Henderson N K, Price R I, Cole J H, Gutteridge D H, Bhagat C I
Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia.
J Bone Miner Res. 1995 Mar;10(3):384-93. doi: 10.1002/jbmr.5650100308.
Potential determinants of bone mineral density (BMD) were studied cross-sectionally in 115 healthy, sexually mature Caucasian women aged 18 years. Bone mineral density (Hologic QDR1000W) of the lumbar spine, proximal femur (five sites), and distal tibia and fibula; fasting blood and urine calcium biochemistry; serum sex hormone levels (follicular phase); nutrient intakes; aerobic fitness; trunk muscle strength; and habitual activity levels were measured. The effects of heredity were considered by measuring the BMD of 107 of the subjects' mothers. Simple and stepwise regression analysis were used to identify significant determinants of BMD at each of the regions studied. The analysis indicated that significant bivariate correlations exist between BMD at all sites and body weight (r = 0.23-0.47, p < or = 0.01), lean body weight (r = 0.34-0.46), trunk strength (r = 0.27-0.47), physical activity score (r = 0.20-0.25), and aerobic fitness (r = 0.29-0.45). Dietary calcium intake correlated significantly with BMD at the trochanter site only (r = 0.19), and none of the biochemical or hormonal indices measured correlated consistently with BMD at any site. Significant correlations between the BMD of mothers and daughters ranged from r = 0.43 at lumbar spine to r = 0.34 at the intertrochanteric site. Paired t-tests showed the daughters had significantly (p < 0.03) lower BMD than their mothers at the lumbar spine (98 +/- 12% [mean +/- SD]) and significantly higher (p < 0.002) BMD at the femoral neck, trochanter, and total hip sites (110 +/- 16%, 108 +/- 17%, 103 +/- 14%, respectively). When stepwise regression analysis included weight-corrected strength of the trunk flexor muscles (Corr Flex), weight-corrected aerobic fitness (Corr VO2max), physical activity score, and body weight, body weight was the only significant determinant of BMD at all sites. Corr Flex made significant contributions at all sites except the femoral neck, while Corr VO2max made additional contribution at the femoral neck, trochanter, total hip, and shaft of femur sites. These variables accounted for 13-27% of the variance in BMD. The addition of mother's BMD to these independent variables, in stepwise regression analysis, improved the prediction to 18-31% of the variance.
对115名年龄为18岁、健康、性成熟的白种女性进行了骨密度（BMD）潜在决定因素的横断面研究。测量了腰椎、股骨近端（五个部位）、胫腓骨远端的骨密度（Hologic QDR1000W）；空腹血、尿钙生化指标；血清性激素水平（卵泡期）；营养摄入量；有氧适能；躯干肌肉力量；以及习惯性活动水平。通过测量107名受试者母亲的骨密度来考虑遗传因素的影响。采用简单回归分析和逐步回归分析来确定所研究各部位骨密度的显著决定因素。分析表明，所有部位的骨密度与体重（r = 0.23 - 0.47，p≤0.01）、瘦体重（r = 0.34 - 0.46）、躯干力量（r = 0.27 - 0.47）、身体活动评分（r = 0.20 - 0.25）以及有氧适能（r = 0.29 - 0.45）之间均存在显著的双变量相关性。膳食钙摄入量仅与转子部位的骨密度显著相关（r = 0.19），所测量的生化或激素指标均未与任何部位的骨密度始终保持相关性。母亲与女儿骨密度之间的显著相关性范围从腰椎的r = 0.43到转子间部位的r = 0.34。配对t检验显示，女儿在腰椎部位的骨密度显著低于其母亲（98±12%[均值±标准差]），而在股骨颈、转子和全髋部位的骨密度显著高于其母亲（分别为110±16%、108±17%、103±14%）。当逐步回归分析纳入体重校正后的躯干屈肌力量（Corr Flex）、体重校正后的有氧适能（Corr VO2max）、身体活动评分和体重时，体重是所有部位骨密度的唯一显著决定因素。Corr Flex在除股骨颈以外的所有部位均有显著贡献，而Corr VO2max在股骨颈、转子、全髋和股骨干部位有额外贡献。这些变量占骨密度方差的13 - 27%。在逐步回归分析中，将母亲的骨密度添加到这些自变量中，可将预测提高到方差的18 - 31%。
