Department of Pediatrics, Medical College of Georgia, Augusta, GA, USA.
Osteoporos Int. 2011 Feb;22(2):655-65. doi: 10.1007/s00198-010-1266-6. Epub 2010 May 7.
Despite adolescent black females experiencing the highest rates of obesity, the effect of excess fat mass on bone structure and strength in this population is unknown. Our findings in postadolescent black females suggest that excess weight in the form of fat mass may adversely influence cortical bone structure and strength.
Although adolescent obesity has been associated with reduced bone structure and strength in white females, this relationship has not been studied in adolescent black females, a population experiencing the highest rates of obesity. Our objective was to compare bone structure and strength between postadolescent black females with normal and high levels of adiposity.
Black females with ≤ 32% body fat were classified as normal body fat (NF; n = 33, aged 19.3 ± 1.3 years); females exceeding this cutoff were classified as high body fat (HF; n = 15, aged 19.0 ± 1.1 years). Using peripheral quantitative computed tomography, tibial and radial bones were scanned at the 4% (trabecular) and 20% (cortical) sites from the distal metaphyses. Fat-free soft-tissue mass (FFST) and %body fat were assessed by dual-energy X-ray absorptiometry.
After controlling for either FFST or body weight, the HF vs. NF group had lower total cross-sectional area (CSA; 9-17%), cortical CSA (6-15%), and strength-strain index (SSI; 13-24%) at the cortical site of the tibia (all p < 0.05). At the cortical site of the radius, the HF vs. NF group had lower total CSA (14%, p = 0.03), cortical CSA (9%, p = 0.04), and SSI (15%, p = 0.07) after control for body weight. There were no group differences in either the FFST-adjusted cortical bone values at the radius or in the trabecular bone parameters (body weight- or FFST-adjusted) at the tibia and radius.
Consistent with our adiposity and bone data in late-adolescent white females, our findings in black females entering adulthood also suggest that obesity may adversely influence cortical bone strength.
尽管青少年黑人女性肥胖率最高,但脂肪量过多对该人群骨结构和强度的影响尚不清楚。我们在青春期后黑人女性中的发现表明,脂肪量形式的超重可能会对皮质骨结构和强度产生不利影响。
体脂率≤32%的黑人女性被归类为正常体脂(NF;n=33,年龄 19.3±1.3 岁);超过此切点的女性被归类为高体脂(HF;n=15,年龄 19.0±1.1 岁)。使用外周定量计算机断层扫描(pQCT),在距远端干骺端 4%(骨小梁)和 20%(皮质)处扫描胫骨和桡骨。通过双能 X 射线吸收法评估无脂肪软组织质量(FFST)和%体脂。
在控制 FFST 或体重后,HF 组与 NF 组相比,胫骨皮质部位的总横截面积(CSA;9-17%)、皮质 CSA(6-15%)和强度应变指数(SSI;13-24%)均较低(均 p<0.05)。在桡骨皮质部位,HF 组与 NF 组相比,在控制体重后,总 CSA(14%,p=0.03)、皮质 CSA(9%,p=0.04)和 SSI(15%,p=0.07)较低。在桡骨的 FFST 调整皮质骨值或胫骨和桡骨的小梁骨参数(体重或 FFST 调整)方面,两组之间没有差异。
与我们在青春期后白人女性中的肥胖和骨数据一致,我们在进入成年期的黑人女性中的发现也表明,肥胖可能会对皮质骨强度产生不利影响。