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采用不同肥胖标准对中国北方男性身体成分与骨密度的相关性研究

Association of body composition with bone mineral density in northern Chinese men by different criteria for obesity.

作者信息

Kang D H, Guo L F, Guo T, Wang Y, Liu T, Feng X Y, Che X Q

机构信息

Department of Endocrinology, Qianfoshan Hospital, Shandong University, No. 16766 Jingshi Road, Jinan, 250014, China.

出版信息

J Endocrinol Invest. 2015 Mar;38(3):323-31. doi: 10.1007/s40618-014-0167-5. Epub 2014 Sep 25.

Abstract

UNLABELLED

With impressive economic development, obesity has emerged as a critical public health issue in China. Recently it was reported that obesity has taken an adverse effect on osteoporosis. Because there is different body mass index (BMI) for obesity globally, studies based on BMI levels on association of obesity with osteoporosis were quite few. Therefore, we discussed the relationship of body composition with skeletal BMD according to WHO BMI and BMI on Working Group on Obesity in China (WGOC).

METHODS

A total of 502 adult men aged 20-89 were enrolled as healthy subjects for osteoporosis study at Qianfoshan Hospital, Shandong University between September 2008 and August 2010. According to WHO BMI, all subjects were divided into three groups: normal weight (18.5 ≤ BMI < 25 kg/m(2), n = 202), overweight (25 ≤ BMI < 30 kg/m(2), n = 242), and obesity (BMI ≥ 30 kg/m(2), n = 58). According to WGOC BMI, normal weight (18.5 ≤ BMI < 24 kg/m(2), n = 137), overweight (24 ≤ BMI < 28 kg/m(2), n = 225), and obesity (BMI ≥ 28 kg/m(2), n = 140). Total body and regional BMD, lean mass (LM), lean body mass index (LBMI), fat mass (FM), percent body fat (%BF) and fat mass index (FMI) were measured by dual-energy X-ray absorptiometry. Age-partial Pearson correlation analyses between body composition-related parameters and BMD. Multiple regression analyses were performed to explore the associations of BMD with LM, LBMI, FM, %BF and FMI.

RESULTS

Fat mass (FM), %BF, FMI, LM and LBMI were positively correlated with BMD at almost sites (P < 0.001) in all subjects. However, the relationship was not different among groups. LM, LBMI, FM and FMI were positively correlated with BMD (P < 0.01) in normal weight. LM and LBMI appeared significantly positive with BMD in overweight and obesity according to WHO and WGOC criteria. %BF and FMI were negative significance with BMD at total body and some regional BMD according to WHO criteria in overweight (P < 0.05). In two obese groups, %BF appeared negatively significant with BMD (P < 0.05) according to WGOC criteria, and %BF and FMI appeared negatively significant with BMD (P < 0.05) according to WHO criteria. In regression of independent variables as FM and LM, LM showed statistically positively significant relations with BMD at almost sites (P < 0.05) in all groups. FM appeared positively significant with BMD in normal groups and overweight group according to WGOC criteria. In regression of independent variables as %BF and FMI, %BF and FMI appeared statistically negatively significant relations with BMD in overweight and obesity, but %BF and FMI were inconsistent in same site.

CONCLUSIONS

Lean mass (LM) and LBMI could help to determinant of BMD, and %BF and FMI were adverse to BMD in overweight and obesity. Comparing with two criteria, we found the differences in fat-related parameters and BMD according to WHO criteria were more obvious than that according to WGOC criteria. We also found that %BF and FMI were useful to research the relationship between osteoporosis and obesity at the same time.

摘要

未标注

随着经济的显著发展,肥胖已成为中国一个关键的公共卫生问题。最近有报道称肥胖对骨质疏松症产生了不利影响。由于全球肥胖的体重指数(BMI)标准不同,基于BMI水平研究肥胖与骨质疏松症关联的研究相当少。因此,我们根据世界卫生组织(WHO)的BMI标准和中国肥胖问题工作组(WGOC)的BMI标准,探讨了身体成分与骨骼骨密度(BMD)之间的关系。

方法

2008年9月至2010年8月期间,山东大学千佛山医院招募了502名年龄在20 - 89岁的成年男性作为骨质疏松症研究的健康受试者。根据WHO的BMI标准,所有受试者分为三组:正常体重(18.5≤BMI<25kg/m²,n = 202)、超重(25≤BMI<30kg/m²,n = 242)和肥胖(BMI≥30kg/m²,n = 58)。根据WGOC的BMI标准,正常体重(18.5≤BMI<24kg/m²,n = 137)、超重(24≤BMI<28kg/m²,n = 225)和肥胖(BMI≥28kg/m²,n = 140)。采用双能X线吸收法测量全身和局部的骨密度、去脂体重(LM)、去脂体重指数(LBMI)、脂肪量(FM)、体脂百分比(%BF)和脂肪量指数(FMI)。对身体成分相关参数与骨密度进行年龄偏相关分析。进行多元回归分析以探讨骨密度与去脂体重、去脂体重指数、脂肪量、体脂百分比和脂肪量指数之间的关联。

结果

在所有受试者中,脂肪量(FM)、体脂百分比(%BF)、脂肪量指数(FMI)、去脂体重(LM)和去脂体重指数(LBMI)与几乎所有部位的骨密度均呈正相关(P<0.001)。然而,各组之间的这种关系并无差异。在正常体重组中去脂体重、去脂体重指数、脂肪量和脂肪量指数与骨密度呈正相关(P<0.01)。根据WHO和WGOC标准,在超重和肥胖组中,去脂体重和去脂体重指数与骨密度呈显著正相关。根据WHO标准,在超重组中,体脂百分比和脂肪量指数与全身及一些局部骨密度呈负相关(P<0.05)。在两个肥胖组中,根据WGOC标准,体脂百分比与骨密度呈负相关(P<0.05);根据WHO标准,体脂百分比和脂肪量指数与骨密度呈负相关(P<0.05)。在以脂肪量和去脂体重为自变量的回归分析中,在所有组中,去脂体重与几乎所有部位的骨密度均呈统计学显著正相关(P<0.05)。根据WGOC标准,在正常组和超重组中,脂肪量与骨密度呈正相关。在以体脂百分比和脂肪量指数为自变量的回归分析中,在超重和肥胖组中,体脂百分比和脂肪量指数与骨密度呈统计学负相关,但在同一部位两者并不一致。

结论

去脂体重(LM)和去脂体重指数(LBMI)有助于确定骨密度,而在超重和肥胖人群中,体脂百分比(%BF)和脂肪量指数(FMI)对骨密度有不利影响。与两种标准相比,我们发现根据WHO标准,脂肪相关参数与骨密度的差异比根据WGOC标准更明显。我们还发现,体脂百分比和脂肪量指数同时有助于研究骨质疏松症与肥胖之间的关系。

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