Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China.
Key Laboratory of Molecular Epidemiology of Shenzhen, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China.
Arch Osteoporos. 2020 Aug 17;15(1):129. doi: 10.1007/s11657-020-00758-9.
This study examined the association between healthy lifestyle score (HLS), which contained 7 items (smoking, BMI, physical activity, diet, alcohol, sleep and anxiety) and BMD. Results showed HLS was positively associated with BMD at all studied sites, suggesting that healthier lifestyle patterns might be beneficial to bone health.
Previous studies have reported favourable associations of individual healthy lifestyle factors with bone mineral density (BMD), but limited evidence showed the relationship of a combined healthy lifestyle score (HLS) with BMD. This study examined the association between the HLS and BMD.
This community-based cross-sectional study included 3051 participants aged 40-75 years. The HLS contained 7 items (smoking, BMI, physical activity, diet quality, alcohol intake, sleep and anxiety). BMD values of whole body (WB), lumbar spine 1-4 (L), total hip (TH) and femur neck (FN) were measured using dual-energy X-ray absorptiometry.
After adjusting for potential covariates, HLS was positively associated with BMD at all studied sites (P-trend < 0.01). The mean BMDs were 2.69% (WB), 5.62% (L), 6.13% (TH) and 5.71% (FN) higher in participants with HLS of 6-7 points than in those with HLS of 0-2 points. The per 1 of 7 unit increase in the HLS was associated with increases of 7.63 (WB)-13.4 (TH) mg/cm BMD levels at all sites. These favourable associations tended to be more pronounced in men than in women. Among the 7 items, physical activity contributed most to the favourable associations, followed by BMI, non-smoking and diet; the other three items played little roles. Sensitivity analyses showed that the significant associations remained after excluding any one of the 7 components or excluding fracture subjects at all sites.
Higher HLS was associated with greater BMD in middle-aged and elderly Chinese, suggesting that healthier lifestyle patterns might be beneficial to bone health.
本研究考察了健康生活方式评分（HLS）与骨密度（BMD）之间的关联，该评分包含 7 个项目（吸烟、BMI、身体活动、饮食、酒精、睡眠和焦虑）。结果显示，HLS 与所有研究部位的 BMD 呈正相关，这表明更健康的生活方式可能有益于骨骼健康。
先前的研究报告称，单个健康生活方式因素与骨矿物质密度（BMD）之间存在有利关联，但有限的证据表明综合健康生活方式评分（HLS）与 BMD 之间存在关联。本研究考察了 HLS 与 BMD 之间的关系。
这项基于社区的横断面研究纳入了 3051 名年龄在 40-75 岁的参与者。HLS 包含 7 个项目（吸烟、BMI、身体活动、饮食质量、酒精摄入、睡眠和焦虑）。全身（WB）、腰椎 1-4（L）、总髋部（TH）和股骨颈（FN）的 BMD 值使用双能 X 射线吸收法进行测量。
在校正了潜在的混杂因素后，HLS 与所有研究部位的 BMD 呈正相关（P 趋势<0.01）。与 HLS 得分为 0-2 分的参与者相比，HLS 得分为 6-7 分的参与者的 WB、L、TH 和 FN 的平均 BMD 分别高出 2.69%、5.62%、6.13%和 5.71%。HLS 每增加 1 分，所有部位的 BMD 水平分别增加 7.63（WB）-13.4（TH）mg/cm。这些有利的关联在男性中比女性中更为明显。在 7 个项目中，身体活动对有利关联的贡献最大，其次是 BMI、不吸烟和饮食；其他三个项目作用较小。敏感性分析表明，在排除任何一个 7 个组成部分或在所有部位排除骨折受试者后，这些显著关联仍然存在。
较高的 HLS 与中国中老年人群的较大 BMD 相关，表明更健康的生活方式可能有益于骨骼健康。
