Tianjin Women and Children's Health Center, No. 96, Guizhou Rd, Heping District, Tianjin, China.
Health and Family Planning Service Center for Women and Children in Dongli District, No. 7, Xianfeng Rd, Dongli District, Tianjin, China.
Medicine (Baltimore). 2021 Aug 13;100(32):e26872. doi: 10.1097/MD.0000000000026872.
Overweight/obesity can influence bone mineral accretion, but the conclusions are not consistent. We aimed to examine the association between bone mineral density (BMD) levels and body mass index (BMI) in 12 to 15 years old adolescents.We performed a cross-sectional study including 8365 adolescents. BMD was evaluated using a quantitative ultrasound device. Z scores for BMI were evaluated using World Health Organization references. Logistic regression models were performed to evaluate the association between BMD levels and BMI.Totally 1866 (22.3%) adolescents had low /reduced BMD, and boys had a higher rate than girls (72.6% vs 27.4%, P < .001). The rates of thinness, normal weight, overweight, and obesity were 2.8%, 57.1%, 22.3%, and 17.8%, respectively. The multivariable-adjusted (age, sex, systolic blood pressure, and height Z score) ORs (95% CIs) of low/reduced BMD associated with BMI groups (thinness, normal [reference], overweight, and obesity) were 0.59 (0.39-0.89), 1.00, 1.61 (1.41-1.84), and 1.98 (1.69-2.30), respectively (Ptrend < .001). This positive association existed in boys and girls though the differences were not significant between normal weight and thin girls. The multivariable-adjusted ORs for each 1-unit increase in BMI Z score were 1.36 (1.24-1.49) for girls, and 1.23 (1.16-1.30) for boys, and 1.26 (1.20-1.32) for all participants.We observed a positive association between BMI and low/reduced BMD in 12 to 15 years old adolescents. More attention should be paid on overweight and obese adolescents to reduce the risk of low BMD. Further studies are needed to explore the mechanisms of this association.
超重/肥胖会影响骨矿物质积累,但结论并不一致。我们旨在研究 12 至 15 岁青少年骨密度(BMD)水平与体重指数(BMI)之间的关系。
我们进行了一项横断面研究,纳入了 8365 名青少年。使用定量超声设备评估 BMD。使用世界卫生组织(WHO)参考标准评估 BMI 的 Z 分数。使用 logistic 回归模型评估 BMD 水平与 BMI 之间的关联。
共有 1866 名(22.3%)青少年存在低/减少的 BMD,且男孩的发生率高于女孩(72.6%比 27.4%,P<0.001)。消瘦、正常体重、超重和肥胖的发生率分别为 2.8%、57.1%、22.3%和 17.8%。多变量调整(年龄、性别、收缩压和身高 Z 评分)的低/减少 BMD 与 BMI 组(消瘦、正常[参考]、超重和肥胖)相关的比值比(95%置信区间)分别为 0.59(0.39-0.89)、1.00、1.61(1.41-1.84)和 1.98(1.69-2.30)(P<0.001)。尽管在正常体重和消瘦女孩之间差异无统计学意义,但这种正相关在男孩和女孩中均存在。对于 BMI Z 评分每增加 1 个单位,女孩的多变量调整比值比为 1.36(1.24-1.49),男孩为 1.23(1.16-1.30),所有参与者为 1.26(1.20-1.32)。
我们观察到 12 至 15 岁青少年 BMI 与低/减少 BMD 之间存在正相关。应更加关注超重和肥胖青少年,以降低低 BMD 的风险。需要进一步研究来探讨这种关联的机制。