中国成年人文化程度与体格指标的长期变化关系

目的 分析中国慢性病前瞻性研究（CKB）人群文化程度与成年人不同阶段体格测量指标及其长期变化之间的关系。方法 本研究在参加第2次重复调查的研究对象中,剔除调查时年龄>65岁者、体格测量指标缺失或极端值者、基线或重复调查时自报患有重大慢性病者。分析研究对象的文化程度与25岁、基线调查时（2004-2008年）和重复调查时（2013-2014年）BMI和腰围、及每5年体重与腰围的变化值的关系。结果 纳入分析3 427名男性和6 320名女性。研究对象的体重和腰围都随年龄增长逐渐增加。从25岁到基线调查[年龄（45.2±6.5）岁],男性和女性每5年体重变化值分别为（1.70±2.63）和（1.27±2.10）kg。从基线到重复调查[年龄（53.2±6.5）岁],男性和女性每5年体重变化值分别为（1.12±2.61）和（0.90±2.54）kg,每5年腰围变化值分别为（3.20±3.79）和（3.83±3.85）cm。无论是25岁、基线还是重复调查时,文化程度低的女性BMI和腰围都更大。而在男性中,25岁时文化程度越低的男性BMI略大;到了基线和重复调查时,不同文化程度者间的BMI差异消失,但初、高中文化程度者的腰围及其增幅略高于其他文化程度者。结论 无论男性或女性,随年龄增长,体重和腰围都在不断增加。文化程度与BMI和腰围的关系存在性别差异。     

2013年中国人群高胆固醇对期望寿命的影响

目的 探讨中国人群高胆固醇对期望寿命的影响。方法 用2013年中国慢性病及其危险因素监测获得人群血清TC水平,计算分城乡、东中西部的高胆固醇人群归因分值,进而利用死因登记资料和人口统计数据,估算高胆固醇的归因死亡及其对期望寿命的影响。结果 2013年,中国≥ 25岁人群血清TC水平为（4.8±1.0）mmol/L,城市人群TC水平[（4.8±1.0）mmol/L]高于农村[（4.7±1.0）mmol/L],东部地区人群TC最高[（4.9±1.0）mmol/L],中部最低[（4.6±1.0）mmol/L],男性和女性TC均为（4.8±1.0）mmol/L。全部死亡中,2.9%归因于高胆固醇（264 998人）,其中89.3%死于缺血性心脏病（236 540人）,女性全死因人群归因分值（3.7%）高于男性（2.3%）,城市（3.4%）高于农村（2.4%）,东部最高（3.7%）,西部最低（2.1%）。中国人群高胆固醇归因死亡率为19.6/10万,女性（21.2/10万）高于男性（18.0/10万）,城市（20.8/10万）高于农村（18.2/10万）,东部归因死亡率最高（23.2/10万）,西部最低（15.6/10万）。2013年中国人群高胆固醇导致期望寿命损失为0.30岁,女性（0.35岁）高于男性（0.26岁）;城市人群期望寿命损失（0.34岁）高于农村（0.28岁）;东部人群期望寿命损失最高（0.36岁）,西部最低（0.23岁）。结论 高胆固醇对中国人群期望寿命的影响存在性别、城乡和地区差异。女性、城市和东部受影响较大。     

中国10个地区成年人骨骼肌质量和手握力的描述性分析

目的 描述中国10个地区成年人骨骼肌质量和手握力的地区和人群分布特征。方法 对来自中国慢性病前瞻性研究项目第2次重复调查的24 533名研究对象进行分析。采用生物电阻抗分析法测量四肢和躯干的肌肉质量,通过Jamar手持握力计测量手握力来衡量肌肉力量水平,并根据亚洲肌少症工作组（AWGS）推荐的标准判断人群低肌肉质量和力量的比例。分地区和人群特征,报告肌肉质量和手握力的均值及标准误,以及低肌肉质量和力量的百分比。结果 男性的四肢和全身肌肉质量分别为（22.0±0.02）kg和（49.7±0.05）kg,高于女性的（15.9±0.02）kg和（37.2±0.04）kg;男性手握力为（32.6±0.06）kg,高于女性的（19.9±0.05）kg。绝对肌肉质量和手握力均呈现北方高于南方、城市高于农村的地区差异（P<0.001）。而身高和体重调整的肌肉质量的地区差异规律相反。随着年龄的增加,肌肉质量各项指标和手握力均呈线性下降趋势（线性趋势P<0.001）,且手握力下降幅度更大。进一步按照AWGS判断,低肌肉质量和力量的比例随年龄增加而不断上升,≥ 80岁的老年男性低肌肉质量和力量的比例分别达到56.2%和74.5%,女性分别达到35.7%和66.0%。结论 中国成年人肌肉质量和手握力的分布存在明显的地区和人群差异,尤其以老年人低肌肉质量和手握力的比例最高。     

中国10个地区成年女性初潮年龄与身高和腿长的关联研究

目的 描述中国慢性病前瞻性研究（CKB）项目覆盖的10个地区30～79岁成年女性初潮年龄与身高和腿长的地区及出生年代分布,并分析初潮年龄与身高和腿长的关联性。方法 剔除初潮年龄缺失或初潮年龄在生理范围外（<9岁或>18岁）个体后,285 187名女性纳入分析。使用多元线性回归模型分析初潮年龄与身高和腿长的关系,并根据出生年代和城乡进行亚组分析。结果 10个项目地区女性的平均初潮年龄为（15.2±1.7）岁,平均身高和腿长分别为（154.2±6.0）cm和（71.0±3.7）cm。女性身高和腿长呈现出随出生年代逐渐增加的趋势（线性趋势检验均P<0.001）。而初潮年龄在1940-1949年代出生的个体略有推迟,之后出生的女性则表现为逐渐提前的趋势（线性趋势检验P<0.001）。在调整了年龄、地区、教育程度和臀围（仅在分析腿长时调整）后,初潮年龄每晚一岁,身高和腿长分别平均增加0.17 cm和0.20 cm（P值均<0.001）。相比出生年代较早的女性,出生年代越晚的女性中,初潮年龄与身高和腿长的回归系数越大（交互检验P值均<0.001）。结论 CKB的10个项目地区女性的初潮年龄与身高和腿长均存在正相关关联。     

中国成年双生子饮茶行为分布特征

目的 描述中国双生子登记系统（CNTR）成年双生子饮茶行为的分布特征,探索饮茶行为在双生子人群中的分布规律,为探究遗传和环境因素对饮茶行为的影响提供线索。方法 样本选自2010-2018年在CNTR进行登记的双生子,纳入≥18岁且具有饮茶信息的双生子共25 264对进行分析,描述双生子中饮茶行为的人群、地区分布特征,以及不同卵型双生子饮茶行为一致率和对内饮茶量差异分布情况。结果 研究对象年龄（35.38±12.45）岁,每周饮茶者占比17.0%,饮茶量（3.36±2.44）杯/d。男性、50~59岁、南方、城镇、文化程度高、双生子中先出生的个体中每周饮茶者比例较高（P<0.05）,未婚者中比例较低（P<0.001）。双生子对内分析发现同卵饮茶行为一致率均大于异卵,饮茶遗传度为13.45%（11.38%~15.51%）,除女性亚组外,不同性别、年龄、地区间饮茶一致率差异有统计学意义（均P<0.05）;根据性别、年龄、地区分层后仅男性同卵一致率始终呈大于异卵趋势。同性别双生子对内饮茶量差异在男性中呈现同卵小于异卵的特征（P<0.05）,而女性中差异不明显。结论 本研究双生子人群饮茶行为的分布存在人群和地区差异,饮茶行为主要受环境因素影响,遗传因素影响较弱,且遗传效应大小在不同性别、年龄、地区间不尽相同,性别可修饰这一遗传作用。     

山西省农村地区居民血清总胆固醇水平追踪分析

目的 分析山西省733名农村居民血清TC水平的纵向变化状况。方法 以曾经参加过2002年中国居民营养与健康调查的山西省5个农村地区居民为基础,于2015年进行追踪调查,采集调查对象空腹静脉血,采用胆固醇氧化酶法测定血清TC浓度。结果 733名研究对象中,男性332名,女性401名。2002年基线调查时年龄为（42.6±9.5）岁,76.2%的男性和83.8%的女性文化程度在初中及以下。男性与女性吸烟的比例分别为65.7%和1.2%,饮酒比例分别为26.8%和4.0%,肥胖比例分别为6.3%和12.0%,中心性肥胖比例分别为27.1%和31.9%。2015年追踪调查时年龄为（55.8±9.5）岁,男性与女性吸烟比例分别为48.2%和1.5%,饮酒比例分别为49.7%和3.0%,肥胖比例分别上升至11.8%和18.2%,中心性肥胖比例分别上升至41.6%和53.6%。2002－2015年,追踪人群血清TC水平由（3.82±0.89）mmol/L上升至（4.72±0.97）mmol/L,平均上升幅度为27.2%。男性血清TC水平由（3.84±0.94）mmol/L上升至（4.54±0.93）mmol/L,女性血清TC水平由（3.81±0.84）mmol/L上升至（4.86±0.98）mmol/L,增幅分别为22.7%和30.9%。18～、30～、40～、50～59岁组的血清TC水平由（3.42±0.83）、（3.72±0.77）、（3.90±0.83）、（4.00±1.03）mmol/L上升至（4.38±1.01）、（4.79±0.92）、（4.73±0.99）、（4.76±0.96）mmol/L。各年龄组增加幅度分别为31.4%、32.1%、25.2%和22.6%。经配对t检验和方差分析,不同性别、年龄、文化程度、婚姻状况、心血管疾病家族史、吸烟、饮酒、BMI和腰围组的血清TC水平在不同年度的差异均有统计学意义（P<0.01）。结论 山西省农村居民血清TC水平纵向上升速度较快。     

中国慢性病前瞻性研究:10个项目地区成年人群饮茶行为特征差异分析

目的 描述中国慢性病前瞻性研究(CKB)10个项目地区成年人群饮茶行为特征的地区差异。方法 分析CKB 10个项目地区512 891名30～79岁队列成员基线调查时饮茶行为信息,重点描述饮茶者每周饮茶行为特征的地区差异。结果 10个项目地区全部队列成员中,男性每周饮茶率(50.7%)高于女性(21.3%)。其中湖南项目地区调查人群每周饮茶率最高(男性74.3%,女性76.6%),河南项目地区最低(男性5.5%,女性1.0%)。除浙江和海口以外的其他8个项目地区,每周饮茶者以饮绿茶为主。青岛项目地区平均每次(男性3.8 g,女性3.1 g)、每日(男性6.2 g,女性4.1 g)和每周(男性38.4 g,女性25.0 g)茶叶消耗量均最高。结论 CKB 的10个项目地区研究人群在饮茶频率、品种、消耗量和浓淡喜好等特征上均存在较为明显的地区差异。     

山西省农村地区18～59岁居民血压水平变化追踪

目的 分析山西省农村地区18～59岁居民血压水平及其变化情况,为探索我国农村地区血压水平及防控措施提供参考。方法 研究对象来自山西营养与慢性病家庭队列,剔除2002年基线调查时年龄<18岁或年龄≥60岁研究对象、基线时患有高血压的个体和2015年随访调查时近2周正在服用降压药物者,共纳入1 629名基线调查时18～59岁的调查对象,分析2002年基线调查和2015年随访调查时的血压水平及变化情况。结果 2002年18～59岁人群的SBP由（122.7±10.4）mmHg（1 mmHg=0.133 kPa）增长至2015年的（132.8±17.6）mmHg,DBP由（72.7±6.9）mmHg增长至（78.8±10.3）mmHg,男性和女性SBP增长率分别为6.7%和9.5%。男性和女性DBP增长率分别为9.3%和7.8%。18～、30～、40～和50～59岁年龄组人群SBP增长率分别为5.0%、6.7%、9.4%和11.8%。而DBP增长率分别为12.2%、8.2%、8.2%和6.5%。结论 山西省农村地区18～59岁居民SBP和DBP均值水平均呈现明显的增长趋势,SBP增加水平呈现女性高于男性,随年龄增加而递增趋势,DBP增加水平呈现男性高于女性,随年龄增加而递减的趋势。     

2013年中国人群血压升高对死亡和期望寿命的影响

目的 评估2013年中国不同地区、性别人群血压升高造成的死亡和期望寿命损失情况。方法 用2013年中国慢性病及其危险因素监测数据和2013年人口死亡信息登记管理系统中死因监测数据,根据比较风险评估理论,计算分性别、城乡、东中西部地区人群血压升高的人群归因分值（PAF）,进而估计血压升高造成的死亡和期望寿命损失。结果 2013年中国≥ 25岁人群SBP平均为（129.48±20.27）mmHg,血压升高[SBP高于（115±6）mmHg）]导致208.79万人死亡,占总死亡人数的22.78%;男性SBP[（131.15±18.73）mmHg]、归因于血压升高的死亡数（115.17万例）、死亡率（165.56/10万）、标化死亡率（106.97/10万）均高于女性[分别为（127.79±21.60）mmHg、93.62万例、141.99/10万和68.93/10万]。农村人群SBP[（130.25±20.66）mmHg]、归因死亡数（112.34万例）、归因死亡率（178.58/10万）和PAF（23.59%）均高于城市人群[分别为（128.58±19.77）mmHg、96.45万例、132.87/10万和21.54%];东、中、西部地区人群之间的SBP水平接近,归因死亡数、归因死亡率和PAF在中部地区最高,分别为76.58万例、179.93/10万和26.72%。2013年中国≥ 25岁人群血压升高导致的心血管病和慢性肾病死亡数为199.12万和9.66万,分别占心血管病总死亡数的52.31%和慢性肾病总死亡数的62.11%。血压升高导致疾病死亡数最多的前3种疾病是缺血性心脏病（66.56万例）、出血性脑卒中（53.31万例）和缺血性脑卒中（35.93万例）。若消除血压升高因素影响,人均期望寿命可平均增加2.86岁,其中女性增加数量高于男性（分别为3.07和2.64岁）,中部地区人群高于东西部地区人群（分别为3.48、2.56和2.58岁）,农村人群高于城市（分别为2.97和2.59岁）。结论 2013年中国人群血压升高对死亡和期望寿命造成严重影响。     

中国慢性病前瞻性研究:10个项目地区成年人超重/肥胖现况分析

目的 描述中国慢性病前瞻性研究(CKB)项目10个地区人群超重/肥胖现状的地区差异。方法 CKB项目于2004－2008年在城市和农村各5个地区募集30～79岁队列成员并完成基线调查,剔除BMI异常个体后,分析10个地区中512 489名队列成员基线调查时的BMI和WC及其对应的超重/肥胖和中心性肥胖分组情况的地区差异。结果 10个地区女性的超重/肥胖(45.3%)和中心性肥胖(44.6%)水平均高于男性(41.7%和38.3%)。青岛项目点人群的超重/肥胖率(男性为66.9%,女性为67.5%)和中心性肥胖率(男性为63.3%,女性为64.9%)均为最高。超重/肥胖的地区差异在男性中更为明显;除河南以外的农村项目点超重/肥胖率相对较低。在BMI< 24.0 kg/m²的非超重/肥胖人群中,部分个体达到中心性肥胖标准(男性为9.8%,女性为15.3%);该比例在青岛项目点更高(男性为22.2%,女性为23.2%)。结论 CKB项目10个地区研究人群的超重/肥胖情况存在明显的地区差异。     

北京市海淀区9 068例学龄前儿童跟骨超声测定结果分析

目的 了解北京市海淀区学龄前儿童骨营养状况及随年龄变化趋势。方法 对9 068名2~6岁儿童应用超声骨密度测定仪测定跟骨超声速度(speed of sound, SOS)。结果 随年龄增长, SOS值逐渐下降, 不同性别变化趋势大致相同, 差异无统计学意义;男童总体骨量缺乏率49.83%, 女童为38.47%, 轻度缺乏率占87.40%;不同年龄段不同性别骨量缺乏程度差异有统计学意义。结论 北京市海淀区2～6岁学龄前儿童随年龄增长SOS值逐渐降低, 骨量缺乏情况普遍, 以轻度缺乏为主。     

Nutritional status using the Mini Nutritional Assessment questionnaire and its relationship with bone quality in a population of institutionalized elderly women

Malnutrition, a risk factor for osteoporotic fractures, is frequent in elderly people and, is underdiagnosed and undertreated. There are only few studies on the nutritional status of elderly people in Europe. The Mini Nutritional Assessment (MNA) is a non invasive and validated questionnaire to evaluate nutritional status in elderly people, classified in three groups: 1 degree score < 17: malnourished, 2 degrees score >17 and < 24: at risk of malnutrition, 3 degrees score >24: well-nourished, with a maximum of 30 points. Quantitative ultrasound of bone (QUS) is a method for assessing quality of bone which can be easily performed in nursing homes. Therefore, these two tests allowed to study the relationships between nutritional status and ultrasonic parameters of bone in 78 institutionalized women aged 86 +/- 6 years, living in 11 nursing homes around Lausanne (Switzerland). All were assessed by the MNA, had a measurement of the tricipital skin fold and of the grip strength. Functional status was evaluated by the scale "Activity of Daily Living" (ADL), and serum albumin level was measured when permitted. All had QUS of the calcaneus (with an Achilles, GE Lunar). The measured parameters are the Broadband Ultrasound Attenuation (BUA), attenuation of a band of ultrasonic frequencies through the medium, expressed in dB/MHz, and the Speed of Sound (SOS), speed of the ultrasounds through the medium, expressed in m/s. A third parameter, the stiffness index (SI), expressed as a percentage of the values obtained by the manufacturer in a young population and derived from BUA and SOS, was calculated automatically : SI = (0.67xBUA) + (0.28xSOS) - 420, expressed in percent compared to a young adult population (%YA). Fifteen percent of the women were undernourished and 58% were at risk of malnutrition. As expected, compared with the well-nourished minority, undernourished subjects had significant lower body mass index (BMI), tricipital skin fold (TSF), ADL score and albumin level (p < 0,01). The subjects "at risk of malnutrition" had significant lower BMI, ADL score (p < 0.01), tricipital skin fold and serum albumin (p < 0.05). Ultrasound parameters were low independently of the nutritional status. MNA score correlated significantly with tricipital skin fold (r = 0.508, p < 0.01), ADL (r = 0.538, p < 0.01) and albumin serum level (r = 0.409, p = 0.01). There was a trend for a correlation between the MNA and the ultrasound parameter BUA (r = 0.207, p = 0.07), whereas no correlation was found with SOS and SI. A multivariate analysis showed that tricipital skin fold and ADL explained 61% of the variance of the MNA. In conclusion, using simple and non invasive methods, this study showed that malnutrition and osteoporosis are frequent in institutionalized elderly persons in our country, and the ultrasound parameters are influenced by many others factors in addition to nutrition, especially at this age and in elderly residents of nursing homes.     

松质骨定量超声检测评估骨质疏松症

在超声诊断技术领域，定量超声密度检测理论已发展了十余年，宽带超声衰减（BUA）和超声声速（SOS）是用定量超声（OUS）进行骨质疏松症诊断的最重要的两项参数。本文利用超声插玉取代式脉冲传输理论推导出测量SOS和BUA参数的相关公式。介绍了松质骨定量超声骨密度诊断系统的组成及其功能实现，提出该项技术与传统技术相比的优势。     

Bone mineral density of the calcaneus and related factors in men

In this cross-sectional study, the bone mineral density of the calcaneus was investigated in healthy young (n = 35, 22-33 years) and middle-aged (n = 49, 45-59 years) men. The relationships among the bone mineral density, body fatness, physical fitness, physical activity in recent and past days, smoking, alcohol, and sex hormones (free testosterone, estradiol, and dehydroepiandrosterone-sulfate; DHEA-S) and sex hormone binding globulin were evaluated. The speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness were measured by ultrasonic measurement. There was no association between age and bone density in each group. In the young group, there was a positive correlation between the body mass index (BMI) and BUA and between the training time during junior high school and BUA, and an inverse correlation between alcohol consumption and SOS after adjustment for the confounding factors using partial correlation analysis. The level of DHEA-S was weakly but not significantly associated with BUA. In the middle-aged group, there was an inverse correlation between the waist to hip ratio and SOS, and between the height of jump and SOS after adjustment for the confounding factors using partial correlation analysis. These results suggest that different factors may affect bone density in the young and middle-aged men. In young men, the higher BMI and the longer training time during boyhood may have a positive effect, and heavy alcohol consumption may have a negative effect on bone density. In middle-aged men, abdominal fat accumulation has a negative effect and leg muscle power has a positive effect on bone density.     

南京市0～3岁健康儿童跟骨骨密度检测结果分析

目的:研究南京地区0～3岁健康儿童跟骨骨密度检测结果,探讨婴幼儿跟骨骨密度变化规律,建立本地区婴幼儿超声骨密度正常参考值。方法:通过定量超声法测定南京地区1 568例0～3岁婴幼儿跟骨骨密度(BMD),同时测量受检者的身长与体重,并计算体重指数(BMI)。结果:不同性别0～36月龄婴幼儿跟骨BMD值在各年龄段之间差异有统计学意义,同一年龄段BMD值男童稍高于女童,但差异无统计学意义(P>0.05)。﹤6个月龄儿童BMD值随年龄增加而降低,﹥6个月龄儿童后随着年龄增长BMD值呈上升趋势。同时,BMD值与身长、体重相关,而与BMI值无相关性。结论:婴幼儿跟骨骨密度值受年龄、体重及身长影响。     

Ultrasound measurement of calcaneus: a promising method for prediction of osteoporotic fractures]

When carrying out quantitative ultrasound (QUS) measurements of the calcaneus, broadband ultrasound attenuation (BUA, in dB/MHz) and speed of sound (SOS, in m/s) are assessed. From in vitro studies it is known that the mechanical properties of trabecular bone (stiffness and strength) can be better predicted with QUS than with dual energy X-ray absorptiometry (DEXA). Bone mineral density (BMD) measurements with DEXA are currently used for the diagnosis of osteoporosis according to the WHO criteria. There is no consensus regarding the diagnosis of osteoporosis with QUS measurements of the calcaneus. In prospective studies in women of 65 years and older it has been shown that fracture risk assessment with QUS measurements is feasible. The value of QUS measurements for the follow-up of patients with skeletal disorders is not yet known. At present there are important differences between ultrasound devices and there is no standardisation. The development of quality standards for and cross-calibrations of QUS scanners is necessary, so that results from different devices can be compared. Although QUS of the calcaneus is a promising method for the prediction of osteoporotic fractures, its routine use in clinical practice cannot yet be recommended.     

Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal

Background

Lifestyle, genetics and environmental factors are established determinants of bone density. We aimed to describe the bone characteristics of competitive top-ranked Nigerian male athletes using calcaneal ultrasound and to assess whether intensive training promotes higher bone density in an environment with reportedly low calcium intake; to compare the bone characteristics of footballers with runners and other sportsmen; and to assess the correlation of stiffness index (SI) with activity level, since energy expenditure correlates with length of training and by extension, magnitude of skeletal loading.

Methods

We recruited 102 male athletes: these included football (n = 68), running (n = 15), handball (n = 7), taekwando (n = 6), cycling (n = 2), judo (1), badminton (1) and high jump (1). Anthropometric data were first recorded on a structured form and energy expenditure was indirectly estimated with a validated questionnaire. Bone density was assessed using the Lunar Achilles+ calcaneal ultrasonometer.

Results

The mean age of athletes was 25 ± 6 years. The means of BMI and energy expenditure were 21.9 ± 2.0 kg/m² and 35.0 ± 13.7 kcal/kg/day, respectively. Footballers were younger (p < 0.001) and heavier (p < 0.001) than runners. Football was a significant determinant of BUA independent of age, BMI and energy expenditure (p = 0.001). Football was also a significant determinant of SOS independent of age, height, weight and BMI (p < 0.001). The mean SI was 127 ± 16 and the median T-score was 0.82 (-1.88, 3.35). The mean SI of footballers (130 ± 15), runners (130 ± 12) and other sportsmen (115 ± 18) differed significantly (p = 0.001). Multivariate analyses revealed that football (p < 0.001) and running (p < 0.001) were significant determinants of SI independent of age and BMI. Footballers when compared with other sportsmen had a higher mean SI independent of age and BMI (p < 0.001). Age was not correlated with SI. The median T-score of footballers, 0.94 (-1.0, 3.35) was higher than that of other sportsmen.

Conclusion

Repetitive skeletal loading at the heel has the potential to improve bone density in black male athletes. The magnitude of increase may be higher in medium impact sports such as soccer and running compared with low or non-impact sports such as judo or taekwando, and is independent of age and BMI. However, future longitudinal data will be required to support our observations.     

Analysis of the Association between Fat Mass Distribution and Bone Mass in Chinese Male Adolescents at Different Stages of Puberty

Background: Bone mineral acquisition during adolescence is crucial for maximizing peak bone mass. Fat mass (FM) and bone mass are closely related. This study investigated the association of FM distribution with bone mass in Chinese male adolescents. Method: A total of 693 male adolescents aged 10–18 years were recruited from a secondary school in Jiangmen, China. Their bone mass and body composition were measured by quantitative ultrasound and bioelectrical impedance analysis, respectively. The associations of the measures of fat distribution with bone parameters, i.e., broadband ultrasound attenuation, speed of sound (SOS), and stiffness index (SI), were analyzed using multiple linear regression. Age, height, body mass index, stage of puberty, physical activity, sedentary behavior, dietary energy intake, and dietary calcium and vitamin D intake were adjusted in the model. Further subgroup analyses of prepubertal and pubertal participants were conducted. Results: The measures of fat distribution showed negative associations with SOS and SI in total subjects (p < 0.010). In prepubertal boys, the measures of fat distribution were only associated with SOS (β = −0.377 to −0.393, p < 0.050). In pubertal boys, the measures of fat distribution had associations with all bone parameters (β = −0.205 to −0.584, p < 0.050). The strongest association was between trunk FM and SOS (β = −0.584, p < 0.001). Conclusion: This study supported that the measures of fat distribution were negatively associated with bone parameters in Chinese male adolescents. Trunk FM had the strongest association with bone parameter. These associations appear to be stronger in pubertal boys than in prepubertal boys.     

广西壮族女大学生亚健康状态和年龄对跟骨骨密度的影响

目的:了解广西壮族女大学生亚健康状态、年龄对跟骨超声骨密度的影响,为预防壮族女性骨质疏松提供科学依据。方法:利用人体能量监测仪Auramed Biopulsar和Achilles Express超声跟骨骨密度仪分别对230名广西壮族女大学生的左手掌生物电能量流动趋势和右脚跟骨骨密度进行检测。结果:亚健康组广西壮族女大学生骨量减少检出率高于健康组,健康组的T值、跟骨超声振幅衰减系数(BUA)和强度指数均明显低于亚健康组,健康组和亚健康组比较差异有统计学意义。19岁与20岁年龄组、21岁和22岁年龄组BUA值比较,差异有统计学意义。结论:BUA随着年龄增加而增加,但在21岁时BUA出现一个回落期。亚健康状态有可能是骨质疏松症发病前期的一个征兆,壮族女大学生亚健康检出率较高,学校有关部门和家庭应及时对亚健康状态的学生采取适当的干预措施,以提高壮族女大学生的健康水平。     

正常学龄儿童超声骨密度测定分析

目的:分析正常学龄儿童超声骨密度的变化规律,指导儿童临床和保健工作。方法:采用定量超声技术(QUS)测定长居广州市的475例6～12岁正常儿童的跟骨定量超声参数[超声传导速度(SOS)、超声衰减系数(BUA)和骨强度指数(STI)],同时测量受检者体重和身高。结果:6～12岁正常儿童SOS值随年龄增加而降低,BUA值随年龄增加而增加,STI值随年龄增加而降低,男童9岁、女童8岁时降至最低,之后随年龄增加而增加,在11岁时出现一高峰后又下降。同年龄男、女童的SOS、BUA、STI值比较差异均无统计学意义(P>0.05)。结论:6～12岁正常儿童的超声骨密度因年龄不同而呈现不同规律,而同年龄男、女童比较差异无统计学意义,在评价时应予考虑。