青春前期和早期女性血清维生素D、雌二醇和瘦体重含量与骨骼发育的相关性研究

The Relation of Serum Vitamin D, Estradiol, and Lean Body Mass to the Bone Development in Early Pubertal and Pre-Pubertal Girls

目的:研究女性从青春前期到初潮腰椎、股骨颈的发育特征及主要影响因素。方法:201名身体健康的女性(10.9±0.7岁)自愿参加本项实验研究并进行体质测量,主要测量脂肪含量(FM)、瘦体重含量(LM)、以及股骨颈(Fn)和腰椎(Ls)骨密度(BMD)、骨量(BMC)和骨面积(BA)。同时检测血清雌二醇(E2)、类胰岛素样生长因子1(IGF-1)、睾酮(T)和维生素D(VD)等。追踪获得受试者初潮的时间,以此作为时间参考来拟合骨骼的最佳生长曲线。采用stepwise forward多元回归方法来确定腰椎、股骨颈的影响因素。结果:①初潮之前快速增长的股骨颈和腰椎各项指标在初潮之后却出现不同的变化趋势:股骨颈BMD、BMC提高了增长速度;而股骨颈和腰椎BA减慢了增长速度;腰椎BMD、BMC继续保持原有的增长速度。②E2是预测股骨颈BMD和腰椎BMD、BMC增长的重要因子,而VD是预测股骨颈和腰椎BMC、BA变化的重要因素。LM则是预测股骨颈和腰椎BMD、BMC和BA发育的重要因素。结论:女性初潮之前是腰椎、股骨颈的骨面积快速生长时期,而初潮之后则是矿物质积累增长的关键时期。血清维生素D、雌二醇水平与瘦体重含量是女性快速生长时期骨骼发育和矿物质沉积的重要调节因素。

Objective To investigate the characteristics of lumbar spine development and femoral neck development in early pubertal and pre-pubertal girls. Methods Two hundred and one girls （aged 10.9±0.7years） participated in recent study. We measured the fat mass （FM）,lean body mass （LM）, BMD and BMC of lumbar spine （Ls） and femoral neck（Fn）, and bone area（BA）, as well as serum estradiol （E2）, IGF- 1, testosterone （T）, and vitamin D （VD） of the subjects, and determined the most important factors that contribute to the bone growth through multiple regressions. Results Results showed that after menarche, BMD and BMC of Ls elevated, and the increment of BA of Ls and Fn depressed, while the growth velocity of BMD and BMC of Ls remained unchanged. Conclusion The study indicated that pre-menarche is an important period for bone growth,while post-menarche is a critical period for mineral accumulation. VD,estradiol,and LM greatly contribute to bone growth and mineral accumulation in early pubertal and pre-pubertal girls.