绝经后妇女体表面积与骨密度和骨超声传导速度的关系

Relationship of Body Surface Area to Mineral Density and Ultrasonic Conduction Speed in Bones of Postmenopausal Women

【目的】探讨体表面积（BS）对绝经后女性骨密度（BMD）和骨强度的影响。【方法】采用双能X线骨密度仪和定量骨超声仪测量481例绝经后妇女不同骨骼部位的BMD和胫骨超声传导速度（SOS），并按BS不同分为低体表面积组（SBSG）、中等体表面积组（IBSG）和大体表面积组（LBSG）进行分析和比较。【结果】绝经后妇女各部位BMD和胫骨SOS均与BS呈正相关（r=0．102～0．415，P=0．000～0．049和r=0．173，P=0．000），KS和髋部BMD相关程度最高（r=0．293～0．415，P=0．000）；多元逐步回归分析显示影响绝经后妇女腰椎正住（L1～L4）、髋部（包括股骨颈、股骨大转子和Ward’s三角）和桡、尺骨超远端及远端总体BMD的最主要因素是KS，其次才是体重指数（BMI）和身高；除腰椎侧位（L2～L4）外，IBSG各部位BMD和胫骨SOS均高于SBSG对应部位（大部分部位P〈0．05～0．01），而LBSG均高于SBSG和IBSG对应部位（P〈0．05～0．01和P〈0．05）；除腰椎侧位外，绝经后妇女各部位骨质疏松症（OP）的患病率：LBSG（IBSG〈SBSG。【结论】KS高的绝经后妇女脚佃和骨强度高；低BS是绝经后OP的危险因素，特别是在髋部。

[Objective]To investigate the effects of body surface area （BS） on bone mineral density （BMD） and bone strength in postmenopausal women. [Methods]BMD at various skeletal sites and speed of sound （SOS） in the tibia were measured by dual energy X-ray absorptiometry and bone quantitative ultrasound （QUS） apparatus in 481 postmenopausal women, who were divided into three groups according to their BS： small body surface area group （SBSG）, intermediate body surface area group （IBSG） and large body surface area group （LBSG）. [Results]Significant positive correlations were found between BS and BMD at various skeletal sites and between BS and SOS of the tibia in postmenopausal women （r=0. 102～0. 415, P =0. 000～0.049 and r=0. 173, P =0.000, ）respectively, the correlation coefficient was the biggest between BS and BMD at hip （r=0. 293～0. 415, P =0. 000） Multiple stepwise regression analysis showed that the most important impact factor was BS and BMD at posteroanterior spine （L1～L4 ）, hip including femoral neck, trochanter and Ward＇s triangle, and forearm including radius ＋ ulna ultradistal and total region, but body mass index （BMI） and height were the secondary impact factors. Except the lateral spine （L2～L4）, BMD at various skeletal sites and SOS of the tibia of subjects in the IBSG were higher than those of SBSG （ P value was mostly less than 0.05～0. 01）, and BMD at various skeletal sites and SOS of the tibia of LBSG were significantly higher than those of both IBSG and SBSG （ P〈0. 05～0.01 and P〈0. 05, respectively）. Except the lateral spine, the osteoporosis incidence at various skeletal sites was decreased in a stepwise manner in subjects of these 3 groups： LBSG〈IBSG〈SBSG. [Conclusion]The postmenopausal women with larger BS have higher BMD and higher bone strength. The small BSA is an important risk factor for osteoporosis, especially at hip.