Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.
Department of Osteoporosis, Metabolic Bone Disease and Genetic Research Unit, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.
Osteoporos Int. 2017 Sep;28(9):2645-2652. doi: 10.1007/s00198-017-4081-5. Epub 2017 May 29.
Associations of adiposity indices with bone mineral density (BMD) and bone turnover markers were evaluated in Chinese participants. Body mass index, fat mass, and lean mass are positively related to BMD in both genders. Subcutaneous fat area was proved to be negatively associated with BMD and positively correlated with osteocalcin in postmenopausal females.
Obesity is highly associated with osteoporosis, but the effect of adipose tissue on bone is contradictory. Our study aimed to assess the associations of adiposity indices with bone mineral density (BMD) and bone turnover markers (BTMs) in the Chinese population.
Our study recruited 5215 participants from the Shanghai area, evaluated related anthropometric and biochemical traits in all participants, tested serum BTMs, calculated fat distribution using magnetic resonance imaging (MRI) images and image analysis software, and tested BMD with dual-energy X-ray absorptiometry.
When controlled for age, all adiposity indices were positively correlated with BMD of all sites for both genders. As for the stepwise regression analysis, body mass index (BMI), fat mass, and lean mass were protective for BMD in both genders. However, subcutaneous fat area (SFA) was detrimental for BMD of the L1-4 and femoral neck (β ± SE -0.0742 ± 0.0174; p = 2.11E-05; β ± SE -0.0612 ± 0.0147; p = 3.07E-05). Adiposity indices showed a negative correlation with BTMs adjusting for age, especially with osteocalcin. In the stepwise regression analysis, fat mass was negatively correlated with osteocalcin (β ± SE -8.8712 ± 1.4902; p = 4.17E-09) and lean mass showed a negative correlation with N-terminal procollagen of type I collagen (PINP) for males (β ± SE -0.3169 ± 0.0917; p = 0.0006). In females, BMI and visceral fat area (VFA) were all negatively associated with osteocalcin (β ± SE -0.4423 ± 0.0663; p = 2.85E-11; β ± SE -7.1982 ± 1.1094; p = 9.95E-11), while SFA showed a positive correlation with osteocalcin (β ± SE: 5.5993 ± 1.1753; p = 1.98E-06).
BMI, fat mass, and lean mass are proved to be beneficial for BMD in both males and postmenopausal females. SFA is negatively associated with BMD and positively correlated with osteocalcin in postmenopausal females.
评估中国人群中体脂指数与骨密度(BMD)和骨转换标志物(BTM)的相关性。
本研究共纳入了来自上海地区的 5215 名参与者,评估了所有参与者的相关人体测量学和生化特征,检测了血清 BTM,使用磁共振成像(MRI)图像和图像分析软件计算了脂肪分布,并使用双能 X 射线吸收法检测了 BMD。
在控制年龄的情况下,所有体脂指数与两性各部位的 BMD 均呈正相关。在逐步回归分析中,BMI、脂肪量和瘦体重对两性的 BMD 均有保护作用。然而,皮下脂肪面积(SFA)对 L1-4 和股骨颈的 BMD 有不利影响(β ± SE -0.0742 ± 0.0174;p = 2.11E-05;β ± SE -0.0612 ± 0.0147;p = 3.07E-05)。体脂指数与 BTM 呈负相关,尤其是与骨钙素。在逐步回归分析中,脂肪量与骨钙素呈负相关(β ± SE -8.8712 ± 1.4902;p = 4.17E-09),男性瘦体重与 I 型胶原 N 端前肽(PINP)呈负相关(β ± SE -0.3169 ± 0.0917;p = 0.0006)。在女性中,BMI 和内脏脂肪面积(VFA)均与骨钙素呈负相关(β ± SE -0.4423 ± 0.0663;p = 2.85E-11;β ± SE -7.1982 ± 1.1094;p = 9.95E-11),而 SFA 与骨钙素呈正相关(β ± SE:5.5993 ± 1.1753;p = 1.98E-06)。
BMI、脂肪量和瘦体重均对男性和绝经后女性的 BMD 有益。SFA 与绝经后女性的 BMD 呈负相关,与骨钙素呈正相关。