体重、体重指数对健康绝经后妇女骨密度的影响

目的探讨体重和体重指数（BMI）对健康绝经后妇女骨密度（BMD）的影响。方法采用双能X线骨密度仪测量591例健康绝经后女性不同部位的BMD，按BMI不同分为低体重组、正常体重组和肥胖组进行分析。结果各部位的BMD随BMI的增加而增高（P〈0．01）。BMD随年龄的增长而降低（P〈0．01）。肥胖组各部位BMD均比正常体重组和低体重组高（P〈0．05或P〈0．01）。年龄和体重是决定BMD变异的主要因素，年龄与BMD呈负相关，体重与BMD呈正相关，绝经年龄与腰椎正位BMD呈正相关；BMI与BMD无相关性。结论体重是影响绝经后妇女BMD的重要因素。对低体重的绝经后妇女定期监测BMD，有助于早期干预。     

体重、体重指数与绝经后妇女骨丢失率的相关性研究

目的 评价体重、体重指数对绝经后妇女骨转换率的影响。方法 对1042名门诊体检的健康绝经后妇女测定身高、体重,计算体重指数（BMI）,DXA骨密度仪测定腰椎和股骨部位骨密度（BMD）,同时留取血液和尿液测定骨转换指标,如血清骨钙素（SM-BGP）、血清骨特异性碱性磷酸酶（S-BALP）、血Ⅰ型前胶原C端肽（S-PICP）,和骨吸收指标,如尿吡啶啉（U-PYD）、尿脱氧吡啶啉（U-DPD）、尿I型胶原羧基端肽（U-CTX）、尿Ⅰ型胶原氨基端肽（U-NTX）、尿钙（U-Ca）、尿肌酐（U-Cr）以及可以反映骨代谢的血完整甲状旁腺素（S-PTH）。结果 U-CTX/Cr（r=-0.233,P=0.000）、U-NTX/Cr（r=-0.110,P=0.016）和SM-BGP（r=-0.193,P=0.027）与BMI呈负相关。根据体重指数将受试对象分为三组：BMI≤24kg/m^2（正常组）,24kg/m^2〈BMI〈27kg／m^2（超重组）．27kg／m^2≤BMI（肥胖组）．U—CTX／Cr在三组的水平分别为：287．73±98．47;239．37±85．26;204．14±79．91,各组间差异均有统计学意义;U-NTX／Cr在三组的水平分别为：61．77±29．83;54．45±20．37;49．53±19．81,只在组1和组3间差异有统计学意义;SM—BGP在三组的水平分别为：26．16±12．75;24．57±10．98;20．82±7．99,组3与组1、组2间差异有统计学意义。多元逐步网归分析,BMI、腰椎BMD和年龄是影响绝经后妇女U—CTX／Cr、U—NTX／Cr、SM～BGP的主要因素。结论 BMI与骨转换率旱负相关,对于绝经后妇女,随着BMI的升高其骨形成（SM—BGP）或骨吸收（U—CTX、U—NTX）均有降低的趋势。     

雌激素替代治疗对绝经妇女血脂血压及体质量指数影响

目的探讨尼尔雌醇联合小剂量安宫黄体酮(MPA)替代治疗对绝经妇女血脂、血压及体质量指数的影响. 方法 78例45～56岁的绝经妇女随机分为治疗组及对照组,观察时间1年,其中56例资料完整,治疗组29例,对照组27例.治疗组每15d服尼尔雌醇2mg,每月服MPA 4mg×10d,对照组服安慰剂,所有入选者分别于服药前、服药后3月、6月、12月检测血脂、血压及体质量指数. 结果服药3月后血HDL-C(1.74±0.45)mmol·L-1、Apo AⅠ(1.37±0.29)mmol·L-1、TG(1.79±0.38)mmol·L-1明显升高,LDL-C(2.57±0.63)mmol·L-1显著降低,持续用药6月后舒张压(73.87±7.81)mmHg明显降低,治疗组与用药前及对照组比较差异有显著性意义(P＜0.05). 结论尼尔雌醇加小剂量MPA对绝经妇女心血管系统有保护作用.     

Waist circumference vs body mass index for prediction of disease risk in postmenopausal women

OBJECTIVE: To test the sensitivity of waist circumference (central adiposity) as an index of disease risk in postmenopausal women. DESIGN: Retrospective analysis of postmenopausal women tested at Washington University School of Medicine. SUBJECTS: A total of 323 healthy postmenopausal (66+/-5 y; mean+/-s.d.) women not using any hormone replacement. MEASUREMENTS: Body composition, hyperinsulinemia (insulin area), triglycerides and HDL-cholesterol. RESULTS: Excess waist size had a stronger association with hyperinsulinemia and hypertriglyceridemia than body mass index (BMI; kg/m(2)) in otherwise healthy, postmenopausal women. After adjusting for BMI, a strong relation existed between waist circumference and insulin area, HDL-cholesterol and triglycerides (P<0.01). Conversely, after adjusting for waist circumference, no relation was apparent between BMI and the dependent variables of interest. The strength of the association between waist circumference and disease risk became most apparent when analyses were restricted to normal-weight women (BMI 24--28 kg/m(2)). When BMI was held constant, hyperinsulinemia and triglyceridemia increased dose-dependently with changes in waist size. CONCLUSION: Waist circumference, an easily obtained index of central adiposity, is a more sensitive measure of relative disease risk than is BMI in middle-aged and older women, particularly in normal-weight individuals.     

Association of changes in body mass index during earlier adulthood and later adulthood with circulating obesity biomarker concentrations in middle-aged men and women

Aims/hypothesis  

The objective of our study was to investigate whether changes in BMI during earlier adulthood are more strongly associated with levels of circulating obesity biomarkers in middle age than are BMI changes during later adulthood.     

Waist circumference,body mass index and glycated hemoglobin in Japanese men and women

AimsTo investigate the relationship of waist circumference and body mass index (BMI) with glycated hemoglobin (HbA_1c) concentrations and to define optimal cutoffs for these indices with respect to elevated HbA_1c (>5.8%).MethodsStudy subjects were 7731 Japanese men and women aged 50–74 years in Fukuoka City who participated in the baseline survey of a cohort study on lifestyle-related diseases. Linear regression analysis and logistic regression analysis were used with and without adjustment for age, smoking, alcohol use and physical activity. Receiver operating characteristic (ROC) curve analysis was performed to determine optimal cutoffs for the obesity indices.ResultsWaist circumference and BMI were linearly related to HbA_1c concentrations in men and women with almost the same magnitude in strength. With adjustment for the covariates, mean percent changes of HbA_1c per one standard deviation (S.D.) of waist circumference and BMI were 1.6% and 1.8% respectively in men, and 1.3% and 1.4% respectively in women. Adjusted odds ratios of elevated HbA_1c per one S.D. of waist circumference and BMI also showed statistically significant increases. Optimal cutoffs for waist circumference were 89 cm for men and 85 cm for women. The area under the ROC curve was much greater in women than in men.ConclusionsIn a population of middle-aged or elderly Japanese men and women, both waist circumference and BMI were strongly, positively associated with HbA_1c concentrations. The determined optimal cutoff points for waist circumference did not support the current Japanese criterion for abdominal adiposity.     

Association of waist circumference,body mass index and conicity index with cardiovascular risk factors in postmenopausal women

Abstract

In menopause, changes in body fat distribution lead to increasing risk of cardiovascular disease and metabolic disorders. The aim of this study was to assess the association of adiposity using the conicity index (CI), body mass index (BMI) and waist circumference (WC) with cardiovascular risk factors (hypertension, diabetes and dyslipidaemia). The sample of this cross-sectional study was collected from June to October 2010 and 165 consecutive menopausal women who had attended the Health and Treatment Centre and Endocrine Research Centre of Firoozgar Hospital in Tehran, Iran were assessed. Age, weight, height, WC, waist–hip ratio (WHR), CI and fat mass were measured. Systolic and diastolic blood pressure (SBP and DBP), fasting blood glucose, insulin, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) levels were also determined. All statistical analyses were performed by SPSS version 17 (SPSS Inc, Chicago, IL, USA).Results showed that BMI was positively and significantly associated with SBP (r = 0.21; p = 0.009). WC was positively and significantly correlated with SBP (r = 0.26; p = 0.02) and DBP (r = 0.16; p = 0.05). WHR was also significantly and positively associated with SBP (r = 0.29; p = 0.001). Age and WC were associated with CI quartiles at the 0.05 significance level. The correlation of CI quartiles with SBP and weight were at the 0.01 significance level.We showed a significant association of WC with SBP and DBP, and that BMI could be an important determining factor of SBP. For assessing the association between CI and cardiovascular risk factors, future studies with larger sample sizes are recommended.     

The effects of physical activity and body mass index on cardiovascular, cancer and all-cause mortality among 47 212 middle-aged Finnish men and women

OBJECTIVE: To examine the association of physical activity and body mass index (BMI), and their combined effect, with the risk of total, cardiovascular disease (CVD) and cancer mortality. DESIGN: Prospective follow-up study. SUBJECTS: In all, 22 528 men and 24 684 women aged 25-64 y at baseline having 7394 deaths during a mean follow-up of 17.7 y. MEASUREMENT: A self-administered questionnaire data on smoking, socioeconomic factors, physical activity and medical history, together with measured height, weight, blood pressure and serum cholesterol using standardized protocol. RESULT: Physically active subjects had significantly lower age-adjusted mortality from cardiovascular, cancer and all causes compared with sedentary ones. Further adjustment for smoking, systolic blood pressure, cholesterol, BMI, diabetes and education affected the results only slightly. Obese subjects (BMI> or =30 kg/m(2)) had significantly higher cardiovascular and total mortality than the normal weight (18.5< or =BMI<25 kg/m(2)) subjects. Part of increased mortality among obese subjects was mediated through obesity-related cardiovascular risk factors. BMI had an inverse association with cancer mortality among men and almost significant direct association among women. Total mortality was also increased among the lean (BMI<18.5 kg/m(2)) subjects. However, less than 0.3% of deaths were attributed to low body weight, whereas in men 5.5% and in women 17.7% of deaths were attributed to obesity. CONCLUSION: Regular physical activity and normal weight are both important indicators for a decreased risk of mortality from all causes, CVD and cancer. Physical activity had a strong independent effect on mortality, whereas the effect of BMI was partly mediated through other obesity-related risk factors.     

Association of estrogen receptor-alpha genotypes with body mass index in normal healthy postmenopausal Caucasian women

Several lines of evidence suggest the importance of the estrogen receptor (ER) in determining body mass index (BMI). Our purpose was to investigate whether genetic polymorphisms at the restriction enzyme PvuII site of the ER-alpha gene locus are associated with BMI variation. Data on BMI, age, and ER-alpha genotypes were obtained from 108 healthy midwestern U.S. postmenopausal Caucasian women. The study subjects were unrelated and aged 65 yr and over (mean age +/- SD, 73.4 +/- 5.1 yr), with an average BMI of 25.25 (SD, 4.04). The ER-alpha genotypes were obtained by PCR followed by restriction enzyme PvuII digestion. We found that in our study subjects the ER-alpha genotypes are significantly associated with BMI (by ANOVA, P = 0.04), explaining about 6.2% of the BMI variation in our study sample. The allelic effects of this locus on BMI are approximately additive. In our sample, individuals of the PP and Pp genotypes have, respectively, 11.4% and 4.8% higher BMI than individuals of the pp genotype. There is a significant ER-alpha genotype by age interaction, so that in our sample PP individuals tend to gain weight with age, whereas Pp and pp individuals tend to lose weight with age. Therefore, the ER-alpha polymorphisms are associated with BMI variation in healthy postmenopausal Caucasian women aged 65 yr and over. Our result is consistent with some recent findings suggesting the potential effects of the ER on BMI. The importance of the ER-alpha genotypes in other populations and other age groups needs to be demonstrated. Although the results of the ER-alpha genotype by age interaction are obtained here from cross-sectional data, direct confirmation may come from longitudinal studies in which individuals are measured multiple times over several years. The importance of the ER-alpha genotypes on BMI should be confirmed by further studies using methods robust to the potential problem of population substructuring that may confound the conclusions of population association studies.     

Influence of body composition on bone mass in postmenopausal osteoporotic women

We aimed at evaluating the relationship of lean and fat mass to bone mass in osteoporotic postmenopausal women. We invited 65 women who were being treated at the São Paulo Hospital osteoporosis outpatients’ clinic to participate. Body composition and bone mineral density (BMD) measurements were performed using Dual-energy X-ray absorptiometry methodology (DXA). The mean age and weight were 69.7 ± 6.4 years and 56.3 ± 7.6 kg, respectively. Accordingly to the body mass index (BMI), 52.8% were of normal weight and 47.1% of the patients were overweight. Overweight women had significantly higher bone mass. Similarly, skeletal muscle index (SMI) showed a positive effect on BMD measurements and women with sarcopenia had significantly lower BMD measurements in total femur and femoral neck. In multiple regression analysis only lean mass and age, after adjustments to fat mass and BMI, were able to predict total body bone mineral content (BMC) (R² = 28%). Also lean mass adjusted to age and BMI were able to predict femoral neck BMD (R² = 14%). On the other hand, none of the components of the body composition (lean mass or fat mass) contributed significantly to explaining total femur BMD and neither body composition measurements were associated with spine BMD. These findings suggest that lean mass has a relevant role in BMC and BMD measurements. In addition, lower BMI and lean mass loss (sarcopenia) is associated to lower BMC and BMD of femoral neck and total femur and possible higher risk of osteoporotic fracture.     

腹型肥胖对体质量指数正常的中老年男性骨骼肌的影响

目的 观察腹型肥胖对正常体质量指数(BMI)的中老年男性骨骼肌质量及功能的影响.方法 选取2019年3月至2020年7月内蒙古包钢医院老年科住院的96例中老年男性(≥45岁)为研究对象,根据有无腹型肥胖分为腹型肥胖组[AO(+)组,n=46]和非腹型肥胖组[AO(-)组,n=50].测定2组患者的生化指标、炎症指标、内...     

Overweight body mass index classification modifies arterial stiffening associated with weight gain in healthy middle-aged Japanese men

The present study was conducted to clarify whether body mass index (BMI [kg/m(2)]) classifications (i.e., without excess weight, overweight, and obese) modify the rate of progression of arterial stiffening, a cardiovascular risk factor associated with weight gain. A 3-year observational study was conducted in 2,080 healthy middle-aged Japanese men (aged 42+/-10 years). Brachial-ankle pulse wave velocity (baPWV) was measured at the beginning and end of the study period. In overweight subjects (30>BMI>or=25), the estimated annual rate of increase of baPWV (ARbaPWV) in subjects with weight gain (>or=5% weight gain; ARbaPWV, 21.8+/-4.4 cm/s/year) was significantly higher than in those without weight gain (<5% weight gain; ARbaPWV, 12.5+/-1.6 cm/s/year), after adjustments for changes in blood pressure and other variables (p<0.05). This change was not observed in subjects without excess weight (BMI<25) or in obese subjects (BMI>or=30). The increase in the ARbaPWV associated with weight gain in the overweight group was also higher than that in the without excess body weight or obese groups. Our study revealed that the BMI classifications modified the annual rate of increase in arterial stiffening associated with weight gain. Weight gain seemed to accelerate arterial stiffening in overweight subjects, but not in subjects without excess weight. The weight gain in overweight subjects seemed to worsen the cardiovascular risk related to arterial stiffness in middle-aged healthy Japanese men. Thus, the prevention of weight gain should be emphasized in overweight subjects.     

Prevalence of cardiovascular risk factors in middle-aged Lithuanian women in different body mass index and waist circumference groups

Background and aimsThe aim of this study was to evaluate the prevalence of cardiovascular risk factors in middle-aged Lithuanian women in different body mass index and waist circumference groups.Methods and resultsData selected from the Lithuanian High Cardiovascular Risk (LitHiR) primary prevention program between 2009 and 2016. This community-based cross-sectional study comprised 53,961 women aged 50–64 years old. We compared the prevalence of arterial hypertension, dyslipidaemia, diabetes mellitus, smoking, and metabolic syndrome in different body mass index (BMI) and waist circumference (WC) groups. The most prevalent cardiometabolic risk factor was dyslipidaemia (91.71%, n = 49,488). The prevalence of arterial hypertension, dyslipidaemia, diabetes mellitus, and metabolic syndrome was greater in those with higher-than-normal BMI and WC. Smoking was the most prevalent in women with low BMI and normal WC (24.00% and 13.17% respectively).ConclusionThe analysis showed that all risk factors, except smoking, were significantly more prevalent in women with higher-than-normal BMI and with increased WC or abdominal obesity. The prevalence of dyslipidaemia was surprisingly high in all BMI and WC groups. Obesity measured by WC was more strongly associated with an adverse metabolic profile.     

Body mass index and risk of death in middle-aged men and women in Poland. Results of POL-MONICA cohort study

BACKGROUND: Overweight and obesity have been considered to be the causes of serious health consequences. So far, there have been no studies in Poland to analyse the relationship between Body Mass Index (BMI) and mortality. AIM: To determine the relationship between BMI and the mortality risk due to all causes and due to cardiovascular diseases (CVD) in the middle-aged population of Poland. METHODS: The study group consisted of men and women aged 35-64, residents of two districts of Warsaw (Praga Pó?noc and Praga Po?udnie) and the former Tarnobrzeg Voivodship who were selected at random for POL-MONICA Project cross-sectional studies in 1983-1994. Risk assessment of death due to all causes and due to CVD was performed using the Cox proportional hazards method. Persons with BMI of 22-23.9 were adopted as reference group. RESULTS: Sample size consisted of 5,281 men and 5,691 women. Prospective observation was carried out from 5 to 15 years, mean duration 10.7 years. Overall, the observation comprised 117,839 person-years. During the study, 914 men died (including 448 due to CVD) as well as 430 women (including 160 due to CVD). After adjusting for age, place of residence (Warsaw vs. the Tarnobrzeg Voivodship), risk factors (hypercholesterolemia, arterial hypertension and smoking) and self-assessment of health, increased risk of all cause death was found in men with BMI lower than 20 kg/m(2) (relative risk 2.27), with BMI of 32-34.9 kg/m(2) (relative risk 1.41), with BMI > or =35 kg/m(2) (relative risk 1.73), and in women whose BMI was lower than 20 kg/m(2) (relative risk 1.66). Increased risk of CVD death was found in men with BMI lower than 20 kg/m(2) (relative risk 1.97), with BMI of 32-34.9 kg/m(2) (relative risk 1.66), with BMI > or =35 kg/m(2) (relative risk 2.06), and in women with BMI > or =35.0 kg/m(2) (relative risk 2.02). CONCLUSIONS: The POL-MONICA study carried out in the middle-aged Polish population did not confirm a relationship between overweight (BMI from 25 to 29.9 kg/m(2)) and risk of death due to all causes or due to CVD.     

Predicting bone mineral density of postmenopausal healthy and cirrhotic Italian women using age and body mass index

The objective of the present report was to develop mathematical prediction formulae for the lumbar spine, pelvis and total bone mineral density (BMD) based on the osteoporosis risk factors age and BMI in healthy and cirrhotic postmenopausal women. The study population comprised 20 postmenopausal cirrhotic women (late PM cirrhotic women), 20 postmenopausal healthy women matched for age and BMI (late PM healthy women), and 19 younger postmenopausal healthy women matched for BMI (early PM healthy women). Segmental and total bone mineral content and BMD, total bone-free lean body mass and total fat mass were measured for all women using dual X-ray absorptiometry (DXA). The prediction formulae for late PM cirrhotic women had higher cumulative correlation coefficients ( r=0.71, p=0.05 for spine BMD, r=0.84, p=0.013 for pelvis BMD, and r=0.89, p=0.004 for total BMD) than those for early PM healthy women ( r=0.64, p=0.015 for spine BMD, r=0.69, p=0.002 for pelvis BMD, and r=0.62, p=0.022 for total BMD) and late PM healthy women ( r=0.29, p=NS for spine BMD, r=0.39, p=NS for pelvis BMD, and r=0.54, p=NS for total BMD). The mathematical formulae based on the variables age and BMI were capable of predicting lumbar spine BMD, pelvis BMD, and total BMD by DXA for the three groups of postmenopausal women.     

Longitudinal study of variation in body mass index in middle-aged UK females

The importance of changing patterns of obesity in society and its implications for public health are well recognized. However, the adult life course of body mass index (BMI) changes in individuals over time is largely unknown and has mostly been extrapolated from cross-sectional studies. The present study examines individual specific variation of BMI during a 15-year follow-up period in a community-based sample of UK females. We attempted to establish whether there is a common, generalized pattern which captures variation in BMI over time. The participants of this study belong to a prospective population cohort of British women studied intensively since 1989: the Chingford Study. The sample originally consisted of 1,003 women aged 45-68 years, who were assessed annually for BMI during follow-up period. Polynomial regression models were used to assess longitudinal BMI variation. We observed a great stability in individual BMI variation during the follow-up period, reflected by high correlations between the baseline BMI and follow-up BMI 10 and 15 years later (r = 0.876, N = 810, and r = 0.824, N = 638, respectively). We also found that three different major age-related patterns in BMI could be clearly identified: no change in 30.6% in 58% it increased and in 11.4% it decreased with age. Thus, our data suggest that individual age-related changes in BMI are very different. Therefore, simply combining all individuals into groups by any other criteria (age, sex, etc.) and overlooking the distinctive patterns of BMI change may lead to biased inferences in epidemiologic and etiologic research of the future.