体重减轻后体重变化对肥胖老年患者骨骼健康的影响。
Effect of Weight Change Following Intentional Weight Loss on Bone Health in Older Adults with Obesity.
机构信息
Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA.
Department of Biostatistics and Data Science, School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.
出版信息
Obesity (Silver Spring). 2019 Nov;27(11):1839-1845. doi: 10.1002/oby.22604. Epub 2019 Sep 4.
OBJECTIVE
This study aimed to examine change in bone mineral density (BMD) and trabecular bone score among older adult weight regainers (WR) and weight maintainers (WM).
METHODS
Observational data come from 77 older adults (mean age: 67 [SD 5] years; 69% women; 70% white) with obesity (mean BMI: 33.6 [SD 3.7] kg/m ) who lost weight during an 18-month weight loss intervention. Total body mass and body composition, along with regional (total hip, femoral neck, lumbar spine) BMD and trabecular bone score, were measured at baseline, 18 months, and 30 months. WR (n = 36) and WM (n = 41) categories were defined as a ≥ 5% or < 5% weight gain from 18 to 30 months, respectively.
RESULTS
Among skeletal indices, only total hip BMD was significantly reduced during the 18-month intervention period in both WRs (-3.9%; 95% CI: -5.8% to -2.0%) and WMs (-2.4%; 95% CI: -4.3% to -0.5%; P = 0.07). After adjustment for relevant baseline covariates and weight change from 0 to 18 months, 30-month change in total hip BMD was -2.6% (95% CI: -4.3% to -0.9%) and -3.9% (95% CI: -5.7% to -2.1%) among WRs and WMs, respectively (P = 0.07).
CONCLUSIONS
Loss of hip BMD persists in the year after a weight loss intervention among older adults with obesity, regardless of weight regain status.
目的
本研究旨在检查老年体重恢复者（WR）和体重维持者（WM）的骨密度（BMD）和小梁骨评分的变化。
方法
观察数据来自 77 名肥胖（平均 BMI：33.6 [3.7] kg/m ）的老年成年人（平均年龄：67 [5]岁；69%为女性；70%为白人），他们在 18 个月的减肥干预期间减轻了体重。在基线、18 个月和 30 个月时测量了全身质量和身体成分，以及区域（全髋、股骨颈、腰椎）BMD 和小梁骨评分。WR（n = 36）和 WM（n = 41）类别定义为 18 至 30 个月体重增加≥5%或<5%。
结果
在骨骼指数中，WRs（-3.9%；95%CI：-5.8%至-2.0%）和 WMs（-2.4%；95%CI：-4.3%至-0.5%；P = 0.07）在 18 个月的干预期间，总髋部 BMD 显著降低。在调整相关基线协变量和 0 至 18 个月的体重变化后，WRs 和 WMs 中 30 个月的总髋部 BMD 变化分别为-2.6%（95%CI：-4.3%至-0.9%）和-3.9%（95%CI：-5.7%至-2.1%）（P = 0.07）。
结论
无论体重恢复情况如何，肥胖的老年人在减肥干预后的一年中，髋部 BMD 仍会丢失。
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