Nutrition Department, School of Public Health, Sao Paulo University, Av. Dr. Arnaldo, 715, São Paulo-SP, Brazil CEP-01246-904.
Lipids Health Dis. 2012 Mar 12;11:37. doi: 10.1186/1476-511X-11-37.
Several parameters are associated with high bone mineral density (BMD), such as overweight, black background, intense physical activity (PA), greater calcium intake and some medications. The objectives are to evaluate the prevalence and the main aspects associated with high BMD in healthy women.
After reviewing the database of approximately 21,500 BMD scans performed in the metropolitan area of São Paulo, Brazil, from June 2005 to October 2010, high BMD (over 1400 g/cm² at lumbar spine and/or above 1200 g/cm² at femoral neck) was found in 421 exams. Exclusion criteria were age below 30 or above 60 years, black ethnicity, pregnant or obese women, disease and/or medications known to interfere with bone metabolism. A total of 40 women with high BMD were included and matched with 40 healthy women with normal BMD, paired to weight, age, skin color and menopausal status. Medical history, food intake and PA were assessed through validated questionnaires. Body composition was evaluated through a GE-Lunar DPX MD + bone densitometer. Radiography of the thoracic and lumbar spine was carried out to exclude degenerative alterations or fractures. Biochemical parameters included both lipid and hormonal profiles, along with mineral and bone metabolism. Statistical analysis included parametric and nonparametric tests and linear regression models. P < 0.05 was considered significant.
The mean age was 50.9 (8.3) years. There was no significant difference between groups in relation to PA, smoking, intake of calcium and vitamin D, as well as laboratory tests, except serum C-telopeptide of type I collagen (s-CTX), which was lower in the high BMD group (p = 0.04). In the final model of multivariate regression, a lower fat intake and body fatness as well a better profile of LDL-cholesterol predicted almost 35% of high BMD in women. (adjusted R2 = 0.347; p < 0.001). In addition, greater amounts of lean mass and higher IGF-1 serum concentrations played a protective role, regardless age and weight.
Our results demonstrate the potential deleterious effect of lipid metabolism-related components, including fat intake and body fatness and worse lipid profile, on bone mass and metabolism in healthy women.
多项参数与骨密度（BMD）升高相关，例如超重、黑色人种、剧烈的体力活动（PA）、高钙摄入和某些药物。本研究旨在评估健康女性中高 BMD 的发生率和主要相关因素。
回顾巴西圣保罗大都市区 2005 年 6 月至 2010 年 10 月期间进行的约 21500 次 BMD 扫描的数据库后，发现 421 例患者的 BMD 升高（腰椎骨密度超过 1400g/cm²，或股骨颈骨密度超过 1200g/cm²）。排除标准为年龄<30 岁或>60 岁、黑种人、孕妇或肥胖者、已知影响骨代谢的疾病和/或药物。共纳入 40 例高 BMD 患者，并与 40 例正常 BMD 的健康女性相匹配，配对因素为体重、年龄、肤色和绝经状态。通过已验证的问卷评估了每位患者的病史、饮食摄入和 PA。采用 GE-Lunar DPX MD+骨密度仪评估身体成分。对胸腰椎进行 X 线检查以排除退行性改变或骨折。生化参数包括血脂和激素谱，以及矿物质和骨代谢。采用参数和非参数检验及线性回归模型进行统计分析。P<0.05 为差异有统计学意义。
患者平均年龄为 50.9（8.3）岁。两组患者的 PA、吸烟、钙和维生素 D 摄入以及实验室检查结果无显著差异，仅血清 I 型胶原 C-末端肽（s-CTX）不同，高 BMD 组的 s-CTX 较低（p=0.04）。多元回归的最终模型显示，脂肪摄入量和体脂率较低，LDL-胆固醇谱更好，这几乎可以预测女性 35%的高 BMD。（调整后的 R2=0.347；P<0.001）。此外，无论年龄和体重如何，瘦体重和 IGF-1 血清浓度较高均发挥保护作用。
我们的研究结果表明，脂质代谢相关成分（包括脂肪摄入量和体脂率及较差的血脂谱）可能对健康女性的骨量和代谢产生有害影响。
