Postgraduate Program in Health Sciences, Pontifical Catholic University of Goias, Goiânia 74605-020, Goiás, Brazil.
Postgraduate Program in Nutrition and Health, Faculty of Nutrition, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil.
Int J Environ Res Public Health. 2020 Sep 25;17(19):7017. doi: 10.3390/ijerph17197017.
Factors associated with bone mineral density (BMD) are poorly known in severely obese individuals i.e., a body mass index (BMI) > 35 kg/m. The objectives of this study were to describe the bone health profile of severely obese Brazilian women, to identify the health risk and health protective factors for BMD in this group and to assess whether these factors vary according to three different bone sites. BMD was assessed using dual-energy X-ray absorptiometry (DXA). This study analyzed baseline data from 104 women who had an average BMI of 43.7 ± 4.5 kg/m and presented the following BMD status: 1.283 ± 0.094 g/cm for total body, 1.062 ± 0.159 g/cm for vertebral column and 1.195 ± 0.134 g/cm for hip. They took part in the "Effect of nutritional intervention and olive oil in severe obesity" randomized clinical trial (DieTBra Trial). The risk factors negatively associated with lower BMD were age ≥50 years for the three bone sites i.e., total body, vertebral column and hip. Smoking for total body BMD ( = 0.045); BMI ≥ 50kg/m for vertebral column and hip; menopause for hip; high C-reactive protein (CRP) levels ( = 0.049), insufficient zinc ( = 0.010) and previous fracture for vertebral column ( = 0.007). The protective factors positively associated with BMD were physical activity (≥150 min/week ( = 0.001)) for hip; type 2 diabetes mellitus (DM2) ( < 0.0001) total body and adequate vitamin D levels from food consumption ( = 0.039) for vertebral column. A BMI ≥ 50 kg/m was a risk factor for lower BMD. The findings showed that protective and risk factors varied by bone site. The original study is registered with ClinicalTrials.gov. (protocol number: NCT02463435).
骨密度（BMD）与多种因素相关，但目前仍不清楚极度肥胖人群（BMI＞35kg/m）的相关因素。本研究的目的在于描述巴西极度肥胖女性的骨健康状况，明确该人群中与 BMD 相关的健康风险和保护因素，并评估这些因素是否因三个不同的骨骼部位而不同。BMD 通过双能 X 射线吸收法（DXA）进行评估。本研究分析了平均 BMI 为 43.7±4.5kg/m 的 104 名女性的基线数据，这些女性的 BMD 状况如下：全身骨密度为 1.283±0.094g/cm，脊柱骨密度为 1.062±0.159g/cm，髋部骨密度为 1.195±0.134g/cm。这些女性参加了一项名为“营养干预和橄榄油对严重肥胖影响”的随机临床试验（DieTBra 试验）。与较低 BMD 相关的风险因素为三个骨骼部位（全身、脊柱和髋部）的年龄≥50 岁。与 BMD 相关的保护因素为每周体力活动≥150min（ = 0.001）（与髋部相关）；2 型糖尿病（DM2）（ < 0.0001）（与全身相关）；饮食中维生素 D 水平充足（ = 0.039）（与脊柱相关）。BMI≥50kg/m 是 BMD 降低的风险因素。研究结果表明，保护因素和风险因素因骨骼部位而异。原始研究在 ClinicalTrials.gov 上注册（注册号：NCT02463435）。
