Nóbrega da Silva Valéria, Goldberg Tamara Beres Lederer, Mosca Luciana Nunes, Bisi Rizzo Anapaula da Conceição, Teixeira Altamir dos Santos, Corrente José Eduardo
Postgraduate Program in Gynecology, Obstetrics, and Mastology, Discipline of Adolescent Medicine, Department of Pediatrics, Botucatu Medicine School, UNESP, São Paulo State University, Botucatu, SP 18618-970, Brazil.
Tropical Disease and Image Diagnosis, Botucatu Medicine School, UNESP, São Paulo State University, Botucatu, SP 18618-970, Brazil.
Bone. 2014 Sep;66:1-7. doi: 10.1016/j.bone.2014.05.011. Epub 2014 May 27.
Growing concern has focused on the occurrence of metabolic syndrome (MetS) and its effects on bone mass. There is little information available in the literature concerning the relationship between MetS and BMD in adolescents. The aim of this study was to evaluate the effects of MetS and its components on bone mineral density (BMD) in overweight adolescent boys and girls. This cross-sectional study assessed 271 overweight adolescents with or without MetS (age 10 to 16years). Anthropometric and biochemical tests were performed. Lumbar spine, proximal femur and total and subtotal body BMD values were obtained by bone densitometry with dual-energy X-ray absorptiometry. MetS was observed in 14% of the adolescents. Overweight adolescents of both genders who were positive for MetS presented with significant decreases in BMD (g/cm(2)/kg bodyweight) at all sites evaluated (p<0.01). Female adolescents with large waist circumference, low HDLc, hypertriglyceridemia and high blood pressure showed significant reductions in BMD at all sites evaluated (p<0.01) and, with the exception of increased triglycerides (which had no effect on BMD, p>0.05), the same pattern was observed in male adolescents. Linear regression analyses revealed that waist circumference was negatively correlated with BMD in both genders and that triglycerides were negatively correlated with BMD only in female adolescents. Our results suggest that overweight adolescents with MetS have lower BMD than adolescents without MetS. Among all MetS components measured, increased waist circumference had the strongest relationship with reductions in BMD.
对代谢综合征（MetS）的发生及其对骨量的影响的关注日益增加。关于青少年中MetS与骨密度（BMD）之间的关系，文献中几乎没有相关信息。本研究的目的是评估MetS及其组成成分对超重青少年男孩和女孩骨矿物质密度（BMD）的影响。这项横断面研究评估了271名有或没有MetS的超重青少年（年龄10至16岁）。进行了人体测量和生化测试。通过双能X线吸收法骨密度测定获得腰椎、股骨近端以及全身和半身的BMD值。在14%的青少年中观察到了MetS。MetS呈阳性的超重青少年在所有评估部位的BMD（g/cm²/体重kg）均显著降低（p<0.01）。腰围大、高密度脂蛋白胆固醇低、高甘油三酯血症和高血压的女性青少年在所有评估部位的BMD均显著降低（p<0.01），除甘油三酯升高（对BMD无影响，p>0.05）外，男性青少年也观察到相同模式。线性回归分析显示，腰围在两性中均与BMD呈负相关，甘油三酯仅在女性青少年中与BMD呈负相关。我们的结果表明，患有MetS的超重青少年的BMD低于没有MetS的青少年。在所有测量的MetS组成成分中，腰围增加与BMD降低的关系最为密切。
