新疆维吾尔族、汉族人群体重指数、身体脂肪组织、非脂肪组织、骨矿物质含量的差异性研究

目的 通过对维吾尔族、汉族不同民族人群BMI、Bone、Fat及Lean的测定比较,了解新疆维、汉两族人群 Bone、Fat、Lean的分布特征,BMI的流行趋势以及有无明显的种族差异.探讨BMI与Bone、Fat及Lean之间的变化规律.方法 利用双能X线骨密度仪(DMS LEXXOS外星人)全身身体成分分析软件,对新疆维吾尔族、汉族人群的BMI以及3个测量指数(Bone、Lean、Fat)进行分析和多元回归分析.结果 无论男女或任何年龄段维吾尔族超重者均多于汉族人群;这与此前多篇相关报道一致[1-3].在同等BMI条件下,汉族男、女性Bone、Lean的百分比均大于维族男、女性.而维族男、女性Fat的百分比均大于汉族男、女性.维、汉人群的身体构建差异不大;从遗传理论的角度来说应该有一定的影响,但是经过近几十年各族人民在文化、饮食等方面的交流,后天因素有了很大的发展空间.结论 新疆维、汉族人群的膳食结构不平衡和身体活动不足是导致超重和肥胖率上升的最主要的原因,也是影响新疆汉族人群与维吾尔族人群身体健康的主要因素.     

绝经后妇女骨密度、体重指数、体脂和雌激素分泌的关系

目的　调查分析绝经后妇女骨密度、体重指数、体脂和雌激素分泌之间的关系。方法　上海市区 5 0～ 70岁社区绝经后女性健康志愿者共 4 5 7例 ,进行身高体重、腰椎和股骨颈骨密度的测定、腰椎和髋部脂肪成分的检测 ,以及随机选取 118例志愿者进行血清雌激素的测定。所有资料输入电脑 ,应用SPSS软件进行统计分析。结果　非骨质疏松 (Non OP)组中体重指数与腰椎和股骨颈骨密度的相关系数分别为 0 . 5 3和 0 . 5 4 ,骨质疏松 (OP)组分别为 0 .33和 0 . 33;Non OP组中体重指数与腰椎和髋部体脂的相关系数分别为 0. 2 1和 0 . 0 92 ,OP组分别为 0 . 72和 0 .2 7;Non OP组的血清雌激素浓度与体脂呈弱相关 ,OP组血清雌激素浓度与体脂无关。Non- OP组中体重指数大于OP组 ,体脂低于OP组 ,但无统计学意义。经体重指数校正后 ,体脂 (即体脂 /体重指数 ,亦即体脂在体重中所占的比重 ) ,OP组体脂明显大于Non -OP组 (P <0 . 0 5 )。结论　体重是影响绝经后妇女骨密度的重要因素 ,体脂在体重中的比重增加会降低绝经后妇女的骨密度 ,这种体脂的增加与雌激素可能无关。绝经后妇女应在不增加体脂的前提下 ,适当增加体重来预防骨质疏松症的发生。     

身高、体重及体重指数对辽宁地区正常中老年人骨矿含量的影响

目的　调查分析身高、体重及体重指数 (BMI)对辽宁地区正常中老年人群骨矿含量的影响。方法　在辽宁地区年龄在 40～ 79岁的中老年人群中随机抽样 173 1例 ,除外可能导致继发性骨质疏松症的各种疾病 ,应用美国lunar公司生产的双能X线骨密度仪 ,分别测试受试者的腰椎及股骨上段的骨密度 (BMD) ,全部资料输入微机 ,用SPSS软件进行统计学处理。结果　身高与腰椎及股骨上段的BMD相关性较差 (r=0 0 87～ 0 197,P <0 0 5 ) ,体重与腰椎及股骨上段的BMD相关性较好(r=0 2 2 6～ 0 3 5 2P <0 0 1)。体重指数与腰椎的相关性最好 ,其次是大转子。腰椎及股骨颈的BMD在超体重组 (BMI>2 5kg/m2 )明显大于低体重组 (BMI≤ 19kg/m2 ) ,其差异有显著性 ,该特点在腰椎最为明显。结论　体重是影响中老年人骨矿含量的重要因素。对低体重的中老年人 (BMI≤ 19kg/m2 )可作为骨质疏松症的易发人群 ,及时监测BMD ,早期预防及治疗     

12285例体检者局部脂肪含量与骨密度的相关性研究

目的了解腰椎周围及髋部周围脂肪比例与骨密度的关系,探讨局部脂肪含量对骨密度检测值的影响。方法收集12285例正常体检人群双能X线骨密度(DEXA)检测的骨密度数据(腰椎和髋部),同时收集每人"骨密度局部模式"所检测的"腰椎周围"及"髋部周围"脂肪比例值数据,按照性别、体重指数(BMI)对本组检测人员分组,采用单因素方差分析和多元线性回归统计方法,回顾分析局部脂肪比例与骨密度之间的相关性。结果单因素方差分析:在髋部脂肪比例高的组中,各组骨密度的平均值均较低。男性髋部和腰椎骨密度在腰周脂肪比例高的组别中平均值较高,而女性腰椎骨密度在腰周脂肪比例高的组中平均值较低,髋部的骨密度则没有明显的改变。多元线性回归分析:女性组:骨密度与身高(r=0.276～0.497)和体重(r=0.216～0.526)正相关,与年龄负相关(r=-0.730～-0.454),与髋部周围脂肪比例负相关(r=-0.369～-0.352),与腰椎周围脂肪比例负相关(r=-0.400～-0.245)。在多元回归分析中,控制其他变量后,腰椎骨密度和腰椎周围脂肪比例无统计学上的相关性。腰椎骨密度和髋部周围脂肪比、髋部骨密度和两个部位的脂肪比均呈负相关,并且在BMI高的组中,负相关性较为显著,其中髋部脂肪比和腰椎骨密度负相关性最为显著(r=-0.220～-0.194)。男性组:骨密度与身高(r=0.139～0.388)和体重呈正相关,与年龄相关性差(r=-0.494～0.077),与髋部周围脂肪比例负相关(r=-0.400～-0.216),与腰椎周围脂肪比例负相关(r=-0.329～-0.223)。在多元回归分析中,控制其他变量后,腰椎骨密度和腰椎周围脂肪比例在BMI20 kg/m2组中呈显著的正相关(r=0.294),在其它组中没有显著的相关性。腰椎骨密度和髋部周围脂肪比、髋部骨密度和两个部位的脂肪比例呈负相关,其中腰椎骨密度和髋部周围脂肪比的负相关性最为显著(r=-0.207～-0.108),并且在BMI低的组中,负相关程度较高。结论脂肪含量对骨密度有显著的影响,局部脂肪比例增加骨密度下降显著(成年女性BMI指数越高相关性越高);脂肪分布对骨密度影响明显,髋部脂肪比(皮下脂肪为主)与腰椎骨密度的负相关性最显著。     

Association between bone mineral density,lean mass,and fat mass among healthy middle-aged premenopausal women: a cross-sectional study in southern Sri Lanka

Associations between lean mass, fat mass, and bone mass have been reported earlier; however, most of those studies have been done in Caucasian populations, and data from Asian countries, especially those in South Asia, are limited. We examined the associations between lean mass, fat mass, bone mineral density (BMD), and bone mineral content (BMC), determined by dual-energy X-ray absorptiometry technology, in a group of healthy, middle-aged, premenopausal female volunteers. The mean (SD) age of the women (n = 106) was 42.1 (6.1) years and the mean (SD) body mass index was 24.3 (3.6) kg/m². Total body BMD, total body BMC, and BMD in total spine, total hip, and femoral neck showed statistically significant partial correlations (adjusted for age) with total fat mass (r = 0.19–0.43, P < 0.05) and lean body mass (r = 0.28–0.54, P < 0.05). Truncal fat mass correlated positively with total body BMC and BMD at total hip and femoral neck (r = 0.33–0.40, P < 0.001). When a stepwise regression model was fitted, lean mass remained the strongest predictor of total body BMD, total body BMC, and total spine BMD (regression coefficients = 0.004–0.008 g/cm² per 1-kg change in lean mass, P < 0.001). Similarly, crude BMD and BMC increased across the tertiles of lean mass (P trend < 0.05). We show that lean mass is the strongest predictor of total body BMC and BMD at different sites, although positive correlations with fat mass also exist.     

体重、体质指数、腰围和腰臀比对正常成人骨密度的影响

目的探讨体重、体质指数(BMI)和腰围、腰臀比(WHR)对正常成人骨密度的影响。方法采用MarcomMx8000多层螺旋CT测定560例正常成人腰椎松质骨密度,将受试者按年龄不同分为青年组、中年组和老年组,然后在同年龄组根据BMI及腰围的不同将受试者分为肥胖组和正常体重组,分析骨密度与体重、BMI、腰围及WHR的关系。结果①以BMI分组,老年肥胖组BMD高于体重正常组(P<0.05);②以腰围分组,中年女性肥胖组BMD低于非肥胖组(P<0.05);③青年组和中年组BMD与腰围及WHR呈负相关,老年组BMD与体重和BMI呈正相关与腰围和WHR不相关。结论预防骨质疏松症在中青年应提倡运动锻炼,避免肥胖,在老年人不应该过分强调降低体重减少肥胖以避免骨量的丢失。     

Normalization of bone mineral content to height,weight, and lean body mass: Implications for clinical use

Summary The main object of the present study was to reduce the large biological variation in forearm bone mineral content (BMC) by correction for individual variation in gross morphology. In 315 normal females aged 45–54 years, determinations of height, weight, and 24-h urinary creatinine excretion rates were performed, and lean body mass was calculated. BMC was measured by photon absorptiometry on both forearms. BMC was correlated to height (r=0.19,P<0.01), to weight (r=0.09,P>0.05), to lean body mass (r=0.15,P<0.05), and to creatinine excretion rate (r=0.29,P<0.001). The biological variation in BMC of the 315 females was for raw BMC 15.8%; after correction of BMC for height 15.5%, for weight 15.8%, for lean body mass 15.6%, and for creatinine excretion rate 15.2%. Regression analysis with two independent variables (creatinine excretion and height or weight) increased in both cases the correlation coefficient to 0.32 and decreased the interindividual coefficient of variation of BMC to 15.0%. For diagnostic purposes BMC must be corrected for age and sex, but further corrections seem of minimal benefit.     

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。     

Body mass index versus percentage body fat in Chinese, African-American and Caucasian postmenopausal women

Objective: The aim of the study was to investigate in postmenopausal women whether the relationship between percentage body fat (PBF) and body mass index (BMI) differs between Asians living in Beijing (BA) and African-Americans (AA), and Caucasians (Ca) living in New York City. Methods: Healthy postmenopausal women (231 BA; 113 AA, 95 Ca), aged 50-80 years, were studied. Weight, height and PBF by dual energy X-ray absorptiometry (DXA) were measured. The relationship between PBF and BMI was assessed by multiple regression analysis. Results: Race, reciprocal of BMI (1/BMI) and the interaction between race and 1/BMI were all significantly (P<0.05) related to PBF in this sample. The slope of the line relating 1/BMI to PBF was different for BA compared to AA (P=0.01) and Ca (P=0.003) while the slopes for AA and Ca were not different (P>0.05). At lower levels of BMI, Asians tended to have higher PBF comparable to AA and Ca, while at BMI >30 BA tended to have less PBF than the other groups. Conclusion: The relation between PBF and BMI in BA postmenopausal women differs from that of AA and Ca women in this sample.     

Body mass index,body fat percentage,and the effect of body fat mass on SWL success

Objectives In the present study, we investigated the effects of the Body Mass Index (BMI), the Body Fat Percentage (BFP), and the Body Fat Mass (BFM) on success of SWL, prospectively. Patients and methods The BMI, BFP, BFM values of patients, who were treated by SWL due to upper urinary system stone disease (pelvis renalis, upper ureter, kidney lower and upper calices) between January and December 2005 in our hospital’s urolithiasis center, were measured. Patients with stones smaller than 5 mm or larger than 20 mm and patients who had a stone localized somewhere other than in the upper urinary system, were not included in the study. Patients evaluated to be clinically successful according to the SWL were put in group 1, and the other patients who were not successful were included in group 2. Results About 158 (97 male, 61 female) patients aged between 16 and 92 (mean 36.69 (±13.22) years), put on SWL therapy due to presence of upper urinary system stone disease, were included in the study. While the mean BMI was 23.97 ± 0.4 in group 1 and 25.98 ± 0.5 (P = 0.02) in group 2, BFP was 23.85 ± 0.8 in group 1 and 29.19 ± 1.1 (P = 0.001) in group 2, and BFM was determined to be 16.74 ± 0.7 and 21.19 ± 1.01 (P = 0.001) in group 2. Regarding all the parameters (BMI, BFP, BFM), the statistical analyses carried out between the groups showed significant differences. Conclusion BFP and BFM parameters are also important factors along with the BMI in providing a successful SWL treatment. All the parameters should be considered regarding the success of the treatment and the patients should be informed.     

Changes in muscle mass, fat mass, and bone mineral content in the legs after stroke: a 1 year prospective study

Demineralization and muscle atrophy, common among patients with hemiplegia, may be risk factors for future hip fracture. The aim of this longitudinal study was to investigate changes in lean (muscle) mass and bone mineral content (BMC) of the legs during the first year after stroke according to the patient’s ambulatory level. Twenty-five patients immobilized due to acute stroke were followed. BMC and lean mass of each leg were measured at a mean of 7 days, 2 months, 7 months, and 1 year after the stroke using dual-energy X-ray absorptiometry. Both BMC and lean mass had decreased significantly in the paretic leg (p < 0.05) at the 1 year evaluation and the loss was significantly greater on the paretic side compared with the nonparetic side (p < 0.001). Patients who had not relearned to walk at the 2 month evaluation (n = 12) lost 6% (p < 0.05) of their lean mass in the paretic leg during this time period, and this mass was not regained within the subsequent 10 months. In contrast, a significant 5% loss of lean mass found at 2 months on the nonparetic side was regained completely. With respect to the patients who relearned to walk within the first 2 months (n = 13) lean mass had increased by 5% after 1 year (p < 0.05) in the nonparetic leg, whereas no significant changes were found in the paretic leg during follow-up. Both groups of patients did, however, lose bone mineral in the paretic leg during the first year after stroke (9% and 6%, respectively, p < 0.05), but only the patients who were still unable to walk by 2 months had significant bone loss in the nonparetic leg also (3%, p < 0.05). Thus, lean muscle mass is rapidly lost and may be regained shortly after stroke, whereas loss of BMC appears difficult to prevent, especially on the paretic side. Regaining muscle mass may, however, slow the loss of bone mineral.     

体质指数和体脂百分比与类风湿关节炎继发骨质疏松的相关性研究

目的探讨体质指数(BMI)和体脂百分比(PBF)与类风湿关节炎(RA)继发骨质疏松(OP)间的相关性。方法采用生物电阻抗体成分测定法测量359例RA患者和158例年龄、性别相匹配的正常对照组体重(kg)、身高(m)和PBF,根据体重/(身高)2计算出BMI,并将BMI分为4组:消瘦BMI18.5,正常24BMI≥18.5,超重28BMI≥24,肥胖BMI≥28;PBF分为2组:肥胖为PBF男25%或女30%,否则为正常。采用双能X线骨密度吸收仪测定髋部(包括股骨颈Neck、Ward三角区、大转子GT、总髋部Hip)及腰椎1-4(L1-4)骨密度(BMD)。结果 RA患者BMI低于正常对照组(22.40±3.76 vs 23.66±3.24,t=3.813,P0.0001),其中消瘦患者百分比明显高于对照组(14.4%vs 5.8%,x~2=10.536,P=0.015);而PBF则高于对照组(32.45±10.38 vs 30.53±6.98,t=2.442,P=0.015)。RA患者OP发生率为37.9%(128/338),明显高于对照组的13.9%(22/158)(x~2=29.265,P0.0001)。RA患者不同BMI分组间各部位BMD均有显著不同,且都表现为消瘦组水平更低,超重或肥胖组水平更高(P0.0001～0.05);除Ward区的PBF正常组BMD高于肥胖组(t=2.224,P=0.027)外,其余各部位BMD均无明显差别(P0.05)。Hip区和L1-4区均表现为消瘦组OP发生率(27.8%、20.7%)明显高于肥胖组(3.7%、1.1%)(x~2=22.041,P=0.001;x~2=13.401,P=0.037)。不同PBF分组间骨量构成比的比较无差别(P0.05)。各部位BMD均与BMI成正直线相关(P0.0001～0.01);而Ward、GT、Hip区BMD与PBF成负直线相关(P=0.015～0.04)。多元Logistic回归分析结果显示:年龄(OR=1.114,95%CI:1.082～1.148,P0.0001)、性别(OR=5.802,95%CI:2.608～12.906,P0.0001)和病程(OR=1.050,95%CI:1.017～1.084,P=0.003)均为RA患者发生OP的危险因素,而BMI(OR=0.879,95%CI:0.815～0.946,P=0.001)为发生OP的保护因素。结论 BMI和PBF在RA中变化不同,且呈现出与BMD相反的相关性,BMI是RA患者发生OP的保护因素。     

Relationship between body composition and bone mineral density in healthy young and premenopausal Chinese women

This study investigated the relative contribution of fat mass and lean mass to bone mineral density (BMD) in young and premenopausal healthy Chinese women. The study was performed in 282 young and premenopausal healthy women with regular menstrual cycles. The BMD at lumbar spine (L2–L4), total hip and total body, together with fat mass and lean mass were assessed by dual-energy X-ray absorptiometry (DXA); body height, weight, waist and hip circumference were also measured, and body mass index (BMI) and waist-hip ratio were calculated. Fat mass was a major determinant for BMI, BMI and lean mass were positively related to L2–L4, total hip and total body bone density (P<0.001 for all), lean mass was the only independent factor contributing to BMD at L2–L4 (standardized coefficient =0.282, P<0.001), total hip (=0.336, P<0.001) and total body (=0.361, P<0.001) in multiple stepwise regression analysis. The correlation between BMI and BMD was improved after adjustment for fat mass, while decreased or even lost when lean mass was adjusted. These data suggested that in the Chinese population, lean mass is an important factor determining BMD in young and premenopausal women.     

Development of fat tissue and body mass index from infancy to adulthood

This paper gives a short overview of our recent research on changes in the body mass index (BMI) or in body fat for children studied longitudinally from birth to adulthood. The BMI shows characteristic changes in childhood and adolescence which are different from those known for skeletal growth. A period of loss of BMI from 1 to 6 years is followed by a pubertal spurt which is larger in females than in males. Fat shows a dramatic increase in the 1st year, and velocity is higher for girls than for boys after 3 years of age. At puberty there is a pre-pubertal and a post-pubertal spurt in total body fat or in arm fat and a dip in between. Those heavy or fat as adults have a qualitatively similar pattern of developmental changes, but much more accentuated fluctuations. The analysis relies on new statistical techniques.     

Genetic determination and correlation of body mass index and bone mineral density at the spine and hip in Chinese Han ethnicity

The purpose of the present study was to evaluate the magnitude of genetic determination of spine and hip bone mineral density (BMD) and body mass index (BMI), and to explore the genetic, environmental, and phenotypic correlations among the above phenotypes in Chinese Han ethnicity. The sample was composed of at least 217 complete nuclear families in Chinese Han ethnicity. BMD at the spine and hip was measured using a dual-energy X-ray absorptiometry scanner. The heritability ( h ²) of BMI and BMD at the spine and hip, the genetic correlation ( _G ) and environmental correlation ( _E ) among the three phenotypes were evaluated via variance analysis, with age, sex, and age-by-sex interaction as covariates. The phenotypic correlation ( _P ) and the bivariate heritability _G² were also calculated. The heritability for BMD and BMI was ~0.70 and ~0.50, respectively ( p <0.0001). The common environment shared by household members (household effect) is significant for BMI variation ( p =0.0004). Significant genetic, environmental, and phenotypic correlation was observed. The _G² values were 0.13 for BMI/spine BMD, 0.18 for BMI/hip BMD, and 0.58 for the spine BMD/hip BMD. While BMD at the spine and hip have significant genetic determination, BMI is more likely to be affected by environmental factors than BMD. In addition, BMD at the spine and hip shares more genetic effect (pleiotropy) than BMI and BMD do in Chinese Han ethnicity, though the effects are significant for both.     

Gender differences in relationships between body composition components, their distribution and bone mineral density: a cross-sectional opposite sex twin study

Numerous studies indicate that bone mineral density (BMD) is closely related to body mass and its components. Most studies have examined these relationships in women with little attention given to how these relationships differ by gender. The aims of the present study were to use the opposite sex twin model to determine if there were gender differences in the relationship between body composition and its relation to BMD and how any such differences were influenced by age. We measured body composition and bone mass by dual energy X-ray absorptiometry in 93 pairs of opposite sex twins. To examine the effect of age, they were divided into two age groups: under 50 years old (45 pairs) and over 50 years old (48 pairs). Lean mass (LM) had stronger positive relationships with the most bone variables than fat mass in both genders at all ages. Fat mass (FM) had positive relationships with total body and hip BMD in women under age 50, but not over 50. There was no significant relationship between FM and total or regional BMD in men under age 50, but men over 50 showed positive relationships between FM measures and total and some regional BMD measures. Central adiposity showed a positive relationship with BMD in men over 50 and women under 50. Fat mass (FM) and lean mass (LM) and their distribution in the body have different relationships with regional BMD in men and women that differ by age.     

体重指数、体表面积对中老年女性股骨骨密度的影响

目的了解体重指数(BMI)、体表面积(BS)对中老年女性股骨近端骨密度的影响。方法①采用美国LUNAR公司的EXPERT-XL双能X线骨密度仪测定成都地区女性健康体检者421例,按年龄分成两组40~59岁、60~80岁组;测量部位包括股骨颈(Neck)、大转子(Troch)、Wards区、股骨干(shaft)、全髋(total)。②不同年龄组分别按BMI大小分成3组BMI≤20kg/m2,(20~25)kg/m2,≥25kg/m2;BS大小分成3组大体表面积组(LBSG),中体表面积组(IBSG),小体表面积组(SBSG)。③结果用SPSS12.0统计软件处理,体重指数、体表面积与股骨近端各部位骨密度用spearson相关分析,不同年龄组、不同BMI、BS组间比较用方差分析。结果①体重指数、体表面积与股骨骨密度呈正相关,r=0.122~0.424(P<0.005);②不同年龄组股骨近端骨密度均为BMI≤20kg/m2组IBSG>SBSG,差异有统计学意义。结论体重指数(BMI)、体表面积(BS)均是影响股骨近端骨密度的重要因素,低BMI、BS中老年女性应注意骨质疏松诊断、防治。     

身高、体重、体重指数对绝经后妇女全身骨密度的影响

目的 探讨绝经后妇女骨密度（BMD）与身高、体重、体重指数（BMI）的关系。方法 对南京地区50岁以上绝经后妇女794人，按身高、体重和BMI，将受检者分为3组：低体重组，正常体重组和超体重组，采用双能X线骨密度（DEXA）测定受检者腰椎2-4、股骨上端及全身MBD。结果 腰椎、股骨和全身MBD随体重、BMI增加而增高。各组间腰椎、股骨和全身MBD均有显著差异（P〈0．01）。身高、体重、BMI与腰椎、股骨及全身的BMD呈正相关。体重比身高、BMI与BMD相关性好。结论 体重对绝经后妇女BMD影响较身高和BMI大，低体重是发生骨质疏松（OP）的危险因素之一，对低体重（BMI≤20kg／m^2）绝经后妇女采取适当措施防治OP，以免发生骨折。     

High bone mineral density is associated with high body mass index

Summary  High BMD is an infrequent finding. In this retrospective cohort study of women 50 years and older, we documented a strong association between high BMD and high BMI. Introduction  High bone mineral density (BMD) has been associated with genetic disorders and a variety of dietary, endocrine, metabolic, infectious and neoplastic diseases that in many cases warrant medical attention. Since body mass index (BMI) is closely correlated with BMD, we sought to explore the relationship between these two parameters in older women. Methods  We conducted a retrospective clinical cohort study of 16,500 women 50 years and older who underwent baseline BMD testing between May 1998 and October 2002. Mean T-scores and Z-scores, and the proportions of women with high BMD (T-score +2.5 or greater, Z-score +2.0 or greater), were assessed according to BMI category. Results  Higher BMI category was associated with higher mean T-scores and Z-scores at all sites (P < 0.001). The proportion of women with high BMD increased with each BMI category (P for trend <0.05). In women with a lumbar spine T-score of +2.5 or more, 43.5% were obese with BMI > 30 kg/m² (55.6% for the femoral neck and 73.1% for the total hip). For women with a lumbar spine Z-score of +2.0 or more, 37.2% were obese (42.0% for the femoral neck and 50.9% for the total hip). There was no evidence of a paradoxical increase in fracture rates in women with high BMD. Conclusions  High BMD is closely associated with elevated BMI in women. This should be taken into consideration prior to initiating extensive investigations for rare pathologies. This study was supported in part by an unrestricted educational grant from the CHAR/GE Healthcare Development Awards Programme.     

体重、身高、体重指数与绝经后妇女骨密度的关系

本研究用双能Ｘ线吸收法（ＤＸＡ）测定２８０名５０～７６岁绝经后妇女腰椎正位、股骨上端骨密度，计算出体重指数，探讨骨密度（ＢＭＤ）与体重、身高、体重指数的相关关系。结果显示：绝经后妇女腰椎、股骨上端ＢＭＤ与体重、身高、体重指数呈正相关，体重与腰椎、股骨上端的ＢＭＤ相关性（γ＝０．３８８，ｒ＝０．２６３～０．２７２，ｐ＜０．０１）比身高、体重指数与ＢＭＤ相关性好，Ｌ２～４ＢＭＤ与体重的直线回归方程为Ｙ＝０．４６２７＋０．００６９Ｘ，ｒ＝０．３８８，ｐ＜０．０１。提示：体重对绝经后妇女ＢＭＤ影响较身高和体重指数大，低体重是发生骨质疏松的危险因素之一，对低体重（ＢＭＩ≤２０ｋｇ／ｍ２）绝经后妇女采取适当措施防治骨质疏松非常有意义。体重超过理想体重每１０ｋｇ，则Ｌ２～４ＢＭＤ测量值应扣除０．０６９ｇ／ｃｍ２。