东乡族成年女性绝经前后骨强度和体成分特征及其相关性

目的 分析东乡族成年女性绝经前后骨强度和体成分变化并探讨体成分变化对骨强度的影响。 方法 2016年9月~2018年7月采用随机整群抽样选取甘肃省东乡族41～50岁成年女性203例（绝经前102例，绝经后101例），采用超声骨密度仪、生物电阻抗分析仪分别测量跟骨骨强度和体成分指标。 结果 东乡族绝经后女性的骨强度、肌肉组织体成分低于绝经前（P<0.05）；脂肪组织体成分高于绝经前（P<0.01）。东乡族绝经后女性骨质疏松的患病率高于绝经前（P<0.01）。Pearson 相关分析显示，绝经前后女性的骨强度均与肌肉组织体成分正相关（P<0.01），与脂肪组织体成分负相关（P<0.01）。多元线性逐步回归分析显示，四肢肌肉量是东乡族女性骨强度的保护性因素，皮下脂肪含量是骨强度下降的危险因素。 结论 肌肉以及脂肪组织共同决定着东乡族女性的骨强度且与体成分分布部位有关，但两者的关系不受绝经状态的影响。绝经是东乡族女性骨质疏松发生的重要影响因素，应加强绝经后女性骨质疏松的防控。加强肢体锻炼，增加四肢肌肉量，减少皮下脂肪，有助于提高东乡族绝经前、后女性骨强度，预防骨质疏松。

Characteristics and relationship of bone strength and body composition in pre- and post- menopausal Dongxiang women

Objective To analyze the changes of bone strength and body composition in pre- and post- menopausal Dongxiang women and explore the impact of body composition change on bone strength. Methods From Sep. 2016 to Jul. 2018, 203 cases Dongxiang 41-50 year old women (102 cases of premenopause and 101 cases of postmenopause) of Gansu Province were selected by stratified random sampling method , whose bone strength and body composition indexes were measured by ultrasonic bone mineral density meter and body composition analyzer respectively. Results There were lower bone strength and muscle tissue composition in the postmenopausal Dongxiang women (P<0.05), and there was higher fat tissue composition (P<0.01). The prevalence of osteoporosis was higher in postmenopausal women (P<0.01). Pearson correlation analysis showed that muscle tissue composition was positively correlated with the bone strength (P<0.01), and it was negatively correlated with fat tissue composition in the pre- and postmenopausal Dongxiang women (P<0.01). Multivariate linear stepwise regression analysis showed that limb muscle mass and subcutaneous fat mass were a protective factor and a risk factor for bone strength in pre- and post-menopausal Dongxiang women, respectively. Conclusion The bone strength of Dongxiang women was determined by muscle and fat tissue, and associated with the distribution of body composition. The relationship between bone strength and body composition was not affected by menopause. Menopause was an important factor that increased the incidence of osteoporosis in Dongxiang women, and we should reinforce osteoporosis prevention in postmenopausal Dongxiang women. Strengthen physical exercise, increase limb muscle mass and reduce subcutaneous fat could contribute to increase bone strength and prevent osteoporosis in in the pre- and post-menopausal Dongxiang women.