通过双能X线吸收法测量的内脏脂肪与非肥胖老年女性非脊柱骨折风险增加相关：来自圣保罗衰老与健康（SPAH）研究的一项基于人群的前瞻性队列分析。
Visceral fat measured by DXA is associated with increased risk of non-spine fractures in nonobese elderly women: a population-based prospective cohort analysis from the São Paulo Ageing & Health (SPAH) Study.
作者信息
Machado L G, Domiciano D S, Figueiredo C P, Caparbo V F, Takayama L, Oliveira R M, Lopes J B, Menezes P R, Pereira R M R
机构信息
Bone Metabolism Laboratory of Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3° andar, sala 3093, São Paulo, SP, 01246-903, Brazil.
RDO Diagnósticos Médicos, São Paulo, Brazil.
出版信息
Osteoporos Int. 2016 Dec;27(12):3525-3533. doi: 10.1007/s00198-016-3682-8. Epub 2016 Jun 28.
UNLABELLED
The present study investigates the relationship between visceral fat measured by dual-energy X-ray absorptiometry (DXA) and the incidence of non-spine fractures in community-dwelling elderly women. We demonstrated a potential negative effect of visceral fat on bone health in nonobese women.
INTRODUCTION
The protective effect of obesity on bone health has been questioned because visceral fat has been demonstrated to have a deleterious effect on bone. The aim of this study was to investigate the association of visceral fat measured by DXA with the incidence of non-spine fractures in community-dwelling elderly women.
METHODS
This longitudinal prospective population-based cohort study evaluated 433 community-dwelling women aged 65 years or older. A specific clinical questionnaire, including personal history of a fragility fracture in non-spine osteoporotic sites, was administered at baseline and after an average of 4.3 years. All incidences of fragility fractures during the study period were confirmed by affected-site radiography. Visceral adipose tissue (VAT) was measured in the android region of a whole-body DXA scan.
RESULTS
The mean age was 72.8 ± 4.7 years, and 28 incident non-spine osteoporotic fractures were identified after a mean follow-up time of 4.3 ± 0.8 years. According to the Lipschitz classification for nutritional status in the elderly, 38.6 % of women were nonobese (BMI ≤ 27 kg/m) and 61.4 % were obese/overweight. Logistic regression models were used to estimate the relationship between VAT and non-spine fractures in elderly women. After adjusting for age, race, previous fractures, and BMD, VAT (mass, area, volume) had a significant association with the incidence of non-spine fractures only in nonobese elderly women (VAT mass: OR, 1.42 [95 % CI, 1.09-1.85; p = 0.010]; VAT area: OR, 1.19 [95 % CI, 1.05-1.36; p = 0.008]; VAT volume: OR, 1.40 [95 % CI, 1.09-1.80; p = 0.009]).
CONCLUSION
This study suggests a potential negative effect of visceral adiposity on bone health in nonobese women.
未标注
本研究调查了通过双能X线吸收法（DXA）测量的内脏脂肪与社区居住老年女性非脊柱骨折发生率之间的关系。我们证明了内脏脂肪对非肥胖女性骨骼健康有潜在的负面影响。
引言
肥胖对骨骼健康的保护作用受到质疑，因为内脏脂肪已被证明对骨骼有有害影响。本研究的目的是调查通过DXA测量的内脏脂肪与社区居住老年女性非脊柱骨折发生率之间的关联。
方法
这项基于人群的纵向前瞻性队列研究评估了433名65岁及以上的社区居住女性。在基线时和平均4.3年后发放了一份特定的临床问卷，包括非脊柱骨质疏松部位脆性骨折的个人病史。研究期间所有脆性骨折的发生率均通过受影响部位的X线摄影得到证实。通过全身DXA扫描测量腹部内脏脂肪组织（VAT）。
结果
平均年龄为72.8±4.7岁，在平均4.3±0.8年的随访时间后，确定了28例非脊柱骨质疏松性骨折。根据老年人营养状况Lipchitz分类，38.6%的女性为非肥胖（BMI≤27kg/m²），61.4%为肥胖/超重。使用逻辑回归模型估计老年女性VAT与非脊柱骨折之间的关系。在调整年龄、种族、既往骨折和骨密度后，VAT（质量、面积、体积）仅在非肥胖老年女性中与非脊柱骨折发生率有显著关联（VAT质量：OR，1.42[95%CI,1.09 - 1.85；p = 0.010]；VAT面积：OR，1.19[95%CI,1.0就5 - 1.36；p = 0.008]；VAT体积：OR，1.40[95%CI,1.09 - 1.80；p = 0.009]）。
结论
本研究表明内脏肥胖对非肥胖女性骨骼健康有潜在的负面影响。
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