Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia.
Department of Anatomy, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia.
Int J Med Sci. 2020 Sep 16;17(16):2585-2593. doi: 10.7150/ijms.49030. eCollection 2020.
Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that elevates the individual risk of cardiovascular diseases. These abnormalities are also known to alter bone remodelling. Therefore, MetS may be associated with osteoporosis. This study aims to determine the association between MetS and its components and bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry (DXA) among Malaysians. 400 Malaysians aged ≥ 40 years (52.5% women) residing in Klang Valley, Malaysia, were recruited. Subjects' demographic and lifestyle details were collected using a questionnaire, and blood pressure and body anthropometry were measured. Subjects' lumbar spine and total hip BMD were measured by DXA. Their fasting blood was collected for blood glucose level and lipid profile analysis. Regression analysis was used to analyze the relationship between MetS or its components and BMD. Subjects with MetS had higher BMD compared to subjects without MetS in models unadjusted for BMI (spine 0.008; hip 0.001). This difference was attenuated with BMI adjustment (spine 0.625; hip 0.478). Waist circumference was associated positively with BMD in models unadjusted for BMI (spine 0.012; hip 0.001), but the association became negative with BMI adjustment (spine 0.044; hip 0.021). Systolic blood pressure was associated positively with total hip BMD (0.019) but BMI adjustment attenuated the relationship (0.080). Triglyceride level was associated with osteoporosis in a fully adjusted model (0.001). Overall, MetS was associated with osteoporosis (0.019) but lifestyle (0.188) and BMI adjustment attenuated the relationship (0.904). MetS is positively associated with BMD, and this relationship is predominantly mediated by BMI. Although MetS is not a significant risk factor for osteoporosis, the inverse relationship between waist circumference, a marker of central obesity, and BMD highlights the need to prevent adiposity to improve metabolic and skeletal health.
代谢综合征（MetS）是一组代谢异常，会增加个体患心血管疾病的风险。这些异常也会改变骨重塑。因此，MetS 可能与骨质疏松症有关。本研究旨在确定马来西亚人代谢综合征及其成分与双能 X 射线吸收法（DXA）评估的骨矿物质密度（BMD）之间的关系。 400 名年龄≥40 岁的马来西亚人（52.5%为女性）居住在马来西亚雪兰莪州，被招募入组。使用问卷收集受试者的人口统计学和生活方式详细信息，并测量血压和人体测量学。使用 DXA 测量受试者的腰椎和全髋 BMD。采集空腹血样进行血糖水平和血脂谱分析。回归分析用于分析 MetS 或其成分与 BMD 之间的关系。 在未调整 BMI 的模型中，患有 MetS 的受试者的 BMD 高于没有 MetS 的受试者（脊柱 0.008；髋部 0.001）。这种差异在调整 BMI 后减弱（脊柱 0.625；髋部 0.478）。在未调整 BMI 的模型中，腰围与 BMD 呈正相关（脊柱 0.012；髋部 0.001），但在调整 BMI 后呈负相关（脊柱 0.044；髋部 0.021）。收缩压与总髋 BMD 呈正相关（0.019），但 BMI 调整后减弱了这种关系（0.080）。在完全调整的模型中，甘油三酯水平与骨质疏松症相关（0.001）。总的来说，MetS 与骨质疏松症相关（0.019），但生活方式（0.188）和 BMI 调整减弱了这种关系（0.904）。 MetS 与 BMD 呈正相关，这种关系主要由 BMI 介导。尽管 MetS 不是骨质疏松症的重要危险因素，但腰围（中心性肥胖的标志物）与 BMD 之间的负相关关系突显了预防肥胖以改善代谢和骨骼健康的必要性。
