Song Cui, Zhu Min, Zheng Rongfei, Hu Yujuan, Li Rong, Zhu Gaohui, Chen Long, Xiong Feng
Department of Endocrine and Genetic Metabolism Disease, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders.
China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing.
Medicine (Baltimore). 2019 Feb;98(8):e14005. doi: 10.1097/MD.0000000000014005.
The aim of this study was to better understand the relationship of bone mass with body composition based on different stages of puberty and to illuminate the contribution of site-specific fat mass and lean mass (FM and LM) compared with bone mass in school-aged children and adolescents in Chongqing, China.A total of 1179 healthy subjects of both sexes were recruited. Bone mineral content (BMC), bone mineral density (BMD), bone area, and both FM and LM were measured by dual-energy X-ray absorptiometry (DXA). The fat mass and lean mass indexes (FMI and LMI, respectively) were calculated as the FM (kg) and LM (kg) divided by the height in meters squared, respectively.Most of the bone mass indicators were significantly higher for postpubertal boys than for girls at the same stage (P < .001). The proportion of subjects with normal bone mass increased, while the proportion of subjects with osteopenia and osteoporosis decreased with increased body weight regardless of gender and puberty stage (P < .01). FM and LM were significantly positively related to bone mass regardless of gender and puberty stage (P < .0001). FMI and LMI were significantly positively related to bone mass in most conditions (P < .05 and P < .0001, respectively). Four components of the FM and LM were linearly and significantly associated with BMD and BMC for TB and TBHL. Among them, the head fat mass and head lean mass showed the greatest statistical contribution.In the process of assessing bone status, we recommend measuring fat and lean masses, including the fat and lean masses of the head.
本研究的目的是基于青春期的不同阶段，更好地了解骨量与身体成分之间的关系，并阐明在中国重庆的学龄儿童和青少年中，特定部位的脂肪量和瘦体重（FM和LM）与骨量相比的贡献。共招募了1179名健康的男女受试者。采用双能X线吸收法（DXA）测量骨矿物质含量（BMC）、骨矿物质密度（BMD）、骨面积以及FM和LM。脂肪量和瘦体重指数（分别为FMI和LMI）的计算方法是将FM（kg）和LM（kg）分别除以身高的平方米数。
大多数骨量指标在青春期后的男孩中显著高于同阶段的女孩（P<0.001）。无论性别和青春期阶段如何，随着体重增加，骨量正常的受试者比例增加，而骨量减少和骨质疏松的受试者比例降低（P<0.01）。无论性别和青春期阶段如何，FM和LM与骨量均呈显著正相关（P<0.0001）。在大多数情况下，FMI和LMI与骨量呈显著正相关（分别为P<0.05和P<0.0001）。FM和LM的四个组成部分与TB和TBHL的BMD和BMC呈线性且显著相关。其中，头部脂肪量和头部瘦体重的统计学贡献最大。
在评估骨状态的过程中，我们建议测量脂肪量和瘦体重，包括头部的脂肪量和瘦体重。
