肥胖男童骨矿物质含量及瘦体重的研究

目的 了解以体脂含量增加为特点的肥胖儿童骨矿物质含量、骨密度及瘦体重有何变化。方法 应用体块指数（BMI）诊断的肥胖组及对年龄、身高进行一一配对的正常组儿童各17例,年龄7－13岁,测定其骨矿物质含量（BMC）、骨密度（BMD）及瘦体重（LM）,观察二组间的差异,再用体脂含量百分比（F％）来重新诊断这34名儿童,观察肥胖组与对照组间上述指标的差异,并应用多因素分析肥胖与骨矿物质含量之间的关系。结果 应用 BMI为诊断标准时肥胖组与对照组间的BMC、BMD、LM有显著差异。改用F％为诊断标准后,肥胖儿童与正常儿童间的BMC、BMD差别消失,LM之间的差别也减小,多因素分析结果：体脂含量、肥胖与BMC无关。结论 若以体脂含量增加来定义肥胖儿童、其骨矿物质含量、骨密度与正常儿童相比无差别,瘦体重差别也不大,单纯体脂含量的增加并不能引起骨矿物质含量的改变。     

Correlation between bone mineral density and body composition in Japanese females aged 18–40 years with low forearm bone mineral density

Objectives  To clarify the relationship between bone mineral density (BMD) and body composition in Japanese women aged 18–40 years with low forearm BMD. Methods  The subjects were Japanese199 women who had been selected for inclusion in the study based on a low forearm BMD determined at the Annual Women’s Health Examination. The subjects’ mean (± standard deviation) age, body height, body weight, and body mass index (BMI) were 33.5 (±4.3) years, 158.1 (±5.1) cm, 49.6 (±5.7) kg, and 19.8 (±2.1), respectively. The BMD of the lumbar spine, total body, and left arm were measured using dual-energy X-ray absorptiometry (DXA). Fat mass (FM), bone-free lean tissue mass (LTM), and body fat percentage (BF%) were measured simultaneously with DXA. Results  In the structural equation model, the standardized regression weights for the path from BMI to BMD of all sites were 0.273–0.434. Conversely, the BF% to BMD of the total body and left arm were −0.192 and −0.296, respectively. In multiple regression analysis, the FM index (FMI) was significantly associated with the BMD of the lumbar spine as a weight-bearing site. The LTM index (LTMI) was significantly associated with the BMD of the total body and left arm as a non-weight-bearing site. Conclusions  Young females with low forearm BMD had low body weight and BMI. Thinness was shown to be a risk factor for low BMD, in accordance with results reported elsewhere. A gain in body weight may have the effect of increasing BMD, but our results suggest that to increase BMD, the gain in body weight must include increases in LTM, and not FM alone.     

Correlation between forearm bone mineral density and body composition in Japanese females aged 18–40 years

Objective The purpose of this study was to clarify the relationship between forearm bone mineral density (BMD), body mass index (BMI), and body composition focusing on body fat percentage (BF%) in Japanese females 18 to 40 years old. Methods Subjects were 2,280 females 18–40 years old. Anthropometric measurements were taken, and a medical history was obtained by questionnaire, including age at the time of the study and age at menarche. BF% was measured by bioelectrical impedance analysis. Forearm BMD was measured using dual-energy X-ray absorptiometry (DXA). The correlations of BMD with BMI and BF% were analyzed using a structural equation model. Results The standardized regression coefficients for the path from BMI to BMD and the path from BF% to BMD were 0.538 and −0.184 respectively. The squared multiple correlation of BMD was 0.146. In addition, the standardized regression coefficient for the path from BMI to BF% was 0.896. Conclusion The results showed a positive correlation between BMD and BMI and an inverse correlation between BMD and BF%. At the same time, it was noted that BF% increased with BMI. This indicated that BMD is dependant on BF% in subjects who have a similar BMI. Therefore, this study concluded that it is necessary to take body composition measurements into account when examining the relationship between BMI and BMD, especially in young females.     

Early Nutrition during Hospitalization in Relation to Bone Health in Preterm Infants at Term Age and Six Months Corrected Age

Aim: to evaluate the potential association of macronutrient intake in the first postnatal weeks on bone mineral content (BMC) and bone mineral density (BMD) in extremely and very preterm infants. Methods: fifty-eight extremely and very preterm infants were included. Daily macronutrient intake was calculated in g kg⁻¹ day⁻¹ from birth up to 36 weeks postmenstrual age. A dual-energy X-ray absorptiometry whole body scan was used to assess BMC and BMD in preterm infants at term corrected age (TCA) and six months corrected age (CA). Results: fat intake (g kg⁻¹ day⁻¹) in the first four postnatal weeks was positively associated with BMC and BMD at TCA. At six months CA, protein and fat intake (g kg⁻¹ day⁻¹) in the first weeks of life were both individual predictors for BMD. Fat intake (g kg⁻¹ day⁻¹) in the first four postnatal weeks was significantly associated with BMC at six months CA. Conclusion: the association of macronutrient intake in the first postnatal weeks on BMC or BMD, at TCA and six months CA, suggest that early nutritional intervention immediately after birth and during early infancy is important for bone health in the first months of life.     

Soy Isoflavones: No Effects on Bone Mineral Content and Bone Mineral Density in Healthy,Menstruating Young Adult Women after One Year

Background: The effects of isoflavone-enriched soy protein on human bone mineral content (mass) and density in healthy, menstruating young adult females have not been examined in a comparative prospective investigation. Peri- and post-menopausal women have been reported to show beneficial effects of isoflavones on bone measurements. Therefore, young women may also be able to improve their accrual of peak bone mineral content (BMC) and bone mineral density (BMD) during the early adult years of bone consolidation with an isoflavone-enriched diet.

Objectives: In this controlled, double-blind intervention, we tested the hypothesis that an isoflavone-rich soy protein diet increases BMC and BMD in young adult females over a period of one year in comparison to a control group receiving soy protein that has isoflavones removed.

Design: Young healthy women of any ethnic background, 21 to 25 years of age, were divided into two groups, placebo (n = 13) and supplement (n = 15). The soy protein supplement was enriched with isoflavones (～90 mg of total isoflavones/day), whereas the control protein diet was isoflavone-deficient, even though it contained the same amount of soy protein and other ingredients as the isoflavone-rich diet. Dual-energy x-ray absorptiometric (DXA) measurements of BMC and BMD were made at baseline and at 6 and 12 months. DXA estimates of body composition, including fat mass and lean body mass, were generated from whole-body BMC measurements. BMI was calculated as weight (kg) over height (m) squared. Physical activity was assessed, and three-day dietary records were taken at entry (baseline) and at 6 and 12 months.

Results: No changes in BMD after 12 months were found in either the isoflavone-treated (treatment) group or the isoflavone-deficient (control) group. Other variables also remained essentially constant over the 12-month period, including normal menstrual patterns in both the treatment and control groups.

Conclusions: The isoflavone-rich soy preparation had no effects on BMC and BMD over a 12-month period in young healthy adult females with normal menses. An isoflavone-rich supplement appears to have little or no effect on bone in young adult women with normal ovarian function, at least over this 12-month study period.     

Obesity and visceral fat in Indonesia: An unseen epidemic? A study using iDXA and surrogate anthropometric measures

ObjectiveIndonesia’s dramatic rise in chronic disease belies their relatively low obesity prevalence. This study provides normative iDXA and anthropometry measures in an Indonesian cohort. We also compare obesity prevalence determined by traditional measures.Methods2623 Indonesian adults were measured by an iDXA and had waist and hip circumferences collected. Normative data were stratified by sex and age. Obesity prevalence was compared using body mass index (BMI) and body fat percentage (BF%). Specificity, sensitivity, and Youden’s Index evaluated the ability of cut-off values to identify individuals with high visceral adipose tissue (VAT).ResultsOverweight and obese prevalence by BF% was 72 % for males and 63 % for females. BMI incorrectly categorized 40 % of obese individuals as normal/overweight. Waist circumference provided the highest Youden’s Index (0.69–0.73), identifying 91 % of Indonesians with high VAT mass.ConclusionsNormative BF% and VAT mass are higher among Indonesians when compared with Caucasian populations. This highlights the rise of chronic disease is potentially due to high BF% and VAT mass. Compared with criterion iDXA BF%, obesity prevalence is severely underestimated by BMI. Measuring waist circumference is recommended in clinical settings due to its ability to identify participants with high VAT mass.     

Bone mineral density in adolescent females with recently diagnosed anorexia nervosa

Anorexia nervosa (AN) can lead to osteoporosis and fractures. OBJECTIVE: This study evaluated adolescent females with AN diagnosed within the previous 12 months to determine whether there is bone mass reduction and to investigate relationships between nutritional indices (weight, body mass index [BMI], lean mass, fat mass, and percentage fat) and total body (TB) and lumbar spine (LS) bone mineral densities (BMD) and content (BMC). METHOD: TB and LS BMD and BMC and body composition were measured in 24 adolescent females with AN. RESULTS: There was no significant reduction in TB or LS BMD. Regression analysis shows significant correlation (p < 0.001) between lean mass and TB BMD (r = +0.83), TB BMC (r = +0.92), LS BMD (r = +0.81), and LS BMC (r = +0.92). There was also a significant relationship between weight percentile and LS BMD z score (p < 0.005; r = +0.60). DISCUSSION: Adolescent females with early AN do not appear to have reduced bone mass. Lean mass is correlated to BMD and BMC.     

Childhood obesity: concept, feasibility, and interim results of a local group-based, long-term treatment program

ObjectiveThe authors performed a group-based program for obese children and adolescents in Bavaria, Germany to enable them to establish a health-oriented lifestyle and to reduce overweight. The authors compared this program with a control approach based on the patients' own initiative.DesignThis is a controlled clinical trial.SettingA nutrition program for outpatients in a German university hospital.ParticipantsSeventy-three obese patients aged 7 to 15 years (mean 11.2 years) were recruited by pediatricians and local newspaper reports and randomized into intervention and control groups. Children and adolescents in each group were divided into 3 groups according to age–7-8 years, 9-10 years, and 11-13 years. Children were classified overweight (defined as body mass index (BMI) > 90th percentile for age and gender), obese (BMI > 97th percentile), and extremely obese (BMI > 99.5th percentile), according to the European Childhood Obesity Group and the German Working Group on Pediatric Obesity, congruent with adult standards used to assess overweight and obesity.InterventionThirty-seven patients (age 7-13 years, mean 10.9 years) for the 1-year intervention. This intervention consisted of modules for physical activity, nutritional education, and coping strategies. The program was performed twice each week and incorporated parental participation and medical supervision, including laboratory tests. The obese controls (n = 36, age 8-15 years, mean 11.6 years) received written therapeutic advice during a visit at 0 and 6 months in the outpatient clinic.Main Outcome MeasureThe primary outcome variable was the body mass index (BMI) z score.AnalysisAnalysis of variance and t test were used, and a P value < .05 was considered significant.ResultsThere was a reduction of BMI z score in the active treatment group (P < .05), but not for controls. Moreover, the active group showed beneficial effects for body mass index (BMI), fat mass, and systolic blood pressure 12 months after beginning the intervention.Conclusions and ImplicationsGroup-based programs for young, obese patients can be effective tools for establishing a health-oriented lifestyle and reducing the burden of obesity.     

Circulating SIRT1 and Sclerostin Correlates with Bone Status in Young Women with Different Degrees of Adiposity

Sirtuin1 (SIRT1) and sclerostin play important roles in adipose tissue and bone metabolism. We evaluated the circulating SIRT1 and sclerostin relationship with mass and quality of bone while considering the degree of adiposity. Sixty-six premenopausal women (16 underweight, 25 normal weight and 25 with obesity), aged <50 years, were enrolled. Plasma SIRT1, sclerostin and DXA body composition (total fat mass (FM), abdominal visceral adipose tissue, lean mass, trabecular bone score (TBS) and lumbar spine and femoral neck (FN) bone mineral density (BMD)) were assessed. The patients with obesity showed the lowest SIRT1 and TBS values and the highest sclerostin concentrations; BMD increased with FM and BMI and had an inverse association with SIRT1. Sclerostin was negatively correlated with SIRT1 (ρ = −0.37, p = 0.002). When spine BMD, FN BMD and TBS were standardized for BMI, a positive correlation with SIRT1 and a negative correlation with sclerostin were seen (p < 0.005). In the regression analysis, sclerostin was the best independent, negative predictor for BMD and TBS, while SIRT1 directly predicted TBS (p < 0.05). In conclusion, blood measurement of SIRT1 and sclerostin could represent a snapshot of the bone status that, taking into account the degree of adiposity, may reduce the interference of confounding factors in the interpretation of bone health parameters.     

Screening Performances of the International Obesity Task Force Body Mass Index Cut-Off Values in Adolescents

Objective: To try to improve the International Obesity Task Force (IOTF) BMI cut-off values, in terms of prediction of body fat percentage assessed by dual-energy X-ray absorptiometry (DXA), in adolescents.

Methods: Cross-sectional survey of the adolescents from the city of Zaragoza (Spain). For this analysis we have included 286 adolescents (116 boys and 170 girls) aged 13.0–17.9 years. Body mass index (BMI) was calculated as body weight (kg), divided by height (m) squared. The percentage of body fat (BF%) was estimated by the use of DXA.

Results: We have calculated, new BMI cut-off values (AVENA cut-offs) to predict BF%, for boys and girls in each age group. In male adolescents, sensitivity was higher with the IOTF cut-offs (0.71, 95^th C.I.: 0.44, 0.90) than with the AVENA ones (0.53, 95^th C.I.: 0.28, 0.77), and specificity was very similar with both cut-off values (0.86 and 0.88, respectively), the differences being not statistically significant. In girls, both sensitivities (0.75 and 0.79, respectively) and specificities (0.90 and 0.92, respectively) were very similar with both cut-off values, and the differences, not significant.

Conclusions: Optimization of the IOTF BMI cut-off values, in terms of BF%, seems not to be possible in adolescents. The IOTF criteria should be used only for overweight and obesity screening; however, in clinical settings, a more accurate measure of body fat should be recommended.     

银川城区儿童青少年骨矿物质含量与肥胖相关关系的研究

目的 分析儿童青少年骨矿物质含量(BMC)与肥胖之间的关系,为预防儿童青少年骨质疏松提供更有力的依据.方法 于2017-2020年以整群随机抽样的方法从银川市随机抽取1578名儿童青少年作为研究对象,进行问卷调查、体格检查、骨矿物质含量测定,采用二元Logistic回归分析不同定义的肥胖指标与骨矿物质含量之间的关系.结...     

Bone Mineral Density in Postmenarchal Adolescent Girls in the United States: Associated Biopsychosocial Variables and Bone Turnover Markers

PurposeDuring adolescence, bone formation prevails over resorption, resulting in accumulation of 40% of peak bone mass throughout this time period. Although multiple studies have explored bone mass accrual during the early stages of puberty, less is known about factors that may influence bone accrual during later years of adolescence. In the present cross-sectional study we examined relationships among bone mineral density (BMD) and demographic factors, behavioral variables, and bone metabolism markers in postmenarchal adolescent girls.MethodsThe population was comprised of 389 healthy postmenarchal adolescent girls aged 11–18 years, who were recruited into a prospective study of the effect of depot medroxyprogesterone acetate (DMPA) on bone health in adolescents. At the baseline visit, investigators collected demographic, reproductive health, and lifestyle data, and performed a complete physical examination. Body mass index (BMI) was calculated. Before study initiation, BMD at the lumbar spine, total hip, and femoral neck was measured by dual-energy X-ray absorptiometry (DXA), and markers of bone metabolism (serum bone-specific alkaline phosphatase [BAP], serum osteocalcin, and urinary N-telopeptide [uNTX]) were measured. The baseline data from this study were analyzed to evaluate possible correlates of BMD in postmenarchal adolescent girls. Potential associations between BMD values and other parameters were assessed by analysis of variance and Pearson’s correlation coefficient.ResultsParticipants enrolled in the study had a mean (± SD) chronological age of 14.9 ±1.7 years (range 11–18), mean gynecologic age of 39.9 ±23.0 months (range 1–120) postmenarche, and mean BMI of 23.5 ±4.6 kg/m² (range 16.0–42.2). Racial/ethnic distribution was 46% African American, 35% Caucasian, and 19% other races; 9% had previously been pregnant. Positive correlations were observed between lumbar spine BMD and chronological age (r = .301, p < .0001), gynecologic age (r = .349, p < .0001), and BMI (r = .371, p < .0001). Total hip and femoral neck BMD values were significantly higher (p < .05 and p < .05, respectively) in African American participants compared with non-African American participants. Previous history of pregnancy was significantly associated with a lower BMD at the lumbar spine (p < .0001) and the total hip (p < .01) when compared with the BMD of adolescents who had never been pregnant. Cigarette smoking and alcohol use were not associated with significant differences in BMD. Negative correlations were observed between gynecologic age and the levels of BAP (r = −.564, p < .0001), osteocalcin (r = −.349, p < .0001), and uNTX (r = −.281, p < .0001), and between lumbar spine BMD and BAP (r = −.363, p < .0001), osteocalcin (r = −.129, p < .05), and uNTX (r = −.202, p < .001) levels.ConclusionsOur data demonstrate that chronological age, gynecologic age, race/ethnicity, BMI, and previous history of pregnancy are markedly associated with BMD in postmenarchal adolescent girls. Bone accretion in the postmenarchal years continues in the face of a slowdown in bone turnover during this time period.     

Maternal Vitamin D Status and Gestational Weight Gain as Correlates of Neonatal Bone Mass in Healthy Term Breastfed Young Infants from Montreal,Canada

The implications of maternal gestational weight gain (GWG) and vitamin D status to neonatal bone health are unclear. We tested whether maternal 25-hydroxyvitamin D (25(OH)D) and GWG relate to neonatal bone mineral content (BMC) and bone mineral density (BMD). Healthy term appropriate for gestational age breastfed neonates (n = 142) and their mothers were recruited 24–36 h after delivery and followed at 1.0 ± 0.5 month. At birth, obstetric data were collected and newborn serum 25(OH)D was measured. At 1 month, neonatal whole-body (WB) BMC, WB BMC relative to body weight (WB BMC/kg), lumbar spine BMC and BMD, maternal and neonatal 25(OH)D concentrations, and anthropometry were measured. Infant BMC and BMD between maternal 25(OH)D (<50, ≥50 nmol/L) and GWG (insufficient, adequate, and excessive) categories were compared. Maternal 25(OH)D was not related to infant whole-body BMC, BMC/kg, lumbar spine BMC, and BMD. Infants in the excessive maternal GWG category had greater (p = 0.0003) whole-body BMC and BMC/kg and lumbar spine BMC and BMD than inadequate GWG, and greater (p = 0.0063) whole-body BMC/kg and lumbar spine BMC and BMD than adequate GWG. These results suggest that maternal GWG, but not vitamin D status, modestly relates to bone mass in neonates.     

Body composition assessment in athletes with physical impairment who have been practicing a wheelchair sport regularly and for a prolonged period

BackgroundToday several important aspects related to the impact of long-term wheelchair sports on whole-body and regional body composition in athletes with a physical impairment are poorly understood.ObjectiveThis cross-sectional study aimed at investigating the impact of the long-term regular practice of wheelchair sports on body composition in male wheelchair athletes (WA) as compared with both non-athletic participants with a physical impairment and non-athletic able-bodied participants.MethodsNine WA were each matched pairwise by age, duration of injury and body mass index (BMI) with a participant with a physical impairment not engaged in any wheelchair sport (N-WA) and by age and BMI with an able-bodied (AB) participant. Whole-body and regional bone mineral content (BMC), fat-free soft tissue mass (FFSTM), fat mass (FM) and percentage FM (%FM) were assessed by means of Dual-Energy X-ray Absorptiometry.ResultsWA had significantly lower FM and %FM vs. N-WA at the whole-body level (P = 0.01 for both) and in the trunk region (P = 0.001 and P = <0.001, respectively). The only difference in body composition variables between WA and AB was found in the legs where WA had significantly higher FM (P = 0.014) along with lower BMC (P = 0.009) and FFSTM (P = 0.005) vs. AB in the legs.ConclusionsThe results of the present study showed that the regular, long-term practice of wheelchair sport may be associated with beneficial body composition adaptations in athletes with a physical impairment at the whole-body and trunk level.     

Relation between body composition and age in healthy Japanese subjects.

OBJECTIVE: To describe the relation between body composition and age measured by dual-energy X-ray absorptiometry (DXA) in healthy Japanese adults. DESIGN: Cross-sectional study. SUBJECTS AND MEASUREMENTS: The subjects were 2411 healthy Japanese adults (males 625, females 1786, age 20--79 y) who attended the Fukuoka Health Promotion Center, Fukuoka, Japan for health check-up. Body composition was determined by DXA (QDR-2000, Hologic) for the whole body and three anatomical regions of arms, legs and trunk. RESULTS: The mean values of body mass index (BMI) and percentage fat mass (%FM) were 23.2+/-3.1 (s.d.) kg/m(2) and 21.8+/-6.8% for males and 22.1+/-3.3 kg/m(2) and 32.0+/-7.5% for females, respectively. For males, curvilinear relations with the peaks in their forties or fifties were seen for the variables associated adiposity, ie BMI, waist and hip circumference, waist-hip ratio, total or regional fat mass (FM), %FM and ratio of trunk FM to leg FM. For females, most of these variables increased linearly in older subjects. Lean mass (LM), bone mineral content (BMC) and bone mineral density (BMD) of the whole body and appendicular LM were relatively constant until the forties and then decreased in both sexes. The rates of decrease in the total or appendicular LM were larger for males than for females, whereas those in BMC or BMD were larger for females than for males. CONCLUSIONS: This study presents the first detailed data on body composition in Japanese, which may be useful when comparing with populations of different racial and ethnic backgrounds and studying ill subjects.     

低体重和肥胖儿童身体成分特点及脂肪肌肉含量与骨密度相关性研究

目的 探讨低体重和肥胖儿童身体成分特点及其脂肪肌肉含量与骨密度的相关性.方法 选择2015年6月至2016年6月于眉山市妇幼保健院儿保门诊体检的5~7岁儿童为研究对象,按体质量指数(BMI)分为低体重组、肥胖组和对照组,测量身体成分各项指标,包括体脂比、全身脂肪含量、肌肉含量及局部和全身骨密度,并对结果进行分析.结果 同性别儿童低体重组的体脂比、全身脂肪含量、肌肉含量及局部和全身骨密度均分别明显低于对照组,二者之间差异均具有统计学意义(t=3.076~3.326,均P<0.05);同性别儿童对照组的体脂比、全身脂肪含量、肌肉含量及局部和全身骨密度均分别明显低于肥胖组,二者之间差异均具有统计学意义(t=2.998~3.427,均P<0.05).经Logistic回归分析:低体重组儿童的肌肉含量与不同部位骨密度均呈正相关性(r=0.779~0.889,均P<0.05);肥胖组男性儿童的肌肉含量与下肢骨密度、体脂比和全身脂肪含量与躯干骨密度均呈正相关性(r=0.779~0.882,均P<0.05),肥胖组女性儿童肌肉含量与上肢骨密度,以及体脂比、全身脂肪含量和肌肉含量与下肢骨密度均呈正相关性(r=0.781~0.901,均P<0.05);对照组儿童的肌肉含量与不同部位骨密度均呈正相关性(r=0.779~0.912,均P<0.05),对照组女性儿童的体脂比、全身脂肪含量和肌肉含量均与下肢骨密度和全身骨密度均呈正相关性(r=0.805~0.912,均P<0.05).结论 与正常儿童相比,低体重和肥胖儿童身体成分构成,各指标与骨密度的相关关系明显不同于正常儿童.在对儿保门诊儿童管理中,体重、体脂比、全身脂肪含量、肌肉含量的变化均是需要关注的重要指标,从而促进其骨骼健康发育.     

Bone response to eccentric versus concentric cycling in adolescents with obesity

ObjectivesBecause adolescents with obesity are susceptible to bone fragility during weight loss (WL), we evaluated the impact of eccentric (ECC) versus classical concentric (CON) training at the same oxygen consumption (${{\displaystyle \dot{\text{V}}\text{O}}}_2$) on bone density, geometry and strength.MethodsThirty five adolescents were included into 2 training (CON and ECC cycling) and a control (CTR, without training) groups. Anthropometry, dual-energy X-ray absorptiometry, hip structural analysis and quantitative bone ultrasound were assessed before and after the 12-week intervention.ResultsThe trainings promoted significant improvements in body mass index, total fat (FM) and lean mass (LM), with better improvements for FM and LM in the ECC group (p < 0.05). Leg LM percentage increased only in the ECC group (p < 0.05). Total body bone mineral content and density increased in both training groups (p < 0.001) with significant time x group interactions only between ECC and CTR (p < 0.05). Buckling ratio at the intertrochanteric region and femoral shaft increased only in CTR and CON groups (p < 0.05). Speeds of sounds at the calcaneum increased only in ECC group (p < 0.01).ConclusionsBone fragility, from a compromised relationship between density, geometry and strength, might be prevented with the ECC modality.     

学龄儿童维生素D营养状况与跟骨骨密度关系的前瞻性队列研究

目的探讨学龄儿童维生素D营养状况与跟骨骨密度的关系。方法研究对象来自“儿童青少年心血管与骨健康促进项目”,于2017年采用分层整群抽样的方法在北京市对15391名6~16岁儿童开展基线调查,2019年对其进行随访调查。进行问卷调查,测量血清25(OH)D和跟骨超声骨密度(BMD)。采用多因素线性回归和logistic回归分析基线维生素D营养状况与随访期跟骨BMD及其变化的关系。结果纳入分析的10914名儿童的年龄为(11.5±3.3)岁,男童占49.6%,基线25(OH)D水平为(35.4±12.0)nmol/L,缺乏率为36.1%。多因素回归分析显示,校正年龄、性别、BMI、吸烟、饮酒、奶制品摄入、维生素D补充、钙剂补充、体力活动、青春期发育状态和基线跟骨BMD Z值后,25(OH)D每增加10 nmol/L,随访时点跟骨BMD Z值增加0.01(P=0.041),2年间发生跟骨BMD Z值下降的OR=0.96(95%CI:0.93~1.00),P=0.030;相对于维生素D充足,维生素D不足和缺乏的儿童随访时点跟骨BMD Z值下降0.03(P=0.307)和0.06(P=0.046),2年间跟骨BMD Z值下降的风险分别增加15%(P=0.037)和21%(P=0.006),趋势P值均<0.05。结论维生素D营养状况与跟骨BMD密切相关,维生素D充足的儿童倾向于获得更高的BMD水平。倡导儿童青少年维持充足的维生素D水平,加强营养与运动,促进骨骼健康。     

青春期学生膳食营养状况对骨量的影响

目的研究学生青春期膳食营养状况对骨量的影响,以增加骨峰值,预防骨质疏松的发生.方法抽取贵阳某高等院校239名青春期学生进行一般情况和食物摄入情况调查,再从摄入豆类、奶类和同时摄入豆类、奶类的学生中抽取60人分为3组,用双能X线骨密度仪测定前臂1/3处骨密度(BMD)及骨矿化物含量(BMC).结果 60例学生的热能及多种营养素的摄入水平很低,尤其是钙摄入量仅占现行供给标准的39%;结果还显示BMD降低率高达58.3%.3组学生的BMD、BMC差异无显著性.BMC、BMD与身高、体重及食物中蛋白质、能量、钙、磷等摄入量呈正相关.结论骨量较低与其膳食营养素摄入低有关.应加强营养宣教,提高膳食营养状况以增加骨量.     

Bone mineral density,vitamin D,and nutritional status of children submitted to hematopoietic stem cell transplantation

ObjectiveThe aim of the study was to evaluate the effect of allogeneic hematopoietic stem cell transplantation (HSCT) on bone mineral density (BMD), serum vitamin D levels, and nutritional status of 50 patients between ages 4 and 20 y.MethodsWe conducted pre-HSCT and 6-mo post-HSCT evaluations. We measured BMD at the lumbar spine (LS) and total body (TB) by dual energy x-ray absorptiometry (DXA); body composition by bioimpedance analysis, and dietary intakes of calcium and vitamin D using the 24-h recall and semiquantitative food frequency questionnaire methods.ResultsWe observed a significant reduction in BMD 6 mo post-HSCT. Nearly half (48%) of patients had reductions at the LS (average −9.6% ± 6.0%), and patients who developed graft-versus-host disease (GVHD) had the greatest reductions (−5.6% versus 1.2%, P < 0.01). We also found reductions in serum levels of 25-hydroxyvitamin D (25-OHD), from 25.6 ± 10.9 ng/dL to 20.4 ± 11.4 ng/dL (P < 0.05), and in body weight. Corticosteroid treatment duration, severity of chronic GVHD, serum 25-OHD levels, and family history of osteoporosis were all risk factors associated with variations in BMD at the LS.ConclusionHSCT in children and adolescents negatively effects their BMD, nutritional status, and vitamin D levels. We suggest that early routine assessment be done to permit prevention and treatment.