Lin Yuxiang, Liang Zijie, Zhang Anxin, Xu Nuo, Pei Xuewen, Wang Nanbu, Zheng Liang, Xu Danghan
Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Slone Epidemiology Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States.
J Clin Densitom. 2023 Apr-Jun;26(2):101361. doi: 10.1016/j.jocd.2023.02.002. Epub 2023 Mar 2.
Some studies suggested obesity may be beneficial in preventing bone loss through the negative relationship between body mass index (BMI) and osteoporosis in senile. However, using BMI to measure obesity is unconvincing due to confounding factors such as muscle mass were not taken into account, and few articles have yet taken a better way to evaluate the relationship between obesity and osteoporosis.
Using a cross-sectional sample of 1,979 participants aged ≥65 years from the National Health and Nutrition Examination Survey (NHANES) 2017 to 2020, we evaluated the relation of weight-adjusted waist index (WWI) with osteoporosis. WWI was calculated as waist (cm) divided by the square root of body weight (kg). Diagnosis of osteoporosis was described as follows: according to the updated reference for calculating bone mineral density T-Scores, we marked the BMD value as X, using the formula T = (X g/cm-0.888 g/cm)/0.121 g/cm, T = (X g/cm- 1.065 g/cm)/0.122 g/cm, and defined those with a final T <-0.25. T <-0.25 or patients with previously diagnosed OP in other hospitals as osteoporosis.
All the 1,979 participants were between 65 and 80 years, there were 379 (21.1%) with osteoporosis, 608 (30.7%) with WWI exceeding 12 (cm/√kg) (range 8.85-14.14), and 955 (48.3%) women. Furthermore, the relationship between WWI and osteoporosis was nonlinear with a threshold effect point. Odds of OP significantly increased with the increase of WWI (OR 2.33, 95% CI 11.48-3.38, P = 0.0001) at the right side of the threshold point (WWI≥12) according to the threshold effect study.
Found a significant positive relationship between WWI and osteoporosis. Body fat management in the senile may be good to prevent osteoporosis if confirmed by other prospective studies analyzing the longitudinal risk of osteoporosis with obesity.
一些研究表明,由于体重指数(BMI)与老年人骨质疏松症之间存在负相关关系,肥胖可能有助于预防骨质流失。然而,由于未考虑肌肉量等混杂因素,使用BMI来衡量肥胖并不具有说服力,而且很少有文章采用更好的方法来评估肥胖与骨质疏松症之间的关系。
我们使用了来自2017年至2020年美国国家健康与营养检查调查(NHANES)的1979名年龄≥65岁参与者的横断面样本,评估了体重调整腰围指数(WWI)与骨质疏松症的关系。WWI的计算方法为腰围(厘米)除以体重(千克)的平方根。骨质疏松症的诊断如下:根据计算骨密度T值的更新参考标准,我们将骨密度值标记为X,使用公式T =(X g/cm - 0.888 g/cm)/0.121 g/cm,T =(X g/cm - 1.065 g/cm)/0.122 g/cm,并将最终T值<-0.25的人定义为骨质疏松症患者。T<-0.25或在其他医院先前被诊断为骨质疏松症的患者被定义为患有骨质疏松症。
1979名参与者的年龄均在65至80岁之间,其中379人(21.1%)患有骨质疏松症,608人(30.7%)的WWI超过12(cm/√kg)(范围为8.85至14.14),955人(48.3%)为女性。此外,WWI与骨质疏松症之间的关系是非线性的,存在阈值效应点。根据阈值效应研究,在阈值点右侧(WWI≥12),骨质疏松症的患病几率随着WWI的增加而显著增加(OR 2.33,95%CI 11.48 - 3.38,P = 0.0001)。
发现WWI与骨质疏松症之间存在显著的正相关关系。如果通过其他分析肥胖与骨质疏松症纵向风险的前瞻性研究得到证实,那么老年人的体脂管理可能有助于预防骨质疏松症。