Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
Bone. 2012 May;50(5):1048-53. doi: 10.1016/j.bone.2012.01.028. Epub 2012 Feb 18.
A socio-economic gradient exists for most reasons of morbidity and mortality including delayed puberty in lower (LSES) as compared to higher (HSES) socio-economic stratum and puberty is an important factor affecting bone status in children and adolescents. Thus, a cross-sectional study was conducted on 195 age-matched pairs of girls (8-17years) from LSES and HSES in Pune City, India to assess the hypothesis that socio-economic factors working through late puberty would have a negative association with bone status of adolescents. Height, weight and Tanner stage were assessed. Total body bone mineral content (TBBMC), total body bone area (TBBA), total body bone mineral density (TBBMD), lean body mass (LBM) and total body fat mass (TBFM) were measured using GE Lunar DPX Pro Pencil Beam DXA (Wisconsin, USA) scanner. Mean TBBMC (1172±434g), TBBA (1351±356cm(2)), TBBMD (0.846±0.104g/cm(2)), LBM (21,622±5306g) and TBFM (7746±5194g) in LSES girls were significantly lower than that of HSES girls [TBBMC (1483±525g), TBBA (1533±380cm(2)), TBBMD (0.942±0.119g/cm(2)), LBM (24,308±5829g) and TBFM (12,196±7404g)] (p<0.01). There was a significant effect of age and puberty on all bone parameters. The differences in TBBMC, TBBA, LBM and TBFM between the 2 socio-economic strata at Tanner stage I were not significant (p>0.1) whereas there were significant differences in these parameters from Tanner stages II to V (p<0.05). The percentage difference between LSES and HSES girls in TBBMC, TBBA, TBBMD, LBM and TBFM was 3.4%, 0%, 3.7%, 0.2% and 17.3% respectively at Tanner stage I which increased to 19.1%, 9.7%, 10.4%, 8.8% and 31.2% respectively at Tanner stage V. In conclusion, our results suggest that pubertal years may provide a window of opportunity to promote bone health in adolescent girls from the lower socio-economic stratum.
存在与大多数发病率和死亡率相关的社会经济梯度，包括较低（LSES）和较高（HSES）社会经济阶层的青春期延迟，而青春期是影响儿童和青少年骨骼状况的重要因素。因此，在印度浦那市对来自 LSES 和 HSES 的 195 对年龄匹配的女孩（8-17 岁）进行了横断面研究，以评估以下假设：通过青春期延迟起作用的社会经济因素与青少年的骨骼状况呈负相关。评估了身高、体重和 Tanner 分期。使用 GE Lunar DPX Pro Pencil Beam DXA（威斯康星州，美国）扫描仪测量全身骨矿物质含量（TBBMC）、全身骨面积（TBBA）、全身骨矿物质密度（TBBMD）、瘦体重（LBM）和全身脂肪量（TBFM）。LSES 女孩的平均 TBBMC（1172±434g）、TBBA（1351±356cm（2））、TBBMD（0.846±0.104g/cm（2））、LBM（21622±5306g）和 TBFM（7746±5194g）明显低于 HSES 女孩[TBBMC（1483±525g）、TBBA（1533±380cm（2））、TBBMD（0.942±0.119g/cm（2））、LBM（24308±5829g）和 TBFM（12196±7404g）]（p<0.01）。年龄和青春期对所有骨骼参数均有显著影响。在 Tanner 分期 I 时，两个社会经济阶层之间的 TBBMC、TBBA、LBM 和 TBFM 差异不显著（p>0.1），而在 Tanner 分期 II 至 V 时，这些参数存在显著差异（p<0.05）。在 Tanner 分期 I 时，LSES 和 HSES 女孩在 TBBMC、TBBA、TBBMD、LBM 和 TBFM 方面的百分比差异分别为 3.4%、0%、3.7%、0.2%和 17.3%，而在 Tanner 分期 V 时分别增加到 19.1%、9.7%、10.4%、8.8%和 31.2%。总之，我们的结果表明，青春期可能为促进来自较低社会经济阶层的青少年的骨骼健康提供一个机会之窗。
