Guo Chunhong, Qu Jianmin, Li Keyi
The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China; Orthopaedic Hospital of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
Department of Intensive Care Unit, Tongxiang First People's Hospital, Jiaochang Road 1918#, Tongxiang, Zhejiang Province, China.
Bone. 2025 Aug;197:117493. doi: 10.1016/j.bone.2025.117493. Epub 2025 Apr 24.
The association between dietary carbohydrate intake and bone mineral density (BMD) remains controversial, and research on this topic among adolescents is lacking. This study aimed to examine the relationship between dietary carbohydrate intake and BMD in adolescents.
This study examined data from adolescents (12-19 years) in the National Health and Nutrition Examination Survey (NHANES) (2005-2010). Dietary carbohydrate intake was assessed via two 24-hour recalls. BMD at the lumbar spine, total spine, total femur, and femoral neck was measured by dual-energy X-ray absorptiometry (DXA). A two-day dietary weighted multivariate regression analysis was employed to adjusted for covariates and assess the relationship between carbohydrate intake and BMD. The consistency of the associations and potential modifying factors were further evaluated through stratification and interaction analyses, both weighted by the two-day dietary data. Additionally, stratified curve fitting elucidated sex-specific differences in this relationship.
After excluding missing data, 2616 adolescents aged 12-19 years were included in the study. In the fully adjusted two-day dietary sample weighted analysis model, a positive association was observed between dietary carbohydrate intake and BMD among all participants. Dietary carbohydrate intake was positively associated with lumbar spine BMD (β = 1.31, 95 % CI = 0.38-2.23), total spine BMD (β = 1.31, 95 % CI = 0.39-2.24), and femoral neck BMD (β = 0.91, 95 % CI = 0.05-1.77) among all participants. Subgroup analyses revealed a significant sex interaction effect (P < 0.05). Subsequently, stratified curve fitting and sex-specific multivariate regression analyses were conducted. The results indicated a positive correlation between dietary carbohydrate intake and BMD in males, whereas no such correlation was observed in females. The multivariate analysis results further confirmed the sex-specific differences in the relationship between dietary carbohydrate intake and BMD, consistent with the initial findings.
Our study demonstrated that carbohydrate consumption significantly enhances BMD during adolescent bone growth. This effect is sex-specific.
膳食碳水化合物摄入量与骨密度（BMD）之间的关联仍存在争议，且缺乏针对青少年这一主题的研究。本研究旨在探讨青少年膳食碳水化合物摄入量与骨密度之间的关系。
本研究分析了国家健康与营养检查调查（NHANES）（2005 - 2010年）中青少年（12 - 19岁）的数据。通过两次24小时膳食回顾来评估膳食碳水化合物摄入量。采用双能X线吸收法（DXA）测量腰椎、全脊柱、全股骨和股骨颈的骨密度。采用为期两天的膳食加权多元回归分析来调整协变量，并评估碳水化合物摄入量与骨密度之间的关系。通过分层和交互分析进一步评估关联的一致性和潜在的调节因素，两者均采用为期两天的膳食数据进行加权。此外，分层曲线拟合阐明了这种关系中的性别差异。
排除缺失数据后，本研究纳入了2616名12 - 19岁的青少年。在完全调整的为期两天的膳食样本加权分析模型中，所有参与者的膳食碳水化合物摄入量与骨密度之间存在正相关。所有参与者的膳食碳水化合物摄入量与腰椎骨密度（β = 1.31，95%CI = 0.38 - 2.23）、全脊柱骨密度（β = 1.31，95%CI = 0.39 - 2.24）和股骨颈骨密度（β = 0.91，95%CI = 0.05 - 1.77）呈正相关。亚组分析显示存在显著的性别交互作用（P < 0.05）。随后，进行了分层曲线拟合和性别特异性多元回归分析。结果表明，男性的膳食碳水化合物摄入量与骨密度呈正相关，而女性未观察到这种相关性。多元分析结果进一步证实了膳食碳水化合物摄入量与骨密度之间关系的性别差异，与最初的研究结果一致。
我们的研究表明，碳水化合物的摄入在青少年骨骼生长过程中显著提高了骨密度。这种影响具有性别特异性。
