Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China.
Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China.
Front Endocrinol (Lausanne). 2022 Jan 25;13:829867. doi: 10.3389/fendo.2022.829867. eCollection 2022.
Bone mineral density (BMD) loss is a major complication of menopause, and this loss is closely associated with Fat mass (FM). The relationship between FM, fat distribution (FD), and BMD in postmenopausal women, however, remains incompletely understood. The present study was thus developed to explore these associations between body fat accumulation, FD, and BMD among non-obese postmenopausal women over the age of 60.
This was a cross-sectional analysis of 357 healthy postmenopausal women between the ages of 60.2 and 86.7 years. Dual-energy X-ray absorptiometry (DXA) was utilized to measure total and regional BMD as well as fat-related parameters including total FM, android and gynoid fat, body fat percentage (BF%), and total lean mass (LM) for all subjects. The android-to-gynoid fat ratio (AOI) was used to assess FD. Pearson's correlation testing and multiple regression analyses were used to explore relationships among AOI, LM, FM, and BMD.
Both LM and FM were positively correlated with total and regional BMD in univariate analysis (all < 0.01), whereas BMD was not significantly associated with AOI in any analyzed site other than the head. Multivariate linear regression models corrected for age, height, and years post-menopause, revealed a sustained independent positive relationship between FM and BMD (standard β range: 0.141 - 0.343, < 0.01). The relationship between FM and BMD was unaffected by adjustment for LM (standard β range: 0.132 - 0.258, < 0.01), whereas AOI had an adverse impact on BMD at most analyzed skeletal sites (total body, hip, femoral neck, arm, leg, and head) (standard β range: -0.093 to -0.232, < 0.05). These findings were unaffected by using BF% in place of FM (standard β range: -0.100 to -0.232, < 0.05).
In this cohort of non-obese postmenopausal women over the age of 60 from China, total FM was positively associated with BMD, while AOI was negatively correlated with BMD. As such, a combination of proper weight gain and the control of central obesity may benefit the overall bone health of women after menopause.
骨密度（BMD）丢失是绝经后妇女的主要并发症，这与脂肪量（FM）密切相关。然而，绝经后妇女的 FM、脂肪分布（FD）和 BMD 之间的关系仍不完全清楚。本研究旨在探讨非肥胖绝经后 60 岁以上妇女的体脂积累、FD 和 BMD 之间的这些关系。
这是一项对 357 名年龄在 60.2 至 86.7 岁的健康绝经后妇女的横断面分析。使用双能 X 射线吸收法（DXA）测量总及各部位 BMD 以及包括总 FM、躯干和臀部脂肪、体脂百分比（BF%）和总瘦体重（LM）在内的脂肪相关参数。用安卓到臀部脂肪比（AOI）评估 FD。采用 Pearson 相关检验和多元回归分析探讨 AOI、LM、FM 和 BMD 之间的关系。
在单变量分析中，LM 和 FM 均与总及各部位 BMD 呈正相关（均 < 0.01），而在头以外的任何分析部位，BMD 与 AOI 均无显著相关性。经年龄、身高和绝经后年限校正的多元线性回归模型显示，FM 与 BMD 呈持续独立正相关（标准β范围：0.141-0.343， < 0.01）。FM 与 BMD 的关系不受 LM 校正的影响（标准β范围：0.132-0.258， < 0.01），而 AOI 对大多数分析部位的 BMD 有不良影响（全身、髋部、股骨颈、手臂、腿部和头部）（标准β范围：-0.093 至-0.232， < 0.05）。用 BF%代替 FM 时，这些发现没有改变（标准β范围：-0.100 至-0.232， < 0.05）。
在本研究中，中国 60 岁以上非肥胖绝经后妇女的总 FM 与 BMD 呈正相关，而 AOI 与 BMD 呈负相关。因此，适当增加体重和控制中心性肥胖可能有益于女性绝经后的整体骨骼健康。
