Liu Jian-Min, Zhao Hong-Yan, Ning Guang, Zhao Yong-Ju, Zhang Lian-Zhen, Sun Li-Hao, Xu Man-Yin, Chen Jia-Lun
Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Second Medical University, Shanghai, China.
Osteoporos Int. 2004 Mar;15(3):238-42. doi: 10.1007/s00198-003-1536-7. Epub 2004 Jan 16.
This study investigated the relative contribution of fat mass and lean mass to bone mineral density (BMD) in young and premenopausal healthy Chinese women. The study was performed in 282 young and premenopausal healthy women with regular menstrual cycles. The BMD at lumbar spine (L2-L4), total hip and total body, together with fat mass and lean mass were assessed by dual-energy X-ray absorptiometry (DXA); body height, weight, waist and hip circumference were also measured, and body mass index (BMI) and waist-hip ratio were calculated. Fat mass was a major determinant for BMI, BMI and lean mass were positively related to L2-L4, total hip and total body bone density ( P<0.001 for all), lean mass was the only independent factor contributing to BMD at L2-L4 (standardized coefficient beta=0.282, P<0.001), total hip (beta=0.336, P<0.001) and total body (beta=0.361, P<0.001) in multiple stepwise regression analysis. The correlation between BMI and BMD was improved after adjustment for fat mass, while decreased or even lost when lean mass was adjusted. These data suggested that in the Chinese population, lean mass is an important factor determining BMD in young and premenopausal women.
本研究调查了年轻及绝经前健康中国女性中脂肪量和瘦体重对骨密度(BMD)的相对贡献。该研究纳入了282名月经周期规律的年轻及绝经前健康女性。采用双能X线吸收法(DXA)评估腰椎(L2-L4)、全髋部和全身的骨密度,以及脂肪量和瘦体重;同时测量身高、体重、腰围和臀围,并计算体重指数(BMI)和腰臀比。脂肪量是BMI的主要决定因素,BMI和瘦体重与L2-L4、全髋部和全身骨密度均呈正相关(均P<0.001),在多元逐步回归分析中,瘦体重是L2-L4(标准化系数β=0.282,P<0.001)、全髋部(β=0.336,P<0.001)和全身(β=0.361,P<0.001)骨密度的唯一独立影响因素。调整脂肪量后,BMI与骨密度的相关性增强,而调整瘦体重后,该相关性减弱甚至消失。这些数据表明,在中国人群中,瘦体重是年轻及绝经前女性骨密度的重要决定因素。