上海地区部分女性髋部骨几何结构与人体成分相关因素分析

目的观察上海地区部分女性髋部骨几何结构指标随增龄的变化趋势,评估人体成分(骨骼、肌肉及脂肪)对其的影响,比较不同肌肉脂肪分布对骨结构影响的差异,探讨上海地区女性髋部骨结构与人体成分的相关性及影响因素。方法 679名年龄为21~94岁的上海地区健康成年女性纳入本研究。受试者根据年龄分为青年组(21~40岁)、中年组(41岁~绝经)和绝经组。应用双能X线吸收仪(DXA)检测骨密度、肌肉量、脂肪量,用DXA自带软件髋部骨结构分析系统(HSA)测定股骨颈、转子间和股骨干3个部位的骨结构指标,包括横截面积(CSA)、平均皮质厚度(ACT)以及弯曲系数(BR)。采用Pearson(正态分布)或Spearman(非正态分布)进行相关性检验,采用多元回归Stepwise进行归因分析。结果上海地区部分女性腰椎和髋部骨密度、CSA和ACT在31~40岁达峰值,随年龄增长逐渐下降,腰椎骨密度在60岁后上升;肌肉量在31~40岁达峰值,随后逐渐下降;脂肪量随年龄的增加上升。髋部骨密度与股骨颈、转子间、股骨干3个部位骨结构指标CSA、ACT、BR具有相关性;全身肌肉含量与股骨颈、转子间、股骨干CSA均呈正相关,与BR呈微弱负相关;全身脂肪对股骨颈、转子间、股骨干的CSA、ACT以及BR影响不一致。青年组全身脂肪含量与CSA和ACT呈微弱正相关,但随年龄增长,全身脂肪量对骨结构的正性作用逐渐增强。随着增龄,躯干部位肌肉量对女性骨结构影响始终显著大于四肢部位肌肉量。结论髋部骨密度与髋部骨几何结构指标相关性最强,肌肉含量与髋部骨几何结构指标也明显相关;不同年龄女性人群脂肪量对骨结构的影响程度不同,具有时间性差异;躯干肌肉量对骨结构影响程度显著高于四肢肌肉量,具有空间性差异。

Relationship between hip geometric structure and body composition of women in Shanghai

Objective To investigate the correlation between hip geometric structure and body composition including bone mineral density （BMD）, lean mass （LM） and fat mass （FM） in health women in Shanghai.Methods A total of 679 healthy women in Shanghai which were divided into three groups： young （2140y）, middle-aged （41y-menopause ） , and postmenopausal .Women were evaluated by assessing BMD of lumber spine and total hip , total lean mass, total fat mass, and hip geometric parameters such as cross-sectional area （CSA）, average cortical thickness （ACT）, and bucking ratio （BR） at narrow neck （NN）, intertrochanteric （IT）, and shaft （FS）.Correlation analysis was performed by Pearson （ normal distribution ） or Spearman （ abnormal distribution ） test, and attribution analysis was performed by stepwise test of multiple regressions .Results The peak BMD values of the spine and total hip were observed at age 31 to 40 years.The peak LM and FM were observed at age 31 to 40 years.The hip geometric parameters including CSA and ACT at NN , IT and FS both reached their peaks at 31 to 40 years, and valley BR at three regions above mentioned was observed at 31 to 40 years as well .The correlation between hip BMD and hip geometric structure were the strongest at all three regions .LM showed significantly positive correlations with CSA and negative correlation with BR .FM effect on hip geometric parameters at the three regions were inconsistent .The positive contribution produced by FM to hip geometric structure became stronger gradually with aging .The contribution produced by trunk LM was the largest positive contribution to CSA and ACT in all group .Conclusion Among all body composition parameters , hip BMD showed the best correlation with hip geometric structure .LM produced the second greatest contribution .The impact of FM and LM on hip geometry changed with aging and different distributions .