Abstract: Objective To explore the bone mineral density(BMD) of 0 to 5-year-old children in Jiangsu province monitored by quantitative ultrasound,and to analyze the association among sex,age,births,district,season and BMD,in order to provide reference for making intervention strategies. Methods A stratified cluster random sampling method was used to select children aged 0-5 years in Jiangsu province from April 2014 to March 2015. Totally 5 289 children were investigated,including 2 786 boys and 2 503 girls. A face to face investigation was conducted by the prepared doctors with self-designed questionnaires to collect related details and the bone mineral density was measured. Analysis of covariance variance(ANOVA) was used to describe mean differences of continuous variables after adjusting potential covariates such as age,gender and chi-square test was used to examine differences in categorical variables. Results The overall detection rate of low BMD in 0 to 5-year-old children was 14.6%. And the low BMD rates in children aged 0-6 months,7-12 months,13-24 months,25-36 months,37-48 months,49-60 months and ≥60 months were 44.9%,21.9%,14.3%,10.0%,9.0%,9.1% and 11.6%,respectively,and the difference was significant(P＜0.001). No significant difference on detection rate of low BMD between boys and girls was found(14.8% vs. 14.5%,P=0.887). The detection rate of low BMD in preterm children was significantly higher than that of full-term children(20.9% vs. 14.4%,P=0.018). After adjusting the confounders of gender and age,the speed of sound(SOS) value in preterm infants was significantly lower than that in full-term infants,and SOS value in low birth weight infants was also lower than normal birth weight infants(P＜0.05). After adjusting the confounders of age,gender,gestational age,parity and birth weight,differences on SOS value was significant among different areas and seasons(P＜0.05). Conclusions The BMD level of children in Jiangsu province is generally low. And children under 1 year old are at high risk of low BMD,with the prevalence rate of 44.9% in 0 to 6-month-old infants. The BMD level of children is related to age,preterm,low birth weight,district and season,but is not influenced by gender,parity,delivery mode and dwelling district.

Key words: bone mineral density, infants, preschool children, epidemiological investigation

摘要： 目的 了解江苏省0~5岁儿童骨密度水平,分析不同年龄、不同性别、不同出生情况和不同地区季节的儿童骨密度状况,为制定防治干预措施提供依据。方法 2014年4月-2015年3月采用分层随机整群抽样的方法,抽取江苏省0~5岁儿童5 289名,其中男童2 786名,女童2 503名,采用自行设计的问卷调查儿童一般健康状况并对调查儿童胫骨中段的骨密度进行测定。计量资料采用x-±s表示,调整年龄和性别混杂因素,计量资料的组间比较采用协方差分析,计数资料采用χ²检验。结果 江苏省0~5岁儿童骨密度不足检出率为14.6%;0~6月,6~11月,12~23月,24~35 月,36~47月,48~59月,60~月骨密度不足检出率分别为44.9%、21.9%、14.3%、10.0%、9.0%、9.1%、11.6%,组间差异有统计学意义(P<0.001)。本次研究男童、女童骨密度不足检出率分别为14.8%、14.5%,组间差异无统计学意义(P=0.887)。早产儿骨密度不足检出率(20.9%)比足月儿(14.4%)高,差异有统计学意义(P=0.018)。调整年龄和性别混杂因素后,早产儿超声骨密度SOS值比足月儿低,差异有统计学意义(P=0.007);低出生体重儿的超声骨密度SOS值比正常体重儿低,差异有统计学意义(P=0.042)。调整年龄、性别、胎龄、分娩方式和出生体重,南京地区、苏南地区、苏中地区和苏北地区儿童的超声骨密度SOS值的组间差异有统计学意义(P=0.042);春季、夏季、秋季和冬季儿童的超声骨密度SOS值的组间差异有统计学意义(P<0.001)。结论 江苏省0~5岁儿童普遍存在骨密度不足的情况,1岁以内尤其是0~6个月婴儿骨密度不足总检出率高达44.9%,是骨密度不足的高发人群。骨密度水平与年龄、早产、低出生体重、地区和季节相关,与性别、胎次、产次、分娩方式和城乡户籍无关。

关键词: 骨密度, 婴幼儿, 学龄前儿童, 流行病学调查