Forsmo Siri, Aaen Jørn, Schei Berit, Langhammer Arnulf
Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
Am J Epidemiol. 2006 Nov 1;164(9):890-7. doi: 10.1093/aje/kwj268. Epub 2006 Aug 3.
Weight loss in the elderly increases bone loss and the risk of fractures, especially at the hip and spine. The influence of weight change on non-weight-bearing parts of the skeleton is less well known. The purpose of this study was to investigate an association between weight change during the peri- and postmenopausal years and forearm bone mineral density (BMD). Among 8,856 women aged 45-60 years attending the first Health Study of Nord-Trøndelag, Norway (HUNT I, 1984-1986), a random sample of 2,795 women was invited to forearm densitometry (single x-ray absorptiometry technology) at HUNT II (1995-1997), after a mean period of 11.3 years. A total of 2,005 women (mean age: 65.1 years) were eligible. The mean weight had increased 3.4 kg; the gain was greater in the youngest women. A total of 382 women (19.1%) had lost and 1,331 women (66.3%) had gained weight. Weight change explained little of the BMD variance, 0.7% and 0.4% for weight loss and weight gain, respectively. Weight loss was an independent and statistically significant negative predictor of BMD, adjusted for body weight, age, age at menopause, smoking, and ovarian hormone treatment, particularly among women with a baseline body mass index greater than 25 kg/m2. No independent association between weight gain and forearm BMD was found.
老年人体重减轻会增加骨质流失和骨折风险,尤其是髋部和脊柱骨折风险。体重变化对骨骼非承重部位的影响则鲜为人知。本研究旨在调查绝经前后几年体重变化与前臂骨矿物质密度(BMD)之间的关联。在挪威北特伦德拉格郡首次健康研究(HUNT I,1984 - 1986年)中,年龄在45 - 60岁的8856名女性中,随机抽取了2795名女性在平均11.3年后的HUNT II(1995 - 1997年)接受前臂骨密度测量(单能X线吸收法技术)。共有2005名女性(平均年龄:65.1岁)符合条件。平均体重增加了3.4千克;最年轻的女性体重增加更多。共有382名女性(19.1%)体重减轻,1331名女性(66.3%)体重增加。体重变化对骨密度变化的解释作用很小,体重减轻和体重增加分别解释了0.7%和0.4%的骨密度变化。体重减轻是骨密度的一个独立且具有统计学意义的负向预测因素,在对体重、年龄、绝经年龄、吸烟和卵巢激素治疗进行调整后,尤其在基线体重指数大于25kg/m²的女性中如此。未发现体重增加与前臂骨密度之间存在独立关联。