钙摄入量对青春前期女童骨量增长的影响—两年随机干预实验

目的研究不同钙摄入量对于青春前期女童骨量增长的影响,为该人群钙适宜摄入量的修订提供科学依据。方法以年龄10.0±0.7岁的241名青春前期健康女童为对象,设计普通膳食组、牛奶补充组和钙剂补充组三组,总钙摄入量分别为600、900和1200mg/d,进行2年干预,采用多次称量及3d膳食询问法获得2年间日均膳食钙摄入量,使用双能X线骨密度仪测量干预前后全身、腰椎及近端股骨骨矿物密度和骨矿物含量。结果2年间三组的平均钙摄入量分别为552±61、864±139和1166±207mg/d;日均钙摄入量与全身、多位点骨矿物含量和骨矿物密度显著正相关;当日均钙摄入量达到864mg/d时,全身骨矿物含量增加值显著高于钙摄入量为552mg/d膳食组;当日均钙摄入量达到1166mg/d时,股骨颈骨矿物含量及骨矿物密度和腰椎骨矿物密度的增加值显著高于未达到1166mg/d的干预组。结论9～11.5岁的青春前期女童钙摄入量达到1166mg/d,全身特别是负重部位能获得较高骨矿物含量和骨矿物密度增长,提示青春前期钙适宜摄入量可能为1200mg/d。     

Calcium supplementation provides an extended window of opportunity for bone mass accretion after menarche

BACKGROUND: High calcium intakes during adolescence may increase bone acquisition. The magnitude of the effect of dietary calcium supplementation and the timing of its administration to achieve significant effects on bone health are still incompletely defined. OBJECTIVE: The objective of this study was to assess the effect of calcium supplementation on bone mass accretion in postmenarcheal adolescent girls with low calcium intakes. DESIGN: A double-blind, placebo-controlled calcium supplementation study was implemented. One hundred girls with a mean (+/- SD) age of 14 +/- 0.5 y with habitual calcium intakes < 800 mg/d completed a 12-mo protocol. The treatment group received a daily supplement containing 1000 mg elemental calcium. Bone mineral density (BMD) and bone mineral content (BMC) of the total body, lumbar spine, and femoral neck were determined at inclusion, 6 mo, and 12 mo. Also measured were serum concentrations of biochemical markers of bone turnover (osteocalcin and deoxypyridinoline), parathyroid hormone, and vitamin D. RESULTS: The calcium-supplemented group had greater accretion of total-body BMD and lumbar spine BMD but not BMC than did the control group. Calcium supplementation appeared selectively beneficial for girls who were 2 y postmenarcheal. Calcium supplementation significantly decreased bone turnover and decreased serum parathyroid hormone concentrations. CONCLUSION: Calcium supplementation of postmenarcheal girls with low calcium intakes enhances bone mineral acquisition, especially in girls > 2 y past the onset of menarche.     

甲状旁腺激素基因多态性与钙摄入量对青春期女童骨量增长的交互作用

目的:探讨甲状旁腺激素(PTH)基因多态性与钙摄入量对青春期女童骨量增长的交互作用。方法:选择228名9～11.5岁未月经初潮的健康女童进行2年追踪,用双能X线骨密度仪(DEXA)检测对象追踪前后全身、左侧近端股骨(包括股骨颈、大转子、粗隆间和华氏三角区)、L1～L4腰椎骨矿含量和骨密度,采用PCR-RFLP技术检测PTH基因BstBⅠ位点多态性。结果:BB基因型女童L1～L4腰椎骨矿含量增长率、左侧近端股骨、粗隆间和L1-L4腰椎骨密度增长率均高于含b等位基因女童(P=0.022～0.047)。BB基因型女童在高钙摄入(>950mg/d)时,粗隆间骨矿含量(ITBMC)增长率较中等和低钙摄入时分别高29.4%和35.0%,股骨颈骨密度(FNBMD)增长率分别高66.7%和46.2%。而含b等位基因女童的ITBMC和FNBMD增长率在不同钙摄入量之间没有显著性差异。结论:PTH基因BstBⅠ多态性与钙摄入量对青春期女童骨量增长存在交互作用,BB基因型女童高钙摄入可促进其骨量增长。     

补钙16个月对青春期男女生骨量的影响

目的探讨不同钙摄入量对我国青少年骨量的影响。方法对北京郊区337人(平均年龄为13.6岁)开展为期16个月的双盲对照干预研究,每天给予3次不同剂量碳酸钙片,每片含60IU维生素D,用双能X线吸收仪(DXA)测定全身、腰椎和前臂骨量。结果女生全身骨矿物密度的年增长率由低钙摄入组到高钙摄入组逐渐升高,调整混杂因素后差异消失。女生前臂远端1/3处和男生前臂远端1/10处的骨矿物含量年增长率和骨面积年增长率均以每天钙摄入900～1100mg/d的人群(平均钙摄入量984mg/d)最高,其中调整混杂因素后男生差异消失。结论青春期钙摄入量达到1000mg/d以上可促进青少年骨量增长,此结果有性别差异。     

Effect of habitual dietary calcium intake on calcium supplementation in 12-14-y-old girls

BACKGROUND: There is no agreement on how much calcium young girls need for optimal bone mineralization. OBJECTIVE: We evaluated whether the effect of calcium supplementation on whole-body bone mineral accretion depends on habitual calcium intake. DESIGN: This was a randomized, double-blind, placebo-controlled, 1-y calcium intervention study of girls aged 12-14 y selected from a larger group according to habitual calcium intake: subgroup A (n = 60) habitually consumed 1000-1307 mg/d (40th-60th percentile), and subgroup B (n = 53) habitually consumed <713 mg/d (<20th percentile). The girls from each subgroup were randomly assigned to receive either 500 mg Ca/d or placebo. Whole-body bone mineral content (BMC), bone area (BA), bone mineral density (BMD), and BMC adjusted for BA, height, and weight (size-adjusted BMC) were measured at baseline and after 1 y. RESULTS: There was no significant effect modification of baseline habitual calcium intake on the relation between calcium supplementation and height, weight, BMC, size-adjusted BMC, BA, BMD, or alkaline phosphatase. Calcium supplementation had an effect on BMD (0.8%; P = 0.049) and tended to show signs of an effect on size-adjusted BMC (0.5%; P = 0.08). CONCLUSION: A modest effect of calcium supplementation on BMD was shown. However, the effect was independent of habitual calcium intake.     

强化钙与维生素D牛奶对北京城区小学女生骨量的影响

目的 :　探讨饮用钙与维生素 D强化牛奶对北京城区青春前期女生骨量的影响。方法 :　为期一年设有对照的双盲干预研究。将来自北京市西城区 9所小学平均年龄为 1 0 .1岁的女生 75 7名随机分为对照组 (n=2 5 9) :保持日常饮食 ;实验 1组 (n=2 3 8) :除日常饮食外 ,饮用钙强化牛奶 1 3 7ml/d,含钙 2 3 3 mg;实验 2组 (n=2 6 0 ) :除日常饮食外 ,饮用钙和维生素 D强化牛奶 1 3 7ml/d,其中钙 2 3 3 mg,VD 3 .3μg。使用 2 4 h回顾法了解食物摄入、体力活动问卷了解体力活动情况 ,用双能 X线吸收仪 (DEXA)测定全身和前臂骨量。结果 :　与干预前相比 ,实验组 2全身骨矿物密度 (BMD)的增长率显著高于实验 1组和对照组 (9.6 %、8.3 %和 8.0 % ,P=0 .0 0 2 ) ;实验 1组、实验 2组桡骨远端 1 /3处 BMC和骨面积的增长率显著高于对照组 (BMC:1 3 .0 %、1 2 .9%和1 1 .7% ,P=0 .0 1 6 ;骨面积 :2 .3 %、2 .0 %和 1 .5 % ,P=0 .0 1 0 ) ;实验 1组前臂远端 1 /1 0处 BMC和BMD的增长率显著高于对照组 (P=0 .0 0 7)。结论 :　饮用钙与维生素 D强化牛奶能促进青春前期女生骨量的增长 ,饮用钙和维生素 D强化牛奶促进骨量增长的作用比饮用钙强化牛奶明显     

Sustained effect of short-term calcium supplementation on bone mass in adolescent girls with low calcium intake

BACKGROUND: The effect of short-term calcium supplementation on peak bone mass in adolescent girls is not completely defined. In our previous double-blind, placebo-controlled, calcium-supplementation study (1000 mg calcium carbonate/d), we showed that calcium supplementation of postmenarcheal girls with low calcium intakes enhances bone mineral acquisition. OBJECTIVE: The objective of this follow-up study, conducted 3.5 y after the end of calcium supplementation, was to investigate the sustained effect of calcium supplementation on bone mineral mass. DESIGN: Anthropometric data, nutrient intakes, and bone variables were reassessed in 96 of the 100 adolescent girls whose data had been studied at the end of the supplementation period. Bone mineral content and bone mineral density (BMD) of the total body, lumbar spine, and femoral neck were determined by dual-energy X-ray absorptiometry. RESULTS: The calcium-supplemented group tended to have a greater accretion of total-body BMD (TBBMD) than did the control group 3.5 y after the end of supplementation. The finding was statistically significant in the active-treatment cohort (n = 17 in the calcium-supplemented group and 28 in the placebo group), who had a compliance rate of > or =75% during the intervention study. In a multivariate linear-regression analysis, TBBMD accretion from the beginning of the intervention study to the follow-up study in the active-treatment cohort was attributed to calcium supplementation and to the time since inclusion in the initial study. CONCLUSION: Calcium supplementation for 1 y in postmenarcheal girls with low calcium intakes may provide a sustained effect on the basis of TBBMD measurements in participants with compliance rates of > or =75%.     

膳食钙摄入量与青春前期女童骨量关系的研究

目的:研究青春前期女童膳食钙摄入量与骨量的关系,为指导合理钙营养提供科学依据。方法:采用双能X线骨密度测量仪测量年龄在10±1岁的194名青春前期女童全身及多位点骨密度和骨矿物质含量,采用食物频数及3d膳食询问法调查膳食钙摄入量,问卷法调查体力活动。结果:日均钙摄入量与所测各位点骨矿物质含量及骨密度均呈显著正相关;日均钙摄入量平均从257mg增加到759mg,不同位点的骨矿物质含量和骨密度分别增加13%～22%和3.6%～16%。结论:增加青春前期女童膳食钙摄入量有助于获得较高骨量和骨密度。     

补充强化钙-维生素D牛奶中止两年后中学女生骨量的随访研究

目的:随访研究补充强化钙、维生素D牛奶中止2年后北京城区中学女生骨量的变化。方法:从完成1999-2001年补充强化钙和维生素D牛奶实验的698名女生(10.1岁)中随机抽取294名2年后进行随访,其中对照组未补充强化奶,实验1组强化钙奶,实验2组强化钙-维生素D奶。采用问卷调查法收集一般情况、膳食营养摄入、体力活动状况等指标,并检查其体格发育和第二性征发育状况。采用双能X线吸收仪(DEXA)测量全身、桡骨和前臂的骨量。结果:干预后两个实验组的桡骨远端1/3处、前臂远端1/3处和前臂远端1/10处的骨矿含量绝对增长值均显著高于对照组。但是,在干预中止两年后随访时三组间三个部位的骨矿含量增长值没有显著差异。结论:补充钙、维生素D强化牛奶后对女生骨量增长的促进作用均在中止两年后消失。     

Effect of calcium supplementation on bone mineral accretion in gambian children accustomed to a low-calcium diet

BACKGROUND: Rural Gambian children have poor growth, delayed puberty, a low bone mineral content, and a low calcium intake. OBJECTIVE: We investigated the effect of a calcium supplement on bone mineral accretion in rural Gambian children. DESIGN: A randomized, double-blind, placebo-controlled study was conducted in 160 children (80 boys, 80 girls) aged 8.3-11.9 y. Bone mineral content (BMC), bone mineral density (BMD), and BMC adjusted for bone width, body weight, and height (size-adjusted BMC) were measured at the midshaft and distal radius. Each child received either 1000 mg Ca/d (as calcium carbonate) or a placebo 5 d/wk for 12 mo. Supplementation increased calcium intake from 342 to 1056 mg/d (8.6 to 26.4 mmol/d). RESULTS: Calcium supplementation resulted in a higher BMC, BMD, and size-adjusted BMC (&xmacr; difference +/- SE): midshaft radius-BMC (3.0 +/- 1.4%; P = 0.034), BMD (4.5 +/- 0.9%; P 相似文献   

Calcium supplementation and bone mineral accretion in adolescent girls: an 18-mo randomized controlled trial with 2-y follow-up

BACKGROUND: A recent meta-analysis raised doubt as to whether calcium supplementation in children benefits spine and hip bone mineral density (BMD). OBJECTIVE: We used state-of-the-art measures of bone (fan-beam dual-energy X-ray absorptiometry and 4 bone turnover markers) to determine whether girls with low habitual calcium intake benefited from supplementation with a soluble form of calcium (calcium citrate malate dissolved in a fruit drink). DESIGN: The trial was an 18-mo randomized trial of calcium supplementation (792 mg/d) with follow-up 2 y after supplement withdrawal. Subjects were 96 girls (mean age: 12 y) with low calcium intakes (mean: 636 mg/d). The main outcome measure was change in total-body, lumbar spine, and total hip bone mineral content (BMC) during supplementation and 2 y after supplement withdrawal. Changes in BMD and bone turnover markers were secondary outcome measures. RESULTS: The mean additional calcium intake in the supplemented group was 555 mg/d. Compared with the control group, the supplemented group showed significantly (P < 0.05) greater gains in BMC (except at the total hip site) over the 18-mo study. BMD change was significantly (P < 0.05) greater for all skeletal sites, and concentrations of bone resorption markers and parathyroid hormone were significantly (P < 0.01) lower in the supplemented group than in the control group after 18 mo. After 42 mo, gains in BMC and BMD and differences in bone resorption were no longer evident. CONCLUSIONS: Calcium supplementation enhances bone mineral accrual in teenage girls, but the effect is short-lived. The likely mechanism for the effect of the calcium is suppression of bone turnover, which is reversed upon supplement withdrawal.     

大鼠骨矿物质含量与组织中钙水平的相关性研究

用ＳＤ１０００型单光子骨矿物测定仪研究了９８只１５周龄Ｗｉｓｔａｒ大鼠的股骨矿物质含量（ＢＭＣ）和骨密度（ＢＭＤ，ＢＭＣ／ＢＷ）与组织和血中钙含量的相关性。结果显示：雌、雄动物的身长、体重、骨宽度（ＢＷ）、ＢＭＣ、ＢＭＣ／体重、ＢＭＤ／体重及ＢＭＤ／身长均有显著性差异，活体ＢＭＤ与动物的钙总摄入量、身长、体重、及钙存留率显著相关（Ｐ＜０．０５）；ＢＭＣ与钙总摄入量、身长、体重、性别和肝脏钙含量显著相关（Ｐ＜０．０５）。多元回归分析表明：动物身长、体重、钙总摄入量和心脏钙含量与活体ＢＭＤ呈线性关系，动物身长和血浆钙含量与离体ＢＭＤ呈线性关系。活体测量结果ＢＭＣ、ＢＭＤ由于其与动物的生长发育、钙存留率及肌肉和血浆钙含量具有相关和直线关系，且简便易行、不需要处死动物，因而认为可以反映动物体内钙营养状况和骨质积累情况。     

Growth, bone mass, and vitamin D status of Chinese adolescent girls 3 y after withdrawal of milk supplementation

BACKGROUND: A 2-y school milk intervention trial showed that 330 mL of a dietary milk supplement (fortified with calcium alone or with both calcium and vitamin D) enhanced the growth and bone mineral accretion of Chinese girls aged 10 y at baseline. Girls who received milk fortified with both calcium and vitamin D also had better vitamin D status than did girls who received nothing or girls who received milk fortified only with calcium. OBJECTIVE: The aim was to evaluate whether these effects were sustained 3 y after supplement withdrawal. DESIGN: Anthropometric measures and dietary intake were reassessed in 501 of the 698 girls whose data had been studied at the end of the intervention. As in the intervention phase, total-body bone mineral content and bone mineral density and serum 25-hydroxyvitamin D concentrations were measured in half of these subjects. RESULTS: At follow-up, 99% of girls had reached menarche, at a mean (+/-SD) menarcheal age of 12.1 +/- 1.1 y. No significant differences in the timing of menarche were observed between the 3 groups (P = 0.6). No significant differences in the changes of total-body bone mineral content and bone mineral density since baseline were observed between the groups. The group receiving calcium-fortified milk had significantly greater gains in sitting height (0.9 +/- 0.3%; P = 0.02) than did the control group. The group that received calcium- and vitamin D-fortified milk had 17.1 +/- 6.7% lower serum 25-hydroxyvitamin D concentrations than did the control group (P = 0.04), but the difference was attenuated by additional adjustment for physical activity level (14.2 +/- 6.7%; P = 0.08). CONCLUSION: Milk supplementation during early puberty does not have long-lasting effects on bone mineral accretion.     

Effects of dairy food supplements on bone mineral density in teenage girls

Summary Background Bone mineral density (BMD) is largely genetically determined and this influence is most powerful in the period of rapid skeletal development in childhood and late adolescence but environmental factors such as exercise and dietary calcium intake may influence up to 20%. Aims of the study The aims of the study were to examine healthy late adolescent females for the effects and benefits of a high calcium intake from dairy product foods on bone mineral density, body composition, lipids and biochemistry. The secondary aim is determine whether a high intake of dairy product foods in the diet is acceptable for this age group long term. Methods Ninety-one teenage girls who participated in a two-year randomised controlled study on the effect of dairy food supplementation on dietary patterns, body composition and bone density in post-pubertal teenage girls were approached one year after the cessation of the study to determine the effects of the cessation of dairy supplements on bone mineral density, dietary habits, biochemical markers, body composition and blood lipids. Bone mineral density and bone mineral content were assessed at the hip, spine and total body. Anthropometric data were collected, and exercise, Tanner, dietary assessment, preference and compliance questionnaires were administered. Lipid profiles, hydroxyproline excretion and urinary calcium and sodium excretion measurements were performed. Results There were no significant differences between the 2 groups for height, weight, lean and fat mass. The supplemented group had significantly higher calcium, phosphorus and protein intake during the supplementation period (p<0.001). No differences were seen between the groups 12 months after supplementation finished. There were no significant differences in exercise level, preference or acceptability of dairy products or in the lipids and bone markers between baseline the end of supplementation and 1 year follow-up. There was a significant increase in trochanter (4.6%), lumbar spine (1.5%) and femoral neck (4.8%) BMD (p<0.05) in the high calcium group at the end of supplementation. There was an increase in bone mineral content at the trochanter (p<0.05) and lumbar spine; however the latter was not statistically significant, in the high calcium group at the end of supplementation. There was no difference in vertebral height or width at any stage of the study, indicating no influence on bone size. Conclusions In this 3 year study (2 years of supplementation, 1 year follow-up), teenage girls, aged 15–18 years, were able to significantly increase their BMD at the trochanter, femoral neck and lumbar spine when supplemented with dairy product foods to a mean calcium intake of 1160 mg/d. There was also an effect seen on the BMC particularly at the trochanter and to a lesser extent at the lumbar spine. The dietary calcium intake achieved did not adversely affect body weight, fat and lean mass or blood lipid profiles. Twelve months after the supplementation finished the girls had returned to their baseline diet, indicating self-selection of a high dairy product diet may be hard to achieve. Received: 5 June 2000, Accepted: 5 September 2000     

Calcium supplementation and bone mineral density in females from childhood to young adulthood: a randomized controlled trial

BACKGROUND: Short-term studies established that calcium influences bone accretion during growth. Whether long-term supplementation influences bone accretion in young adults is not known. OBJECTIVE: This study evaluated the long-term effects of calcium supplementation on bone accretion among females from childhood to young adulthood. DESIGN: A 4-y randomized clinical trial recruited 354 females in pubertal stage 2 and optionally was extended for an additional 3 y. The mean dietary calcium intake of the participants over 7 y was approximately 830 mg/d; calcium-supplemented persons received an additional approximately 670 mg/d. Primary outcome variables were distal and proximal radius bone mineral density (BMD), total-body BMD (TBBMD), and metacarpal cortical indexes. RESULTS: Multivariate analyses of the primary outcomes indicated that calcium-supplementation effects vary over time. Follow-up univariate analyses indicated that all primary outcomes were significantly larger in the supplemented group than in the placebo group at the year 4 endpoint. However, at the year 7 endpoint, this effect vanished for TBBMD and distal radius BMD. Longitudinal models for TBBMD and proximal radius BMD, according to the time since menarche, showed a highly significant effect of supplementation during the pubertal growth spurt and a diminishing effect thereafter. Post hoc stratifications by compliance-adjusted total calcium intake and by final stature or metacarpal total cross-sectional area showed that calcium effects depend on compliance and body frame. CONCLUSIONS: Calcium supplementation significantly influenced bone accretion in young females during the pubertal growth spurt. By young adulthood, significant effects remained at metacarpals and at the forearm of tall persons, which indicated that the calcium requirement for growth is associated with skeletal size. These results may be important for both primary prevention of osteoporosis and prevention of bone fragility fractures during growth.     

补充钙剂对青春期骨矿含量的影响

为研究补充钙剂对青少年骨矿含量以及体格发育的影响 ,选取 1 61例 9～ 2 0岁健康青少年 ,按性别和性发育程度分为补钙组和对照组。实验前后评价两组膳食钙摄入量、运动量水平、性发育程度 ,并测定两组青少年身高、体重和桡骨远端 1 3处骨矿含量、骨宽和血清总碱性磷酸酶水平。结果表明本组青少年膳食钙摄入量低于每日膳食钙参考摄入量的适宜摄入量水平 ,补充钙剂对青少年身高、体重无明显影响 ;骨矿含量增长除女性青春期后期有显著性差异外 ,其余各组增长与对照组比较无显著性。结果提示 ,青春期存在体格快速发育和骨量迅速积累的特点 ,补充钙剂对骨矿含量的增长作用有限 ,对体格发育也无明显影响 ;在女性骨量增长较少阶段补充钙剂则可能有助于骨矿含量的增加 ,且这种作用可能通过降低骨代谢率实现     

Bone mineral contents and plasma osteocalcin concentrations of Gambian children 12 and 24 mo after the withdrawal of a calcium supplement

BACKGROUND: Our randomized, placebo-controlled supplementation study of 160 rural Gambian children aged 8.3-11.9 y showed that an increase in calcium intake of 714 mg/d for 12 mo resulted in a 5% increase in forearm bone mineral acquisition and a 22% decrease in plasma osteocalcin concentration, a bone formation marker, but had no effect on height or bone dimensions. OBJECTIVE: We investigated whether these results were sustained after supplement withdrawal. DESIGN: All participants were followed up 12 (FU1) and 24 (FU2) mo after supplementation ended. Bone mineral content (BMC), bone mineral density (BMD), and BMC adjusted for bone width, body weight, and height (size-adjusted BMC) were measured at the midshaft and distal radius. Plasma osteocalcin concentration was measured at FU1. RESULTS: At follow-up, the calcium group had greater bone mineral status than did the placebo group at the midshaft radius (mean difference +/- SE), FU1: BMC (4.7 +/- 1.6%; P = 0.004), BMD (5.1 +/- 1.1%; P 相似文献   

青春早期女童体力活动与骨量关系的研究

目的探讨体力活动与青春前期女童骨量的关系。方法采用双能X线骨密度测量仪测量年龄在（10±1）岁的194名青春早期女童全身、股骨颈、Ward三角区和L1-L4的骨密度（BMD）和骨矿物质含量（BMC）,采用问卷和跟踪记录调查女童的体力活动和膳食钙摄入。结果日均承重和日均总体力活动能耗与上述位点BMD和BMC均显著正相关,而非承重体力活动与BMD和BMC无显著相关。BMD和BMC随着承重体力活动能耗增高而增高,平均能耗从950kJ（227kcal／d）增加到1737kJ（415kcal／d）时,各位点BMC增加17．5％～29．0％,BMD增加8．8％-17．1％。结论青春前期女童适当增加体力活动量,尤其是承重体力活动量,有助于获得更多的骨量积累。     

青春前期女童骨钙素基因多态性与骨量的相关关系

目的:了解我国青春前期女童骨钙素基因多态性分布并探讨其对骨量的影响。方法:选择152名9～11.5岁未月经初潮的健康女童,采用双能X线骨密度仪(DXEA)检测对象全身、L1-L4腰椎、左侧近端股骨的骨矿含量、骨密度以及体成分,采用PCR-RFLP技术检测骨钙素基因多态性。结果:152名女童OC基因HindⅢ位点多态性基因型的分布频率分别为:突变型纯合子(HH)5.26%,杂合子(Hh)36.84%,野生型纯合子(hh)为58.90%,各基因型TBBMC、全身及各部位的BMD、血骨钙素水平均存在显著差异(P<0.05),表现为HH相似文献   

Bone mass in Chinese premenarcheal girls: the roles of body composition, calcium intake and physical activity

The association of growth and anthropometric characteristics and lifestyle factors with bone mass and second metacarpal radiogrammetry parameters was evaluated in 373 healthy Chinese premenarcheal girls aged 9-11 years. Bone mineral content (BMC) and density (BMD) and bone area (BA) of distal forearm, proximal forearm and total body, bone mineral-free lean (BMFL) mass and fat mass were measured by dual-energy X-ray absorptiometry. Metacarpal bone periosteal and medullary diameters were measured. Dietary intakes were assessed by 7 d food record and physical activity (PA) by questionnaire. BMFL and fat mass together explained 6.3 and 51.6% of the variation in total body BMC and BMD, respectively. BMFL mass contributed to a substantial proportion of the variation in forearm BMC and BMD and periosteal diameter (10.4-41.0%). The corresponding BA explained 14.8-80.4% of the variation in BMC. Other minor but significant predictors of total body bone mass were Ca intake, height, age and PA score (BMD only), and of forearm bone mass were PA score, bone age, height and fat mass. Nevertheless, after adjusting for bone and body size and for age or bone age, subjects with Ca intake above the median (417 mg/d) had 1.8% greater total body BMC (P<0.001), and subjects with PA scores above the median had 2.4-2.5% greater distal and proximal forearm BMC (P<0.05) than those below. Vitamin D intake negatively associated with medullary diameter (partial R2 1.7%). The results indicate that premenarcheal girls should be encouraged to optimise nutrition and Ca intake and exercise regularly to achieve maximum peak bone mass.