绝经妇女体成分与糖代谢相关关系的研究

目的探讨绝经妇女体成分与空腹血糖及胰岛素抵抗指数（HOMA-IR)的相关关系,寻求预测绝经妇女空腹血糖异常 的体成分敏感指标及其临界值,从而对绝经后骨质疏松的高危人群起警示作用。方法选取2009年8月-2011年7月来北 京妇产医院体检并被确诊为自然绝经的妇女200名。年龄41 -60(51. 30 ±4. 58)岁,绝经年限1 ~9(2. 96 ± 1. 87)年。测量研 究对象的身高、体重、腰围、臀围、腹部矢状径及全身脂肪含量,测定研究对象的测定空腹血清血糖、空腹胰岛素、促卵泡生成 素、促黄体生成素、雌二醇,计算胰岛素抵抗指数HOMA4R。结果（1)绝经妇女全身性肥胖率为37.5%( BMI^25 kg/ m2)或 88%(脂肪含量>30% ),中心型肥胖率为48. 5%。（2)空腹血糖与年龄、绝经年限及体成分指标（体重指数、腰围、腰臀比、腹 部矢状径、脂肪含量）均具有明显的正相关关系（P <0. 05),与E2水平无明显相关关系。消除年龄、绝经年限、E2水平的影 响,空腹血糖与体成分指标(体重指数、腰围、腰臀比、腹部矢状径、脂肪含量）均具有明显的偏相关关系（P <0. 05)。HOMA- IR与年龄及体成分指标具有明显的正相关关系（P <0. 05),与绝经年限及E2无明显相关关系。（3)体成分指标（体重指数、 腰围、腹部矢状径、脂肪含量）预测绝经妇女发生空腹血糖异常的切割点分别为25.80 kg/m2、82.50 cm、18. 55 cm、36.92%。 (4)体成分指标(体重指数、腰围、腹部矢状径、脂肪含量）与年龄、绝经年限均有明显的正相关关系（P <0. 05) ;E2水平与年龄 及绝经年限具有明显的负相关关系（P <0. 05),与体成分指标无明显相关关系。（5)体成分指标（体重指数、腰围、腰臀比、腹 部矢状径、脂肪含量）间均具有明显的正相关关系（P < 0. 05)。对绝经妇女的脂肪含量及体重指数、脂肪含量及腰围的相关关 系进行曲线拟和,各得出一直线方程,BF (%) = 1. 480BMI ( kg/m2)( R =0.999,R =0.997),BF (%) =0.447WC ( cm) (R = 0. 996,R2 =0.993)。结论绝经妇女肥胖发生率高,肥胖是绝经妇女空腹血糖异常的独立危险因素,初步发现绝经妇女发生 空腹血糖异常的体成分敏感指标及其临界值,这也对绝经妇女骨质疏松的高危人群起警示作用。     

绝经后2型糖尿病妇女血脂水平和骨密度的关系

目的探讨绝经后2型糖尿病妇女血脂和骨密度改变的相关性。方法将290例绝经后2型糖尿病妇女按T值分成骨质疏松组和非骨质疏松组;检测各组患者血清总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇LDL-C)以及腰椎骨密度(BMD),然后分析血脂和骨密度的关系;对骨密度和血脂、年龄、绝经年龄等变量之间的关系进行多元逐步回归分析。结果(1)绝经后2型糖尿病妇女的HDL-C与腰椎BMD存在负相关(r=-0.305,P=0.001),LDL-C、TG、TC与腰椎BMD无相关;(2)在校正体重指数、年龄和绝经年限影响因素后,绝经后2型糖尿病妇女的HDL-C与腰椎BMD仍存在负相关(r=-0.160,P=0.018),而LDL-C、TG、TC与腰椎BMD仍无相关。(3)在多元逐步回归分析中,HDL-C(β1=-0.199,P=0.005)仍与骨密度独立相关。结论绝经后2型糖尿病妇女的HDL-C与腰椎BMD存在负相关而TC、TG、LDL-C与腰椎BMD无相关。     

绝经后女性的体成分与年龄和绝经的关系及其对不同部位骨密度的影响

目的 调查绝经后女性的体成分与年龄、绝经年龄、绝经年限和腰椎、髋部BMD之间的关系.方法 用双能X线骨密度仪测量919例绝经后女性的体成分、正位腰椎和髋部BMD.结果 下身脂肪量、全身脂肪量和全身瘦组织量与年龄、绝经年龄和绝经年限都相关(P＜0.05～0.01),但只有绝经年限进入体成分的多元逐步回归方程,采用复合或三次回归模型拟合优度最佳.体成分随绝经年限的延长有下降趋势.绝经10年以上女性的下身脂肪量和全身瘦组织量显著减少,分别较绝经年限5年以内女性下降8.6%和3.1%.所有部位的体成分与所测区域的BMD 均呈正相关(P＜0.05～0.01),控制体重变量后,仅有全身脂肪量与腰椎BMD 呈正相关(P＜0.05),而全身瘦组织量与髋部BMD 呈正相关(P＜0.05).多元逐步回归分析发现体成分是影响腰椎和髋部BMD的一个重要因素,但对腰椎BMD影响最大的是全身脂肪量,而对髋部BMD影响最大的是全身瘦组织量.BMD 越低者,全身脂肪量和全身瘦组织量也越低,组间比较有显著性差异.结论 绝经后女性的体成分与年龄、绝经年龄、绝经年限和腰椎、髋部BMD相关,其中,绝经年限对体成分的影响最大,体成分组分对BMD的影响存在部位差异.     

DXA在糖耐量低减的老年男性脂肪含量测量中的应用

目的 探讨应用双能X线吸收法(DXA)进行人体脂肪含量测量的可行性,并研究糖耐量低减的老年男性患者中脂肪含量与骨密度的相关性.方法 选取171例糖耐量低减的老年男性行腰椎、股骨及全身的DXA检查,收集测量的骨密度、脂肪含量百分比、组织厚度及体重指数(BMI)等数据进行相关性统计分析.结果 腰椎骨密度与腹部脂肪含量(fat%腹部)呈正相关,相关系数r=0.263(P<0.001);股骨颈骨密度与臀部脂肪含量(fat%臀部)呈负相关,r=-0.284(P<0.001).fat%腹部、fat%臀部与BMI高度相关,r=0.561,0.377(P<0.001);腹部、臀部组织厚度与BMI高度相关,r分别为0.854,0.850(P<0.001).结论 DXA测量所得的脂肪含量百分比及组织厚度可作为肥胖检测的定量指标,更多应用于临床;脂肪成分对骨密度具有双重影响,其机制尚待进一步研究.     

绝经后2型糖尿病患者血脂与骨代谢的关系

目的探讨绝经后2型糖尿病患者血脂与骨代谢的相关性。方法将300例绝经后2型糖尿病患者按T值分成骨质疏松组和非骨质疏松组;检测两组患者血清总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及骨代谢指标,分析血脂各成分与骨代谢之间的关系。结果 (1)绝经后2型糖尿病患者的HDL-C与OT、TrACP、uNTX/Cr存在正相关(r1=0.134,P1=0.020;r2=0.181,P2=0.002;r3=0.126,P3=0.030),与BALP无相关性;TC与TrACP呈负相关(r=-0.153,P=0.038),与OT、BALP、uNTX/Cr无相关性;TG、LDL-C与OT、BALP、TrACP、uNTX/Cr均无相关性。(2)在校正年龄、绝经年限和BMI影响因素后,HDL-C与TrACP、uNTX/Cr仍存在正相关(r1=0.160,P1=0.010;r2=0.125,P2=0.045),而HDL-C与OT、TC与TrACP间的相关性失去统计学意义。结论绝经后2型糖尿病患者的HDL-C与TrACP、uNTX/Cr存在正相关,与OT、BALP无相关性;而TC、TG、LDL-C与OT、BALP、TrACP、uNTX/Cr无明显相关性。     

老年骨质疏松女性髋部骨密度、骨转换指标与血脂、血清尿酸相关性研究

目的研究老年骨质疏松女性髋部骨密度(bone mineral density,BMD)与血清总胆固醇(total cholesterol,TC)、血清甘油三酯(triglyceride,TG)、血清高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、血清低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)和血清尿酸(uric acid,UA)的相关性。方法收集2014年1月1日至2015年12月31日就诊的老年女性骨质疏松患者108例。记录患者的年龄、身高、体重、股骨颈BMD、股骨大转子BMD、股骨粗隆间BMD、髋部整体BMD、Ward’s区BMD、TC、TG、HDL-C、LDL-C、UA、血清I型胶原交联C末端肽(C-terminal crosslinking telopeptide of type I collagen,CTX)、I型原胶原N-端前肽(procollagen type I N propeptide,PINP)、25羟基维生素D(25-OH-Vit D,Vit D-T)及基础疾病情况等资料。髋部BMD、体质量指数(body mass index,BMI)、β-CTX、PINP、Vit D-T、TC、TG、LDL-C、HDL-C、UA相关性检验采用Pearson相关性检验。结果股骨颈BMD与年龄、β-CTX呈负相关,与BMI、Vit D-T、TG、UA呈正相关(r0,P0.05)。股骨大转子BMD与年龄、β-CTX呈负相关(r0,P0.05),与BMI、Vit D-T、TC、TG、LDL-C、UA呈正相关(r0,P0.05)。股骨粗隆间BMD与年龄、β-CTX、PINP呈负相关(r0,P0.05),与BMI、Vit D-T、TC、TG、UA呈正相关(r0,P0.05)。髋部整体BMD与与年龄、β-CTX呈负相关(r0,P0.05),与BMI、Vit D-T、TC、TG、LDL-C、UA呈正相关(r0,P0.05)。股骨Ward’s区BMD与年龄、β-CTX呈负相关(r0,P0.05),与BMI、Vit D-T、TC、LDL-C、UA呈正相关(r0,P0.05)。TC与β-CTX、PINP呈负相关(r0,P0.05),与Vit D-T、UA呈正相关(r0,P0.05)。TG与UA呈正相关(r0,P0.05)。HDL-C与Vit D-T、UA呈正相关(r0,P0.05)。LDL-C与β-CTX、PINP呈负相关(r0,P0.05),与Vit D-T、UA呈正相关(r0,P0.05)。结论骨质疏松患者髋部不同部位骨密度与血脂的相关性不同,适当水平的血清总胆固醇及尿酸有利于维持骨量,预防低骨量及骨质疏松的发生。     

绝经后女性体质量指数、体成分与骨密度的变化特征及关系

目的 探讨绝经后女性年龄、体质量指数（body mass index, BMI）及体成分的变化特征及与骨质疏松症之间的关系。方法 选取广州中医药大学第三附属医院2019年12月–2021年1月门诊收集的98名绝经后女性的体成分及骨密度资料,根据受试者的年龄和BMI分组,比较各年龄组及各BMI组的体成分差别,通过Spearman分析年龄、BMI及体成分对骨质疏松情况的影响,利用多元线性回归研究整体骨密度和整体骨矿含量的影响因素。结果 各个年龄组的整体骨密度（P＜0.001）及整体骨矿含量（P＜0.05）随年龄增加而下降,而各个BMI组的整体骨矿含量（P＜0.05）、整体肌肉质量（P＜0.001）、整体脂肪质量（P＜0.001）随BMI增加而增加。Spearman相关分析显示,随着年龄增加（P=0.005,r=0.281）,骨质疏松程度越严重;而随着BMI（P=0.019,r= – 0.237）、整体骨矿含量（P＜0.001,r= – 0.719）、肌肉质量（P=0.014,r= – 0.249）和脂肪质量（P=0.013,r= – 0.249）的增加,患骨质疏松的程度越轻。多元线性回归分析结果显示,年龄与绝经后女性整体骨密度（P=0.002,B= – 0.004）及整体骨矿含量呈负相关（P=0.000,B= – 0.013）;而整体肌肉质量（P=0.018,B=0.022）和整体脂肪质量（P=0.037,B=0.027）则与绝经后女性整体骨矿含量呈正相关。结论 年龄是绝经后女性患骨质疏松症的危险因素,而BMI、肌肉质量和脂肪质量是保护因素,有助于提高整体骨密度和整体骨矿含量。     

绝经后女性肌肉质量的影响因素研究

目的 探讨广州市绝经后女性肌肉质量的相关影响因素。方法 收集2019年6月至2020年12月广州市120名自愿参加本研究的绝经后女性的临床资料;其中符合纳入标准的有90例,年龄47～88岁,平均年龄(62.4±7.5)岁。所有受试者均记录其年龄、绝经年龄、绝经年限和身高、体重,计算BMI数值并进行骨密度测定、体成分分析检测肌肉质量。根据ASMI数值将受试者分为肌肉减少组及非肌肉减少组;分析两组年龄、绝经年龄、绝经年限和BMI数值、骨密度及肌肉质量的差异,比较两组患骨质疏松症的比率,利用Pearson相关性分析研究各因素与肌肉质量的相关程度,利用多元线性回归分析分析各指标与肌肉质量的相关性并得出回归方程。结果 肌肉减少组BMI和ASMI数值低于非肌肉减少组(P<0.05);肌肉减少组发生骨质疏松的比例大于非肌肉减少组(P>0.05); Pearson相关性分析提示绝经年龄(r=0.262,P=0.012)和BMI(r=0.771,P<0.001)与ASMI呈正相关;多元线性回归分析显示,影响绝经后女性ASMI值的因素主要有绝经年龄(P=0.037,B=0.034)和BM...     

中国围绝经期妇女体脂含量与骨密度关系的初步研究

目的探讨肌肉、脂肪含量与围绝经期骨质疏松妇女骨密度之间的关系。方法利用双能X线骨密度测量仪(美国,Hologic DiscoveryA型)测量门诊围绝经期妇女(90例,年龄:45~52岁(47.3±8.2))骨密度与体脂含量;同时测量登记受试者的年龄、身高、体重。结果结果显示,21%受试者腰椎和股骨骨量降低,全身脂肪含量(20675.129±5080.44)g与腰椎骨密度(0.91±0.177)g/cm2(P>0.05,r=-0.17)和髋部骨密度(0.99±0.102)g/cm2(P>0.05,r=0.158)没有相关性,肌肉含量(39790.80±6551.54)g与腰椎骨密度没有相关性(P>0.05,r=0.078),但是与髋部骨密度高度正相关(P<0.05,r=0.216)。体重(63.01±9.39)kg和腰椎(P<0.05,r=0.217)和髋部(P<0.05,r=0.305)骨密度高度正相关;BMI指数(24.6751±3.45637)与腰椎(P<0.05,r=0.244)和髋部(P<0.01,r=0.339)骨密度高度正相关。结论研究结果表明BMI指数和肌肉含量与围绝经期妇女髋部骨密度高度相关。     

绝经后骨质疏松症妇女血清痩素水平与骨密度的关系

目的 观察绝经后骨质疏松症妇女血清瘦素水平与骨密度(BMD)、骨矿含量(BMC)的相关性。方法 ELISA法检测32名绝经后骨质疏松症妇女(绝经组)和27名体重指数(BMI)相匹配的非绝经正常对照者(非绝经组)的空腹血清瘦素浓度,双能X线骨密度仪测定受试者腰椎BMD、BMC、T值、Z值。结果 绝经组和非绝经组的血清瘦素浓度分别为12.43±7.90ng/ml和11.76±4.42ng/ml,两组之间无差异;两组血清瘦素浓度均与体重、BMI和脂肪含量(Fat％)显著正相关,绝经组的瘦素水平与BMD及BMC无相关性,非绝经组瘦素浓度与BMDIL3和BMCL5相关(r=0.132,P<0.05;r=0.140,P<0.05),但调整BMI后瘦素浓度与BMD及BMC:的相关性消失(r=0.079,P>0.05;r=0.067,P>0.05)。结论成年妇女瘦素水平与体重、体脂及脂肪含量显著相关,瘦素不是绝经后妇女骨质疏松症的主要影响因素。     

Influence of insulin-like growth factor-1 and leptin on bone mass in healthy postmenopausal women

This study examines the influence of circulating insulin-like growth factor-1 (IGF-1) and serum leptin on bone mass as well as modulation of bone mass during skeletal development. Moreover, an inverse relationship between IGF-1 and leptin is reported. To evaluate the effects of serum IGF-1 and serum leptin on bone mass in healthy postmenopausal women, and the possible role of IGF-1 in leptin production, we studied a population of 123 women, aged 39-82 years. Bone mineral density (BMD) was determined by whole-body dual-energy X ray absorptiometry, which also enables measurement of body composition. Bone metabolism was assessed by measuring serum total alkaline phosphatase (TAP) and urinary hydroxyproline/creatinine (HP/Cr) excretion. IGF-1 correlated significantly with age (r = -0.28, p < 0.01) and years since menopause (r = -0.24, p < 0.01). A negative correlation was also found with weight and body mass index (r = -0.15, p < 0.05 and r = -0.19, p < 0.05, respectively). Leptin values were strongly correlated with weight (r = 0.7, p < 0.01), BMI (r = 0.7, p < 0.01), fat mass (r = 0.77, p < 0.01), and lean mass (r = 0.39, p < 0.01); a significant correlation was found with total body BMD (r = 0.29, p < 0.01), TAP (r = 0.15, p < 0.05), and HP/Cr (r = 0.18, p < 0.05). After adjustment for BMI, the significance of these relationships disappeared, demonstrating the lack of effect of serum leptin on BMD and bone turnover independent of body weight. On the other hand, the relationship between BMD and fat mass remained statistically significant after adjusting for serum leptin (r = 0.15, p < 0.05). Controlling for BMI eliminated the significant inverse correlation between IGF-1 and leptin; significant differences in leptin levels were found among women in the lower and higher quartile of IGF-1, suggesting that leptin production may be inhibited only at high values of serum IGF-1. We conclude that serum IGF-1 and serum leptin have no direct effect on bone mass and bone turnover.     

Low body mass index is an important risk factor for low bone mass and increased bone loss in early postmenopausal women. Early Postmenopausal Intervention Cohort (EPIC) study group.

Thinness (low percentage of body fat, low body mass index [BMI], or low body weight) was evaluated as a risk factor for low bone mineral density (BMD) or increased bone loss in a randomized trial of alendronate for prevention of osteoporosis in recently postmenopausal women with normal bone mass (n = 1609). The 2-year data from the placebo group were used (n = 417). Percentage of body fat, BMI, and body weight were correlated with baseline BMD (r = -0. 13 to -0.43, p < 0.01) and 2-year bone loss (r = -0.14 to -0.19, p < 0.01). Women in the lowest tertiles of percentage of body fat or BMI had up to 12% lower BMD at baseline and a more than 2-fold higher 2-year bone loss as compared with women in the highest tertiles (p 相似文献   

绝经后妇女骨密度影响因素的相关性分析

目的 探讨沈阳地区绝经后妇女不同部位骨密度值与亚洲人骨质疏松自我筛查工具(OSTA)得分、体表面积(BS)、体重指数（BMI）的关系,判断OSTA评分与绝经后妇女髋关节骨折风险的相关性。方法 采用双能X线骨密度仪测定沈阳地区670例绝经后妇女的骨密度值( BMD),并与OSTA 得分、体表面积、体重指数( BMl)、绝经年限进行Pearson相关性回归分析。应用WHO骨折风险因子评估工具(FRAX)评估绝经后妇女髋关节骨折风险,采用线性图表及Pearson相关性回归分析比较OSTA评分与绝经后妇女髋关节骨折风险是否存在相关性。结果 骨密度与OSTA评分、体表面积、体重指数呈线性正相关,相关性由大到小分别为OSTA评分、体表面积、体重、身高、BMI、年龄、绝经期、肥胖度;骨密度与绝经年限呈线性正相关趋势;OSTA评分与髋关节骨折风险呈负相关。结论 OSTA得分能较好的反映出绝境后妇女骨密度减低的趋势及程度,同时也能预测绝经后妇女髋关节骨折风险的程度,在临床中应对OSTA评分较低患者应采取必要的相关性治疗及干预。     

绝经后妇女年龄、绝经年龄、绝经年限与腰椎和髋部骨密度的关系分析

目的 探讨绝经后妇女年龄、绝经年龄、绝经年限与腰椎和髋部骨密度的关系.方法 调查248名健康的绝经后妇女的年龄、绝经年龄、绝经年限,测量身高、体重、正位腰椎（L2～L4）、髋部骨密度进行分析.结果 随着绝经年限的增长,腰椎和髋部骨密度逐渐降低.单因素相关分析表明年龄、绝经年限与腰椎及髋部各部位骨密度呈显著负相关（P＜0.01）,绝经年龄与腰椎及髋部各部位骨密度无显著相关性（P＞0.05）.调整身高、体重指数后,年龄、绝经年龄与腰椎及髋部骨密度呈显著负相关（P＜0.01）,绝经年龄与腰椎及髋部各部位骨密度无显著相关性（P＞0.05）.多元逐步回归分析显示绝经年限与腰椎、股骨颈及股骨大转子的骨密度呈显著负相关（P＜0.01）,年龄与腰椎、股骨颈及Ward三角区骨密度呈显著负相关（P＜0.05）.结论 年龄、绝经年限与腰椎和髋部骨密度有关.     

早期液体复苏对严重烫伤大鼠肝脏脂肪变性的疗效观察

目的观察早期液体复苏对严重烫伤大鼠肝脏脂肪变性的治疗效果。方法选择健康成年SD大鼠144只,随机分为4组。麻醉后假伤组背部给予30％TBSA的模拟烫伤。其余大鼠背部给予30％TBSAⅢ度烫伤,之后分为单纯烫伤组:烫伤后不补液;早期复苏组:烫伤后立即按Park- land公式用复方乳酸钠林格液进行复苏;延迟复苏组:烫伤后6 h给予液体复苏,方法同早期复苏组。分别于伤后0．5、1．0、2．0、3．0、7．0及21．0 d取各组大鼠肝脏组织,利用光学显微镜、透射电镜观察其病理变化。在相同时相点采集大鼠下腔静脉血,检测血浆总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、碱性磷酸酶(ALP)的含量。分别于采血前测量各组大鼠体重,采血后取完整肝组织称重并计算肝重:体重比值。进行统计学相关分析。结果早期复苏组大鼠肝细胞脂肪变性程度明显轻于其余两烫伤组。大鼠伤后各时相点TC、TG、ALP的含量按早期复苏组、延迟复苏组、单纯烫伤组顺序依次增高,HDL的含量依次降低。伤后大鼠肝重:体重比值升高,伤后1．0 d延迟复苏组与早期复苏组比较差异有统计学意义(P<0．05);伤后7．0 d,单纯烫伤组、延迟复苏组与早期复苏组比较,差异有统计学意义(P<0．01)。严重烫伤后肝脏脂肪变性程度与HDL含量呈显著负相关(r= -0．37,P<0．01),与ALP含量呈显著正相关(r=0．45,P<0．01),与TG含量呈显著正相关(r= 0．25,P<0．01),与肝重:体重比值呈显著正相关(r=0．44,P<0．01)。其他指标与烫伤后肝脏脂肪变性程度无相关性。结论及时有效的液体复苏可以减轻烫伤大鼠肝脏脂肪变性的严重程度,降低其发生率,有利于促进肝细胞损害的尽早恢复。     

雷洛昔芬对绝经后妇女同型半胱氨酸及血脂的影响

目的观察雷洛昔芬(RLX)对绝经后妇女同型半胱氨酸及血脂的影响。方法采用随机、双盲、安慰剂对照研究,对62例绝经后妇女分为试验组(n=32)和安慰剂组(n=30),分别给予RLX 60 mg/d及安慰剂,共12个月。结果RLX组用药6个月前后同型半胱氨酸无明显变化,用药12个月时明显降低,与安慰剂组比较有显著性差异(P<0.05);RLX组用药12个月总胆固醇、低密度脂蛋白胆固醇显著降低(P<0.01),高密度脂蛋白胆固醇和甘油三酯则无明显变化。结论RLX可降低绝经后妇女同型半胱氨酸水平,降低血清总胆固醇、低密度脂蛋白胆固醇水平。     

Lateral Spine Densitometry in Obese Women

The lateral (LAT) spine scan has been suggested as a more sensitive measure than posterior-anterior (PA) scanning for assessing age-related bone loss in normal-weight postmenopausal women. The measurement error of PA and LAT bone mineral density (BMD) using dual energy X-ray absorptiometry (DXA) has also been shown to rise with incremental increases in fat and from large variance in fat thickness, respectively. The purpose of this cross-sectional study was to determine specific affects of obesity on paired PA and LAT lumbar (L₂–L₄) BMD and Z score (BMD of patient versus age-matched reference database) correlation in 30 obese postmenopausal women (mean BMI ± SD = 33.3 ± 4.06). The mean PA and LAT BMD ± SD were 0.946 ± 0.123 and 0.749 ± 0.134, respectively. The mean PA and LAT Z scores were −0.17 ± 1.15 and 0.80 ± 1.7. The correlation between PA and LAT BMD was significantly lower (r = 0.55; P < 0.05) than previously reported, and PA and LAT Z score correlation was (r = 0.57; P= 0.0016). After adjusting for body mass index (BMI), percent body fat, fat mass, and truncal fat by DXA, waist:hip ratio (WHR) and visceral and subcutaneous abdominal fat by computerized axial tomography (CT), PA and LAT Z score correlation increased to r = 0.62; P= 0.0065. In our subjects, the mean LAT Z score was 4.6 times higher than the mean AP Z, contrary to previous observations in normal-weight postmenopausal women. Our findings may be due to increased soft tissue composition and fat inhomogeneity in the LAT scanning field resulting in increased X-ray attenuation in obesity. Received: 22 July 1997 / Accepted: 26 January 1998     

Bone turnover and body weight relationships differ in normal-weight compared with heavier postmenopausal women

Low body weight is associated with increased risk for fractures, whereas higher body weight has been shown to be protective against osteoporosis. This study evaluated whether body weight plays a role regulating bone turnover and mass in normal-weight (body mass index (BMI) <25 kg/m2), overweight (BMI 25-29.9 kg/m2) and obese (BMI> or =30 kg/m2) postmenopausal women who were either receiving hormone replacement therapy [HRT(+)] or not [HRT(-)] (total of six groups). Body weight, BMI, total body bone mineral content (TBBMC), and markers of bone formation (serum osteocalcin) and bone resorption (urinary pyridinoline (PYD) and deoxypyridinoline) were retrospectively analyzed in 210 postmenopausal women. The mean age was 67+/-6 years, with mean body weight of 70.8+/-14.2 kg, ranging from 45.0 to 115.5 kg. Body weight was positively correlated with TBBMC ( r=0.50, p<0.0001). There was a lower TBBMC and higher bone formation rate in normal-weight than obese HRT(-) women, but in women taking HRT there were no differences between BMI categories. In addition, in normal-weight HRT(-) women only, PYD and body weight showed a negative correlation (r=-0.39, p=0.01). Among normal-weight, but not overweight or obese subjects, we observed higher TBBMC and lower bone turnover in the HRT(+) compared with the HRT(-) group. Regression models explained 36% of the variance in TBBMC, mainly through body weight. Additional models could only explain 11-15% of the variance in bone turnover. Taken together, these data suggest that among normal-weight but not obese postmenopausal women, higher bone turnover is associated with lower bone mass, and that only normal-weight women show a different bone turnover profile with HRT treatment. Body weight should be considered an important factor in bone metabolism with relevant clinical implications.     

Influence of Body Mass Index on the Age-related Slope of Total and Regional Bone Mineral Content

The influence of body mass index (BMI) on T scores for total body bone mineral content (TBBMC) and regional bone mineral content (RBMC) was studied in 186 healthy women: 100 postmenopausal, 35 perimenopausal, and 51 premenopausal. The three groups were divided by BMI >25 kg/m² and BMI <25 kg/m² and the postmenopausal women were further subdivided by years since menopause (YSM): <10, 10–20, and >20. Tartrate-resistant acid phosphatase (TRAP) concentration was higher in perimenopausal and postmenopausal women with BMI <25 kg/m² (P < 0.001). T scores for TBBMC and for axial or peripheral RBMC differed (P < 0.05 in all) between women with BMI >25 kg/m² and BMI <25 kg/m². The rate of perimenopausal and postmenopausal age-related slope of BMC, as reflected in all measurements, differed with BMI. In the overall group of women, the T score for TBBMC correlated significantly with BMI (r = 0.46, P < 0.0001); this correlation increased when adjusted for age (r = 0.62, P < 0.0001). BMI correlated with TRAP only in postmenopausal women (r = 0.57, P < 0.0001). Yearly TBBMC decline was twice as high in postmenopausal women with BMI <25 kg/m² (P= 0.0004) than in those with BMI >25 kg/m²; the decline of trunk RBMC was more significant (P < 0.0001). These findings confirm the influence of BMI and gonadal status on bone mass. Received 20 February 1996 / Accepted 31 December 1996