 Original Article Prevalence of Osteoporosis in Rural Men of Fars Based on Both Local and WHO Reference Data Adine pour A1, Tohidi M1, Dabbaghmanesh M1, Jafari P2, Fattahi M3, Ranjbar Omrani Gh1 1Endocrine and Metabolism Research Center, 2Department of Biostatistic, 3Gastroenterology and Hepatology Research Center Shiraz University of Medical Sciences, Shiraz, I.R. Iran e-mail:hormone@ sums .ac.ir Received: 12/03/2010 Accepted: 04/08/2010 Abstract Introduction: Recently osteoporosis (OP) has emerged as a basic public health problem. It is characterized by low bone mass with micro architectural destruction of bone, resulting in increased bone fractures, morbidity and mortality. Materials and Methods: To evaluate the prevalence of OP using the local reference data of rural males of Fars and to compare it with WHO criteria, a total of 263 male adults, aged between 20-94 yrs, participated in this cross-sectional study. Bone Mineral Density (BMD) was measured by DXA. We utilized a fit curve method to determine the best age range over which to calculate Peak Bone Mass (PBM) and we used regression analysis for association of OP with age and Body mass index (BMI). Results: PBM was observed at the age range of 20-24 years, at the various sites. The prevalence of OP increased with age. It was negatively correlated with BMI and varied dramatically based on local versus WHO criteria. Based on local criteria, prevalence of OP in the lumbar spine, femoral neck and total femur were 3.8%, 24.8% and 14.8%, respectively, and, based on WHO criteria, they were 10%, 6.1% and 24%, respectively. Conclusion: Using local or WHO reference values for evaluation of OP may yield different prevalences. Therefore prospective fracture studies in correlation with the two above reference values are recommended. Keywords: Osteoporosis, Peak Bone Mass, Reference data, WHO