绝经后妇女骨密度与肥胖指标的相关性

Association between bone mineral density and obesity related indexes in postmenopausal women

目的:探讨绝经1～10年妇女腰椎和股骨近端的骨密度与肥胖相关指标之间的相关性。方法:①选择2001-08在广州医学院第二附属医院门诊进行健康体检的绝经1～10年的妇女85例,年龄46～63岁。均自愿接受各项指标测定。②计算体质量指数(体质量/身高2);用放射免疫法测定胰岛素和瘦素。采用生物阻抗法测定体脂量。采用骨密度仪测定腰椎及左侧股骨颈、Wards区和大转子的骨密度。③用直线相关分析数据间的相关性。其中三酰甘油、瘦素和胰岛素的数据分析前先经自然对数转换。结果:纳入绝经后妇女85例进入结果分析。①单因素相关分析结果:腰椎骨密度与绝经年限呈显著负相关(t=-0.431,P<0.01),与体质量呈显著正相关(t=0.244,P<0.05);股骨颈和Wards区骨密度与绝经年限呈显著负相关(t=-0.334,-0.374,P<0.01),股骨颈、Wards区和大转子骨密度与体质量、身高、体质量指数、体脂量呈显著正相关(t=0.225～0.520,P<0.05～0.01)。股骨颈骨密度与瘦素呈显著正相关(t=0.225,P<0.05)。②多元逐步回归分析结果:腰椎骨密度=1.077-0.022绝经年限;股骨颈骨密度=-0.376+0.651身高+0.011体质量指数-0.006绝经年限-0.028ln三酰甘油;Wards区骨密度=0.398+0.008体质量-0.011绝经年限-0.048ln三酰甘油;大转子骨密度=0.389+0.006体质量。结论:①胰岛素、瘦素、三酰甘油、总胆固醇水平与骨密度无明显相关性。②影响骨密度的主要因素是身高、体质量、体质量指数、绝经年限和三酰甘油,与肥胖密切相关的胰岛素和瘦素不是影响骨密度的重要因素。

AIM：To investigate the association between the lumbar and proximal femoral bone mineral density and the obesity related indexes in postmenopausal women for 1-10 years. METHODS： In August 2001, 85 postmenopausal women for 1-10 years aged 46-63 years, who received physical examination in the outpatient clinic of the Second Affiliated Hospital of Guangzhou Medical College, voluntarily accepted the determinations of each index. The body mass in-dex was calculated （body massZbody height2）, insulin and leptin were de-tected with radioimmunoassay. Body lipid was detected with the biological resistance method. The bone mineral density at lumbar spine, left femoral neck, Wards triangle and greater trochanter were measured with the appa-ratus. The correlations among the data were analyzed with the linear corre-lation analysis, and the data of triacylglycerol, leptin and insulin should be transformed with natural logarithm before the analysis. RESULTS： All the 85 postmenopausal women were involved in the analysis of results. ①The results of univariate correlation analysis showed that bone mineral density at lumbar spine was significantly and negatively correlated with menopausal years （t=-0.431, P 〈 0.01）, and significantly and positively correlated with body mass （t=0.244, P 〈 0.05）; The bone mineral density at femoral neck and Wards triangle had significant negative correlation with menopausal years （t=-0.334, -0.374, P 〈 0.01）; The bone mineral density at femoral neck, Wards triangle and greater trochanter had significant positive correlations with body mass, body height, body mass index and body lipid content （t=0.225-0.520,P 〈 0.05-0.01）; The bone miner-al density at femoral neck was significantly and positively correlated with leptin （t=0.225, P 〈 0.05）.②The results of multiple stepwise regression analysis showed that bone mineral density at lumbar spine = 1.077- 0.022 menopausal years, bone mineral density at femoral neck=-0.376 ＋ 0.651 body height＋0.0111 body mass index -0.006 menopausal years -0.048 In triacylglycerol, bone mineral density at Wards triangle= 0.398 ＋ 0.008 body mass -0.011 menopausal years-0.048 In triacylglycerol; BMD at greater trochanter= 0.389 ＋ 0.006 body mass. CONCLUSION：①The levels of insulin, leptin, triacylglycerol and total cholesterol have no obvious correlation with bone mineral density. ②The main influencing factors of bone mineral density were body height, body mass, body mass index, menopausal years and triacylglycerol. Insulin and leptin, which are closely correlated with obesity, are not the important factors that affect bone mineral density.