Wang H, Xie K X, Chen L L, Xu H, Shen Z J, Lyu J, Yu C Q, Sun D J Y, Pei P, Zhong J M, Yu M
Department of Chronic and Non-communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
Department of Chronic and Non-communicable Disease Control and Prevention, Tongxiang County Center for Disease Control and Prevention, Tongxiang 314599, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2025 Mar 10;46(3):448-454. doi: 10.3760/cma.j.cn112338-20240805-00477.
To evaluate the association between body mass index (BMI) and bone mineral density of calcaneus in adults. Data of the second resurvey of China Kadoorie Biobank study from Tongxiang of Zhejiang Province were used. A total of 2 896 participants aged 44-84 years were included in the final analysis. Overweight was defined as 23.0 kg/m≤BMI<25.0 kg/m, and obesity was defined as BMI ≥25.0 kg/m based on the criteria recommended by WHO/West Pacific Region. Multiple linear regression model was used to evaluate the association between BMI and calcaneus bone mineral density. Restricted cubic splines were used to investigate the dose-response relationship between BMI and calcaneus bone mineral density. The calcaneus bone mineral density in the study subjects were as follow (±): the broadband ultrasound attenuation was (109.4±12.1) dB/MHz, the speed of ultrasound was (1 545.9±33.8) m/s, and the stiffness index was 85.7±15.8. After adjusting for socio-demographic factors, lifestyle, waist circumference, diabetes and hypertension prevalence, BMI was positively associated with calcaneus stiffness index in non-overweight and non-obese adults, with of 2.30 (95%: 1.11-3.49) for men (<0.001) and 1.08 (95%: 0.38-1.78) for women (0.003), respectively. In addition, BMI was positively associated with calcaneus stiffness index in overweight and obese women (=0.90, 95%: 0.38-1.42) (<0.001), and null association was found in overweight and obese men (=0.06, 95%: -0.92-1.04) (0.900). Restricted cubic spline model showed a nonlinear dose-response relationship between BMI and calcaneus stiffness index. Non-linear association was found between BMI with calcaneus bone mineral density in adults.
评估成人体重指数（BMI）与跟骨骨密度之间的关联。使用了中国嘉道理生物银行研究浙江省桐乡市第二次再调查的数据。最终分析纳入了2896名年龄在44 - 84岁的参与者。根据世界卫生组织/西太平洋区域推荐的标准，超重定义为23.0kg/m≤BMI<25.0kg/m，肥胖定义为BMI≥25.0kg/m。采用多元线性回归模型评估BMI与跟骨骨密度之间的关联。使用受限立方样条来研究BMI与跟骨骨密度之间的剂量反应关系。研究对象的跟骨骨密度如下（±）：宽带超声衰减为（109.4±12.1）dB/MHz，超声速度为（1545.9±33.8）m/s，硬度指数为85.7±15.8。在调整了社会人口学因素、生活方式、腰围、糖尿病和高血压患病率后，在非超重和非肥胖成年人中，BMI与跟骨硬度指数呈正相关，男性的β值为2.30（95%置信区间：1.11 - 3.49）（P<0.001），女性的β值为1.08（95%置信区间：0.38 - 1.78）（P = 0.003）。此外，超重和肥胖女性的BMI与跟骨硬度指数呈正相关（β = 0.90，95%置信区间：0.38 - 1.42）（P<0.001），而超重和肥胖男性未发现相关性（β = 0.）（P = 0.900）。受限立方样条模型显示BMI与跟骨硬度指数之间存在非线性剂量反应关系。在成年人中发现BMI与跟骨骨密度之间存在非线性关联。
