不同年龄绝经后妇女骨密度与体成分的相关分析

Relationship between body composition and bone mineral density in postmenopausal women of different

目的了解不同年龄段绝经后妇女体成分对骨密度的影响。方法选取绝经后妇女287例，分为4组：50～59岁82例，60~69岁73例，70～79岁66例，80～89岁66例。应用美国GELunar公司的Prodige型双能x线骨密度仪，测定正位2～4脊柱、左侧股骨颈和全髋部骨密度，利用该仪器体成分分析功能，测量全身、躯干、大腿部位的脂肪含量、肌肉含量，计算脂肪含量、肌肉含量百分比。采用SPSSl8．0统计软件包进行统计学处理。结果一元线性回归分析结果显示，50～59岁组2～4脊柱骨密度仅与躯干部位各体成分相关，股骨颈、全髋部骨密度与各部位体成分具有相关性。60～69岁组，2～4脊柱骨密度与躯干脂肪含量、躯干肌肉含量相关（r值分别为0．27、0．25，均Pd0．05），其余部位骨密度与体成分无相关性。70～79岁、80～89岁组部分骨密度与各体成分均相关。结论绝经后妇女脂肪组织和瘦组织均对骨密度具有重要作用，60～69岁体成分对于骨密度影响最小，在此年龄段行激素替代疗法可能对于骨质疏松的预防与治疗效果最佳。不同的年龄段、不同的锻炼及减肥方式可预防骨质疏松症和脆性骨折的发生。

Objective To determine the effect of lean mass and fat mass on bone mineral （BMD） in postmenopausal women of different age groups. Methods A total of 287 postmenopausal women （aged 50 years and over） participated in this study. Individuals were divided into 4 age groups by decades： group 1, 50-59 yr （82 eases）; group 2, 60-69 yr （73 cases）; group 3, 70-79 yr （66 cases）; group 4, 80 years and over （66 cases）. The BMD of lumbar spine （L2-4）, left femoral neck and total hip were measured by dual-energy X-ray absorptiometry. Fat and muscle mass were analyzed by its analysis function and the percent of fat mass and muscle mass were calculated. Then data were processed by the SPSS 18.0 programme. Results One linear regression analysis showed that the L2-4 BMD was significantly associated only with body composition of trunk, while femoral neck （FN） and total hip （TH） BMD were respectively associated with body composition of different parts in group 1. L2-4 BMD was significantly associated only with trunk fat mass and muscle mass （r=0.27, 0.25, both P〈 0.05）, but there were no relationships between BMD of FN and TH and body composition of different parts in group 2. The BMD of L2-4, FN and TH were significantly respectively associated with body composition of different parts in group 3 and 4. Conclusions In postmenopausal women,fat mass and muscle mass play an important role in BMD. In postmenopausal women aged 60-69 yr, the body composition has a minimal impact on BMD, and hormone replacement therapy may be the best for osteoporosis prevention and treatment in this period. Different exercise and loosing of weight in postmenopausal women of different ages can prevent osteoporosis and fragility fractures.