Shatrugna Veena, Kulkarni Bharati, Kumar P Ajay, Rani K Usha, Balakrishna N
National Institute of Nutrition, Indian Council of Medical Research, Jamai Osmania P.O., 500 007, Hyderabad, India.
Osteoporos Int. 2005 Dec;16(12):1827-35. doi: 10.1007/s00198-005-1933-1. Epub 2005 Jun 15.
Indian women from low-income groups consume diets that have inadequate calcium coupled with too few calories, proteins and micronutrients. Hospital-based data suggest that these women have osteoporotic hip fractures at a much earlier age than Western women. Studies reporting bone parameters of the Indian population involving large sample sizes are not available. This study was therefore carried out with 289 women in the 30-60-year age group to estimate the prevalence of osteoporosis and measure the bone parameters by dual energy X-ray absorptiometry (DXA). Their mean (+/- SD) age was 41.0+/-8.60 years. Their mean (+/- SD) height, weight and body mass index (BMI) were 149.1+/-5.49 cm, 49.2+/-9.85 kg and 22.1+/-3.99, respectively. Dietary intake of calcium was estimated to be 270+/-57 mg/day. The prevalence of osteoporosis at the femoral neck was around 29%. Bone mineral density (BMD) and T scores at all the skeletal sites were much lower than the values reported from the developed countries and were indicative of a high prevalence of osteopenia and osteoporosis. BMD showed a decline after the age of 35 years in cases of the lumbar spine and femoral neck. This was largely due to a decrease of bone mineral content (BMC). The nutritional status of women appears to be an important determinant of bone parameters. BMD and BMC at all the skeletal sites and whole body increased significantly with increasing body weight and BMI of women (P<0.05). However, bone area (BA) did not change with an increase in BMI. In the multiple regression analysis, apart from body weight, age, menopause and calcium intake were the other important determinants of BMD (P<0.05). In addition to these, height was also an important determinant of WB-BMC. This study highlights the urgent need for measures to improve the nutritional status, dietary calcium intake and thus the bone health of this population.
来自低收入群体的印度女性饮食中钙含量不足，同时热量、蛋白质和微量营养素也过少。基于医院的数据表明，这些女性患骨质疏松性髋部骨折的年龄比西方女性早得多。目前尚无涉及大样本量的印度人群骨参数研究报告。因此，本研究对289名年龄在30至60岁之间的女性进行了调查，以评估骨质疏松症的患病率，并通过双能X线吸收法（DXA）测量骨参数。她们的平均（±标准差）年龄为41.0±8.60岁。她们的平均（±标准差）身高、体重和体重指数（BMI）分别为149.1±5.49厘米、49.2±9.85千克和22.1±3.99。估计钙的膳食摄入量为270±57毫克/天。股骨颈骨质疏松症的患病率约为29%。所有骨骼部位的骨密度（BMD）和T值均远低于发达国家报告的值，表明骨量减少和骨质疏松症的患病率较高。腰椎和股骨颈的骨密度在35岁以后呈下降趋势。这主要是由于骨矿物质含量（BMC）的减少。女性的营养状况似乎是骨参数的一个重要决定因素。随着女性体重和BMI的增加，所有骨骼部位和全身的骨密度和骨矿物质含量均显著增加（P<0.05）。然而，骨面积（BA）并未随BMI的增加而变化。在多元回归分析中，除体重外，年龄、绝经和钙摄入量也是骨密度的其他重要决定因素（P<0.05）。除此之外，身高也是全身骨矿物质含量的一个重要决定因素。本研究强调迫切需要采取措施改善这一人群的营养状况、膳食钙摄入量，从而改善骨骼健康。
