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.

Characteristics of body composition and relativity of fat and lean masses with bone mineral density in low weight and obese children

Objective To analyze the characteristics of body composition and relativity of fat and lean masses with bone mineral density (BMD) in low weight and obese children.Methods Children aged 5-7 years old receiving physical examination in Child Health Care Department of Meishan Maternal and Child Health Care Hospital from June 2015 to June 2016 were selected as study subjects and divided into low weight group, obese group and control group according to body mass index (BMI).Body composition indexes including percentage of body fat (PBF), fat mass (FM), lean mass (LM) and local and systemic BMD were measured and analyzed.Results Percentage of body fat, fat mass, lean mass and local and systemic bone mineral density in low weight group were significantly lower than those of children of same sex in control group, and differences had statistical significance (t value ranged 3.076 to 3.326, all P<0.05).Percentage of body fat, fat mass, lean mass and local and systemic bone mineral density in control group were significantly lower than those of children of same sex in obese group, and differences had statistical significance (t value ranged 2.998 to 3.427, all P<0.05).Logistic regression analysis showed that lean mass of children in low weight group was positively associated with bone mineral density at different parts (r value ranged 0.779 to 0.889, all P<0.05), lean mass was positively associated with lower limb bone mineral density and percentage of body fat and fat mass positively associated with trunk bone mineral density in obese group male children (r value ranged 0.779 to 0.882, all P<0.05), lean mass was positively associated with upper limb bone mineral density and percentage of body fat, fat mass and lean mass positively associated with lower limb bone mineral density in obese group female children (r value ranged 0.781 to 0.901, all P<0.05), and lean mass of children in control group was positively associated with bone mineral density at different parts (r value ranged 0.779 to 0.912, all P<0.05) and percentage of body fat, fat mass and lean mass were all positively associated with lower limb and systemic bone mineral density in control group female children (r value ranged 0.805 to 0.912, all P<0.05).Conclusion Body composition and correlation of each index with bone mineral density in low weight and obese children are different from those in normal children.In child health care department outpatient management, changes in body weight, percentage of body fat, fat mass, lean mass are important indicators demanding attention to enhance healthy bone development.