Zhao Hong-yan, Liu Jian-min, Ning Guang, Zhang Lian-zhen, Xu Man-yin, Chen Jia-lun
Department of Endocrine and metabolic diseases, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China.
Zhonghua Nei Ke Za Zhi. 2004 Jul;43(7):506-9.
To investigate the effect of fat mass and fat-free mass on bone mineral density (BMD) in pre- and postmenopausal women.
282 premenopausal women with regular menstruation and 205 postmenopausal women were enrolled in this study. BMD at lumbar spine (L(2 - 4)) and femoral neck (FN) were measured with dual-energy X-ray absorptiometry (DEXA). Fat mass and fat-free mass were measured with bioelectric impedance analysis (BIA). Height, weight, waist and hip circumference were recorded. Body mass index (BMI) and waist hip ratio (WHR) were calculated.
Fat mass and fat-free mass were significantly positively correlated with L(2 - 4) and FN BMD in both pre- and postmenopausal women (P < 0.01). Multiple regression analysis showed that in premenopausal women, fat-free mass and age were significant determinants of L(2 - 4) BMD (R(2) = 0.077, P = 0.000), while fat-free mass, age and BMI were significant determinants of FN BMD (R(2) = 0.130, P = 0.000). In postmenopausal women, fat mass and age were significant determinants of BMD at L(2 - 4) and FN (R(2) were 0.153 and 0.184 respectively, P = 0.000).
Fat mass and fat-free mass have different effects on BMD in pre- and postmenopausal women. Fat-free mass is a significant determinant of BMD in premenopausal women, while fat mass contributes most to BMD in postmenopausal women.
探讨绝经前和绝经后女性的脂肪量和去脂体重对骨密度（BMD）的影响。
本研究纳入282例月经规律的绝经前女性和205例绝经后女性。采用双能X线吸收法（DEXA）测量腰椎（L(2 - 4)）和股骨颈（FN）的骨密度。采用生物电阻抗分析（BIA）测量脂肪量和去脂体重。记录身高、体重、腰围和臀围。计算体重指数（BMI）和腰臀比（WHR）。
绝经前和绝经后女性的脂肪量和去脂体重均与L(2 - 4)和FN骨密度呈显著正相关（P < 0.01）。多元回归分析显示，在绝经前女性中，去脂体重和年龄是L(2 - 4)骨密度的显著决定因素（R(2) = 0.077，P = 0.000），而去脂体重、年龄和BMI是FN骨密度的显著决定因素（R(2) = 0.130，P = 0.000）。在绝经后女性中，脂肪量和年龄是L(2 - 4)和FN骨密度的显著决定因素（R(2)分别为0.153和0.184，P = 0.000）。
脂肪量和去脂体重对绝经前和绝经后女性的骨密度有不同影响。去脂体重是绝经前女性骨密度的重要决定因素，而脂肪量对绝经后女性骨密度的影响最大。
