母患骨质疏松的女儿呈低峰值骨量吗?

目的研究骨质疏松母亲的女儿峰值骨量是否比正常母亲的女儿更低,并初步探讨导致这一差异的因素。方法从上海市各社区招募401个汉族核心家庭(包括父母双亲和一名20～40岁的健康女儿),用双能X线吸收仪测定腰椎(L1-4)和股骨近端各部位骨密度(BMD),剔除父亲患骨质疏松或骨量减少的家庭,获得126个骨质疏松母亲及其女儿和136个年龄匹配的BMD正常母亲及其女儿。结果骨质疏松母亲的女儿L1-4、股骨颈和大转子各部位BMD值(0.94g/cm2±0.10g/cm2,0.75g/cm2±0.10g/cm2,0.61g/cm2±0.08g/cm2,显著低于正常母亲的女儿(1.00g/cm2±0.11g/cm2,0.80g/cm2±0.11g/cm2,0.66g/cm2±0.09g/cm2,均P<0.001),且体重也显著低于正常母亲的女儿(P<0.05),两组间年龄、身高、月经初潮年龄、牛奶摄入者比例、摄入量等差异均无统计学意义。多因素逐步回归分析显示:体重是影响女儿各部位BMD的最重要因素,分别解释L1-4、股骨颈和大转子BMD值变异的9.4%、16.5%和16.6%。剔除体重因素后,母亲患骨质疏松成为影响女儿BMD的最重要因素,分别解释L1-4、股骨颈和大转子的BMD值变异的5.1%、5.3%和4.2%。结论母患骨质疏松的女儿具有低的峰值骨量,体重是最重要的影响因素,其次为母亲具低的BMD。

Do the premenopausal daughters of women with postmenopausal osteoporosis have lower peak bone mass?

OBJECTIVE: To determine whether premenopausal daughters of women with postmenopausal osteoporosis have lower peak bone mass than the daughters of normal women the same age, and to analyze the related risk factors affecting bone mass variation. METHODS: 126 pairs of mother with postmenopausal osteoporosis and her premenopausal daughter, and 136 pairs of normal postmenopausal mother and her premenopausal daughter selected for 410 core families including one healthy premenopausal daughter aged 20 - 40, all of Han ethnicity living in Shanghai recruited by advertisement and lectures. A questionnaire survey was conducted to investigate their dietary custom, Dual-energy X-ray absorptiometry at lumber spine 1 - 4 (L(1 - 4)) and proximal femur was conducted to measure the values of bone mineral density (BMD). RESULTS: The BMD values in L(1 - 4), femoral neck, and greater trochanter of the daughters of mothers with osteoporosis were 0.68 g/cm(2) +/- 0.07 g/cm(2), 0.59 g/cm(2) +/- 0.08 g/cm(2), and 0.47 g/cm(2) +/- 0.07 g/cm(2) respectively, all significantly lower than those of the daughters of normal mothers (0.86 g/cm(2) +/- 0.14 g/cm(2), 0.70 g/cm(2) +/- 0.11 g/cm(2), and 0.57 g/cm(2) +/- 0.10 g/cm(2) respectively, all P < 0.001). The average body weight of the daughters of mothers with osteoporosis was lighter then that of the daughters of normal mothers by 4.8% (P < 0.05). Multivariate regression analysis showed that age, body height, age of menarche, and milk intake were not influencing factors of BMD value, however, body weight was most significantly associated with BMD of the premenopausal daughters, contributing to the BMD variation at L(1 - 4), femoral neck, and greater trochanter by 9.4%, 16.5%, and 16.6% respectively. When body weight was excluded in the model, lower BMD of mother became the most important factors affecting the BMD variation, contributing to the BMD variation at L(1 - 4), femoral neck, and greater trochanter by 5.1%, 5.3%, and 4.2% respectively. CONCLUSION: The daughters of mothers with osteoporosis have reduced peak bone mass. It is likely due to the lower body weight of the daughter and the lower bone mass of the mother.