Academic Rheumatology, Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, United Kingdom.
J Clin Endocrinol Metab. 2010 Feb;95(2):699-706. doi: 10.1210/jc.2009-1907. Epub 2009 Dec 11.
It is unclear whether fat mass (FM) and lean mass (LM) differ in the way they influence cortical bone development in boys and girls.
The aim of the study was to investigate the contributions of total body FM and LM to parameters related to cortical bone mass and geometry.
DESIGN/SETTING: We conducted a longitudinal birth cohort study, the Avon Longitudinal Study of Parents and Children.
A total of 4005 boys and girls (mean age, 15.5 yr) participated in the study.
We measured cortical bone mass, cortical bone mineral content (BMC(C)), cortical bone mineral density, periosteal circumference (PC), and endosteal circumference by tibial peripheral quantitative computed tomography.
LM had a similar positive association with BMC(C) in boys and girls [regression coefficients with 95% confidence interval (CI); P for gender interactions: boys/girls, 0.952 (0.908, 0.997); P = 0.85]. However, the mechanisms by which LM influenced bone mass differed according to gender because LM was positively associated with PC more strongly in girls [boys, 0.579 (0.522, 0.635); girls, 0.799 (0.722, 0.875); P < 0.0001], but was only associated with cortical bone mineral density in boys [boys, 0.443 (0.382, 0.505); girls, 0.014 (-0.070, 0.097); P < 0.0001]. There was a stronger positive association between FM and BMC(C) in girls [boys, 0.227 (0.185, 0.269); girls, 0.355 (0.319, 0.392); P < 0.0001]. This reflected both a greater positive association of FM with PC in girls [boys, 0.213 (0.174, 0.253); girls, 0.312 (0.278, 0.347); P = 0.0002], and a stronger negative association with endosteal circumference(PC) [boys, -0.059 (-0.096, 0.021); girls, -0.181 (-0.215, -0.146); P < 0.0001].
Whereas LM stimulates the accrual of cortical bone mass to a similar extent in boys and girls, FM is a stronger stimulus for accrual of cortical bone mass in girls, reflecting a greater tendency in females for FM to stimulate periosteal growth and suppress endosteal expansion.
目前尚不清楚脂肪量（FM）和瘦体量（LM）在影响男孩和女孩皮质骨发育的方式上是否存在差异。
本研究旨在探讨总体身体 FM 和 LM 对与皮质骨量和几何形状相关的参数的贡献。
设计/设置：我们进行了一项纵向出生队列研究，即阿冯纵向父母与子女研究。
共有 4005 名男孩和女孩（平均年龄 15.5 岁）参加了这项研究。
LM 在男孩和女孩中与 BMC(C) 呈相似的正相关[95%置信区间（CI）的回归系数；性别交互作用的 P 值：男孩/女孩，0.952（0.908，0.997）；P=0.85]。然而，LM 影响骨量的机制因性别而异，因为在女孩中，LM 与 PC 的正相关性更强[男孩，0.579（0.522，0.635）；女孩，0.799（0.722，0.875）；P<0.0001]，但仅与男孩的皮质骨密度相关[男孩，0.443（0.382，0.505）；女孩，0.014（-0.070，0.097）；P<0.0001]。FM 与 BMC(C) 在女孩中的正相关性更强[男孩，0.227（0.185，0.269）；女孩，0.355（0.319，0.392）；P<0.0001]。这反映了 FM 与 PC 的正相关性在女孩中更强[男孩，0.213（0.174，0.253）；女孩，0.312（0.278，0.347）；P=0.0002]，以及与骨内周长（PC）的负相关性更强[男孩，-0.059（-0.096，0.021）；女孩，-0.181（-0.215，-0.146）；P<0.0001]。
虽然 LM 以相似的程度刺激男孩和女孩的皮质骨量增加，但 FM 是女孩皮质骨量增加的更强刺激因素，这反映了女性 FM 刺激骨膜生长和抑制骨内扩张的趋势更大。
