Chain Amina, Crivelli Marise, Faerstein Eduardo, Bezerra Flávia F
Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Pesquisa e Capacitação Física do Exército, Rio de Janeiro, Brazil.
Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Nutrition. 2017 Jan;33:14-19. doi: 10.1016/j.nut.2016.08.001. Epub 2016 Aug 24.
The aim of this study was to investigate the association between bone mineral density (BMD) and fat mass (FM) in a multiethnic population of Brazilian women and to evaluate the influence of total body mass and lean mass on this association.
This was a cross-sectional study nested within the Pro-Saúde Study, a prospective cohort of university civil servants in Rio de Janeiro. Participants were pre- (n = 100) and postmenopausal (n = 166) women. Total fat, lean mass, and BMD of total body, lumbar spine, and femoral neck were measured using dual energy x-ray absorptiometry. The association of BMD with FM was investigated after adjustment for total body mass (model 1) and lean mass (model 2) and potential confounding variables using multivariate linear regression models.
In model 1, FM was inversely associated with BMD for total body (B = -0.010; P < 0.01) and for femoral neck (B = -0.009 P < 0.05) in premenopausal women. No association between FM and BMD was observed in postmenopausal women. Model 2 yielded direct associations between FM and BMD (total and specific sites; B = 0.003-0.008; P < 0.01) in postmenopausal women only.
Independently of the adjustment used, the results of the present study suggest the absence of an inverse association between FM and BMD in postmenopausal women. Additionally, when adjusted for lean mass, a direct association between FM and bone mass can be observed, suggesting that for postmenopausal women being slightly obese does not confer excessive risk for bone loss and may even result in a bone density advantage.
本研究旨在调查巴西多民族女性群体中骨矿物质密度（BMD）与脂肪量（FM）之间的关联，并评估总体质量和瘦体重对这种关联的影响。
这是一项嵌套于“健康促进研究”的横断面研究，该研究是里约热内卢大学公务员的前瞻性队列研究。参与者为绝经前（n = 100）和绝经后（n = 166）女性。使用双能X线吸收法测量全身、腰椎和股骨颈的总脂肪、瘦体重和BMD。在对总体质量（模型1）和瘦体重（模型2）以及潜在混杂变量进行调整后，使用多元线性回归模型研究BMD与FM之间的关联。
在模型1中，绝经前女性的全身（B = -0.010；P < 0.01）和股骨颈（B = -0.009；P < 0.05）的FM与BMD呈负相关。绝经后女性未观察到FM与BMD之间的关联。仅在绝经后女性中，模型2得出FM与BMD（全身和特定部位；B = 0.003 - 0.008；P < 0.01）之间存在正相关。
无论采用何种调整方法，本研究结果表明绝经后女性中FM与BMD之间不存在负相关。此外，在对瘦体重进行调整后，可以观察到FM与骨量之间存在正相关，这表明对于绝经后女性来说，轻度肥胖不会带来过多的骨质流失风险，甚至可能导致骨密度优势。
