Kumar Ashok, Sharma Aparna K, Mittal Soniya, Kumar Guresh
Department of Obstetrics & Gynaecology, Maulana Azad Medical College, Associated Lok Nayak Hospital, New Delhi, 110002 India.
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India ; D-11/1, DLF Exclusive Floors, DLF Phase V, Gurgaon, 122009 Haryana India.
J Obstet Gynaecol India. 2016 Feb;66(1):52-6. doi: 10.1007/s13224-014-0629-x. Epub 2014 Oct 29.
Present study aims to examine the relationship of the bone mineral density (BMD) with body mass index (BMI) in an apparently healthy premenopausal and postmenopausal north Indian female population.
Two hundred and fifty-five apparently healthy women were evaluated by a detailed questionnaire including all possible factors that could affect the BMD. The height and weight of all the subjects were recorded and BMI was calculated. Bone mineral density was measured by DXA (Dual Electron X-ray Absorptiometry) at L1-L4 Lumbar spine (LS) and femur neck (FN) by using the Prodigy DXA system (software version:8.50) manufactured by GE medical systems LUNAR.
The population was divided into pre and postmenopausal groups. The BMD at all sites increased with BMI in both groups. In a multiple regression model, the attributability of BMI and age to variation in LSBMD and FNBMD was 10.3 and 13.9 %, respectively. In postmenopausal women, age, BMI, and a previous history of fracture together attributed to a variance in BMI of 40.1 and 27.6 % at lumbar spine and femur neck, respectively. BMI was found to be significantly associated with low BMD at both sites in premenopausal women, while the association was lost in postmenopausal females.
BMI is an important determinant of BMD in Indian females. However, the association is not present in postmenopausal women with osteopenia. In addition, the effect of increase in BMI on BMD has a ceiling effect, and moderate to morbid obesity might not actually be a preventive factor for osteopenia.
本研究旨在探讨在明显健康的印度北部绝经前和绝经后女性人群中，骨密度（BMD）与体重指数（BMI）之间的关系。
通过一份详细问卷对255名明显健康的女性进行评估，问卷涵盖所有可能影响骨密度的因素。记录所有受试者的身高和体重，并计算体重指数。使用GE医疗系统LUNAR生产的Prodigy DXA系统（软件版本：8.50），通过双能X线吸收法（DXA）测量第1 - 4腰椎（LS）和股骨颈（FN）的骨密度。
将人群分为绝经前和绝经后两组。两组中所有部位的骨密度均随体重指数增加而升高。在多元回归模型中，体重指数和年龄对腰椎骨密度（LSBMD）和股骨颈骨密度（FNBMD）变化的贡献率分别为10.3%和13.9%。在绝经后女性中，年龄、体重指数和既往骨折史共同导致腰椎和股骨颈处体重指数变化的贡献率分别为40.1%和27.6%。在绝经前女性中，发现体重指数与两个部位的低骨密度均显著相关，而在绝经后女性中这种关联消失。
体重指数是印度女性骨密度的重要决定因素。然而，在患有骨质减少的绝经后女性中不存在这种关联。此外，体重指数增加对骨密度的影响存在上限效应，中度至重度肥胖实际上可能并非骨质减少的预防因素。
