绝经后妇女骨密度、体重指数、体脂和雌激素分泌的关系

Relationship between bone density, body mass index, body fat and estrogen in menopausal women

目的 调查分析绝经后妇女骨密度、体重指数、体脂和雌激素分泌之间的关系。方法 上海市区 5 0～ 70岁社区绝经后女性健康志愿者共 4 5 7例 ,进行身高体重、腰椎和股骨颈骨密度的测定、腰椎和髋部脂肪成分的检测 ,以及随机选取 118例志愿者进行血清雌激素的测定。所有资料输入电脑 ,应用SPSS软件进行统计分析。结果 非骨质疏松 (Non OP)组中体重指数与腰椎和股骨颈骨密度的相关系数分别为 0 . 5 3和 0 . 5 4 ,骨质疏松 (OP)组分别为 0 .33和 0 . 33;Non OP组中体重指数与腰椎和髋部体脂的相关系数分别为 0. 2 1和 0 . 0 92 ,OP组分别为 0 . 72和 0 .2 7;Non OP组的血清雌激素浓度与体脂呈弱相关 ,OP组血清雌激素浓度与体脂无关。Non- OP组中体重指数大于OP组 ,体脂低于OP组 ,但无统计学意义。经体重指数校正后 ,体脂 (即体脂 /体重指数 ,亦即体脂在体重中所占的比重 ) ,OP组体脂明显大于Non -OP组 (P <0 . 0 5 )。结论 体重是影响绝经后妇女骨密度的重要因素 ,体脂在体重中的比重增加会降低绝经后妇女的骨密度 ,这种体脂的增加与雌激素可能无关。绝经后妇女应在不增加体脂的前提下 ,适当增加体重来预防骨质疏松症的发生。

Objective To investigate the relationship between bone mineral density (BMD), body mass index(BMI), body fat (BF) and estrogen (E_2) in menopausal women. Methods 457 menopausal women aged 50～70, residing in Shanghai, were recruited. Their height, weight, bone density and body fat were measured, and serum estrogen was determined in 118 subjects selected randomly. The data were statistically analyzed using SPSS software. Results The correlation coefficient between BMI and BMD of lumbar spines and femoral neck in the non-osteoporotic(NOP) group was higher than that in the osteoporotic(OP) group. However, the correlation coefficient between BMI and BF of lumbar spines and hip bone in the NOP group was lower than that in the OP group. There was a weak correlation between E_2 and BF in the NOP group, while no correlation in the OP group. BMI in the NOP group was higher than that in the OP group, and BF in the NOP group was lower than that in the OP group, but the difference was not statistically significant. After adjusting by BMI, the difference was statistically significant, (P<0.05). Conclusions Weight is one of the most important factors influencing the bone mineral density in menopausal women. With increasing proportion of BF and BMI, it may cause reduction of BMD. There is no correlation between E_2 and the increasied BF. Menopausal women, should gain her weight without increasing BF to prevent osteooporosis.