中老年女性体表面积和骨强度的关系

Relationship between body surface area and bone strength in middle and old age women

目的:探讨中老年女性体表面积(bodysurfacearea,BSA)与胫骨超声传播速度(speedofsound,SOS)之间的关系及其与骨质疏松(osteoporosis,OP)发生的相关风险。方法:应用SoundScan2000骨定量超声仪测量1596例年龄在12～96岁的健康女性非优势侧胫骨的SOS,将全部受试者按每5岁年龄段为一组,确定峰值SOS和峰值SOS的年龄。用回归分析评价BSA与SOS的关系;用偏相关(控制年龄变量)和多元回归分析SOS与身高、体质量、人体质量指数(BMI)和BSA之间的关系;对峰值SOS年龄后妇女,用全部受试峰值SOS年龄后妇女BSA的均数±标准差进行分组,比较不同BSA组之间OP的患病率、相对危险度(RR)及其95%可信区间(CI)。结果:胫骨SOS与身高、体质量和BSA显著相关;峰值SOS为(3991±68)m/s,出现在35～39岁年龄段;描述SOS与BSA关系的最佳模型是二次回归方程,SOS=914.28+3498.91(BSA)-1013.20(BSA)2(R2=0.131,P=0.000);多元回归分析显示体质量、BSA和BMI是胫骨SOS的重要预测因子(R2分别为-1.759,1.250,0.740);大体表面积组与小体表面积组之间SOS和OP的患病率显著不同,OP的RR和95%CI随BSA的下降而降低(RR=3.16,95%CI3.15～6.51,<1.403m2vs1.403～1.649m2;RR=5.31,95%CI4.26～15.13,<1.403m2vs>1.649m2);与全部受试峰值SOS年龄后妇女、小体表面?

AIM:To investigate the relationship between body surface area(BSA) and speed of sound(SOS) and the relative risk of osteoporosis (OP).METHODS:One thousand five hundred and ninty six females ranging from 12 to 96 years of age were measured the speed of sound(SOS) at the midshaft of the non dominant tibia with a quantitative ultrasound device.Data were analyzed in age groups divided by intervals of 5 years to determine the peak SOS and the age of peak SOS. BSA related variations in tibial SOS were assessed with regression analysis. Partial correlation coefficients(controlling for age) were calculated and multiple regression analysis was used between tibial SOS and parameters of height,mass,index of body mass and BSA.Data after the age of peak SOS were analyzed in groups divided by the Mean ±SD of BSA to examine the impact of BSA on tibial SOS in our middle aged and elderly women.The prevalence of osteoporosis was compared among different BSA groups.The relative risk and 95%confidence interval(CI) were calculated and compared. RESULTS:Significant dependency was found between tibial SOS and height, body mass and BSA. The peak SOS at the tibia [(3 991 ±68)m/s] occurred in the 35 to 39 year old group.The curve representing the SOS change according to BSA in women aged 40 years was the best fitting, using regression analysis of the quadratic model;SOS=914.28+3 498.91(BSA)-1 013.20(BSA)2(R2=0.131,P=0.000).Multiple regression analyses showed that body mass, BSA and body mass index were significant determinants of tibial SOS(R2=-1.759,1.250,0.740 respectively).The differences of tibial SOS and prevalence of osteoporosis were statistically significant between the large BSA group and the small BSA group. Relative risks(RR) and 95%CI for osteoporosis increased with BSA declining(RR=3.16,95%CI 3.15 to 6.51,(1.403 m2 vs 1.403 to 1.649 m2;RR=5.31,95%CI 4.26 to 15.13,(1.403 m2 vs (1.649 m2).Compared with the total reference population(after the age of peak value of tibial SOS),the small and intermediate BSA groups,the likelihood of suffering from osteoporosis declined by 53%,81%and 41%respectively in the large BSA group.CONCLUSION:The parameters of height including mass, BSA and body mass index have significant impact on bone strength and are the strongest predictors of bone strength in middle and old age women.Small BSA is indicated as an important risk factor for osteoporosis.