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[体重指数与腰椎平均骨密度的相关性:对男性骨质减少和骨质疏松患者的一项研究]

[On correlation between body mass index and lumbar spine average bone mineral density: a study in male patients with osteopenia and those with osteoporosis].

作者信息

Lin Haidan, Luo Qinglu, He Chengqi, Yang Lin, He Hongchen, Wu Yuanchao, Lan Qun, Xie Wei, Xiong Enfu

机构信息

Department of Rehabilitation, West China Hosiptal, Sichuan University, Chengdu 610041, China.

出版信息

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2010 Feb;27(1):138-41.

Abstract

From among the patients who visited the Dept. of Rehabilitation of West China Hospital for arthalgia in the period from Aug. 2003 to Dec. 2005, we recruited 566 male patients who were over 40 years of age and did not have hyperostosis in the lumbar spine, and whose T scores were each less than--1. Their ages ranged from 40 to 93 years, and the average age was 62.93 +/- 13.50. The dual-energy X-ray absorptiometry from DMS Company in France was used to measure the bone density of the L2-4 anterior-posterior. The basic data about the subjects, containing the age, height, weight, diabetes mellitus, exercise and smoking or not, were recorded. Then the body mass index were calculated. In accordance to the T score, the subjects were separated into two groups: osteopenia group and osteoporosis group. In comparison of the basic data between groups, BMI of osteoporosis group was significantly higher than that of the osteopenia group, but the number of the subjects who exercised was smaller (P < 0.05). Multiple linear regression analysis revealed that in the case BMI increased by 1 kg/m2, BMD significantly decreased by 0.003 g/cm2 (P = 0.002), and the age negatively correlated with BMD (B = -0.001, P = 0.035). "Exercise or not" was positively related to BMD (B = 0.028, P = 0.000). "Smoking or not" and BMD were not significantly correlated (P = 0.837). In conclusion, increase of BMI, or we may say, increase of fat, would decrease the lumbar spine average BMD in the patients of osteoporosis or osteopenia. Some reports have pointed out that only by increasing BMI with increased amount of muscles, but not with increased amount of fat, would be beneficial to the prevention of osteoporosis. So we concluded that the muscle amount in the subjects should be taken into account when we probe into the relation between BMI and BMD.

摘要

在2003年8月至2005年12月期间到华西医院康复科就诊的关节痛患者中,我们招募了566名40岁以上、腰椎无骨质增生且T值均小于-1的男性患者。他们的年龄在40至93岁之间,平均年龄为62.93±13.50岁。采用法国DMS公司的双能X线吸收法测量L2-4椎体前后位的骨密度。记录受试者的年龄、身高、体重、糖尿病、运动情况及是否吸烟等基本数据,然后计算体重指数。根据T值将受试者分为两组:骨量减少组和骨质疏松组。组间基本数据比较显示,骨质疏松组的体重指数显著高于骨量减少组,但运动的受试者人数较少(P<0.05)。多元线性回归分析显示,体重指数每增加1kg/m2,骨密度显著降低0.003g/cm2(P = 0.002),年龄与骨密度呈负相关(B=-0.001,P = 0.035)。“是否运动”与骨密度呈正相关(B = 0.028,P = 0.000)。“是否吸烟”与骨密度无显著相关性(P = 0.837)。综上所述,体重指数增加,或者说脂肪增加,会降低骨质疏松或骨量减少患者的腰椎平均骨密度。一些报道指出,只有通过增加肌肉量而非脂肪量来增加体重指数,才有利于预防骨质疏松。因此我们得出结论,在探讨体重指数与骨密度的关系时应考虑受试者的肌肉量。

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