Mgodi Nyaradzo M, Kelly Cliff, Gati Brenda, Greenspan Susan, Dai James Y, Bragg Vivian, Livant Edward, Piper Jeanna M, Nakabiito Clemensia, Magure Tsitsi, Marrazzo Jeanne M, Chirenje Z Mike, Riddler Sharon A
University of Zimbabwe-University of California San Francisco Collaborative Research Programme, 15 Phillips Avenue, Belgravia, Harare, Zimbabwe,
Arch Osteoporos. 2015;10:206. doi: 10.1007/s11657-015-0206-7. Epub 2015 Feb 14.
There is a paucity of normative bone mineral density (BMD) data in healthy African women. Baseline total hip and lumbar spine BMD was measured in premenopausal women. BMD distribution was comparable to that of a reference population and was impacted by several factors including contraception and duration of lactation.
Normative data on bone mineral density (BMD) and the cumulative impact of lactation, contraceptive use, and other factors on BMD in healthy African women have not been well studied.
The objective of this study was to determine the factors associated with BMD in healthy premenopausal women in Uganda and Zimbabwe.
Baseline total hip (TH) and lumbar spine (LS) BMD was measured by dual x-ray absorptiometry in 518 healthy, premenopausal black women enrolling in VOICE, an HIV-1 chemoprevention trial, at sites in Uganda and Zimbabwe. Contraceptive and lactation histories, physical activity assessment, calcium intake, and serum vitamin D levels were assessed. Independent factors associated with BMD were identified using an analysis of covariance model.
The study enrolled 331 women from Zimbabwe and 187 women from Uganda. Median age was 29 years (IQR 25, 32) and median body mass index (BMI) was 24.8 kg/m(2) (IQR 22.2, 28.6). In univariate analyses, lower TH BMD values were associated with residence in Uganda (p < 0.001), lower BMI (p < 0.001), and any use of and duration of depot-medroxyprogresterone acetate. Use of oral contraceptives, progestin-only implants, and higher physical activity levels were protective against reduced BMD. Similarly, lower LS BMD values were associated with these same factors but also higher parity and history of breastfeeding. In a multivariable analysis, lower TH and LS BMD values were associated with enrollment in Uganda, lower BMI, and lower physical activity level; contraceptive use was associated with lower spine BMD, and breastfeeding contributed to lower total hip BMD.
Among healthy premenopausal women, TH and LS BMD was higher in Zimbabwe than Uganda. Additional factors independently associated with BMD included BMI, physical activity level, contraceptive use, and lactation.
健康非洲女性的正常骨矿物质密度（BMD）数据匮乏。对绝经前女性测量了基线全髋部和腰椎的骨矿物质密度。骨矿物质密度分布与参考人群相当，并受到包括避孕和哺乳期在内的多种因素影响。
关于健康非洲女性骨矿物质密度（BMD）以及哺乳期、避孕措施使用和其他因素对骨矿物质密度的累积影响的规范数据尚未得到充分研究。
本研究的目的是确定乌干达和津巴布韦健康绝经前女性骨矿物质密度的相关因素。
通过双能X线吸收法对518名参与HIV-1化学预防试验VOICE的健康绝经前黑人女性测量基线全髋部（TH）和腰椎（LS）的骨矿物质密度，这些女性来自乌干达和津巴布韦的试验点。评估了避孕和哺乳史、身体活动情况、钙摄入量和血清维生素D水平。使用协方差分析模型确定与骨矿物质密度相关的独立因素。
该研究纳入了331名来自津巴布韦的女性和187名来自乌干达的女性。中位年龄为29岁（四分位间距25，32），中位体重指数（BMI）为24.8kg/m²（四分位间距22.2，28.6）。在单因素分析中，较低的全髋部骨矿物质密度值与居住在乌干达（p<0.001）、较低的BMI（p<0.001）以及任何醋酸甲羟孕酮长效避孕针的使用及其持续时间有关。使用口服避孕药、仅含孕激素的植入剂以及较高的身体活动水平对骨矿物质密度降低具有保护作用。同样，较低的腰椎骨矿物质密度值与这些相同因素有关，但也与较高的产次和母乳喂养史有关。在多变量分析中，较低的全髋部和腰椎骨矿物质密度值与在乌干达参与研究、较低的BMI以及较低的身体活动水平有关；避孕措施的使用与较低的脊柱骨矿物质密度有关，而母乳喂养导致较低的全髋部骨矿物质密度。
在健康绝经前女性中，津巴布韦的全髋部和腰椎骨矿物质密度高于乌干达。与骨矿物质密度独立相关的其他因素包括BMI、身体活动水平、避孕措施的使用和哺乳。
