Kim Y M, Kim S H, Kim S, Yoo J S, Choe E Y, Won Y J
Division of Endocrinology, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea.
Institute for Translational and Clinical Research, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea.
Osteoporos Int. 2016 Aug;27(8):2543-54. doi: 10.1007/s00198-016-3566-y. Epub 2016 Apr 25.
The relationship of body composition and bone mineral density is complex and controversial. When classifying Korean population based on gender, age, and body mass index, fat mass had varying contributions to bone mineral density.
The relationship between body composition and bone mineral density (BMD) is complex, and it is uncertain how components of body mass variably affect BMD.
This cross-sectional observational study was performed in subjects ≥20 years based on the Korea National Health and Nutrition Examination Survey (KNHANES) 2008 to 2011. Among 17,583 subjects, the mean ages were 49.1 ± 16.0 years (M, n = 7495) and 49.3 ± 16.3 years (F, n = 10,088). Subjects were divided into age groups, either <50 or ≥50 years for males, or menopausal state, either premenopausal or postmenopausal, for females. A further classification used BMI, either <25 or ≥25 kg/m(2). Anthropometric and body composition parameters were compared and evaluated to look for correlations with BMD. Further, appendicular lean mass (ALM), fat mass (FM), fat percentage (FP), and waist circumference (WC) were included for multivariate analysis with BMD, controlling for covariates in each age group and BMI subgroup.
Anthropometric and body composition parameters significantly correlated with BMD in all age groups for both genders. After adjusting for covariates, ALM strongly affected BMD in all age groups for both genders. FM, FP, and WC significantly affected BMD in both age groups of women and in older men, but they did not affect BMD in younger men. Fat indices positively affected BMD of all sites in all non-obese women and in non-obese older men. However, little contribution was found in obese subgroups of both genders and in non-obese younger men.
Considering different weights of covariates, ALM strongly contributed to BMD in all gender, age, and BMI groups. On the other hand, fat indices positively affected BMD of both age groups in women and older men with normal BMI, but they showed little contribution to BMD within the same age groups with high BMI or any BMI subgroups of younger men.
身体成分与骨密度之间的关系复杂且存在争议。在根据性别、年龄和体重指数对韩国人群进行分类时，脂肪量对骨密度的贡献各不相同。
身体成分与骨密度（BMD）之间的关系很复杂，体重各组成部分如何不同地影响骨密度尚不确定。
本横断面观察性研究基于2008年至2011年韩国国家健康与营养检查调查（KNHANES），对年龄≥20岁的受试者进行。在17583名受试者中，男性的平均年龄为49.1±16.0岁（n = 7495），女性为49.3±16.3岁（n = 10088）。男性按年龄组分为<50岁或≥50岁，女性按绝经状态分为绝经前或绝经后。进一步分类采用BMI，分为<25或≥25 kg/m²。比较并评估人体测量和身体成分参数，以寻找与骨密度的相关性。此外，将四肢瘦体重（ALM）、脂肪量（FM）、脂肪百分比（FP）和腰围（WC）纳入与骨密度的多变量分析，在每个年龄组和BMI亚组中对协变量进行控制。
人体测量和身体成分参数在所有年龄组的男女中均与骨密度显著相关。在调整协变量后，ALM在所有年龄组的男女中均对骨密度有强烈影响。FM、FP和WC在女性的两个年龄组和老年男性中对骨密度有显著影响，但在年轻男性中对骨密度没有影响。脂肪指数对所有非肥胖女性和非肥胖老年男性所有部位的骨密度有正向影响。然而，在男女肥胖亚组和非肥胖年轻男性中发现其贡献很小。
考虑到协变量的不同权重，ALM在所有性别、年龄和BMI组中对骨密度有很大贡献。另一方面，脂肪指数对BMI正常的女性和老年男性的两个年龄组的骨密度有正向影响，但在BMI高的同一年龄组或年轻男性的任何BMI亚组中对骨密度的贡献很小。
