青春期学生骨量影响因素的研究

Factors Affecting Bone Mass in Pubertal Adolescents

目的了解青春期学生骨量的影响因素,从而为生命早期预防骨质疏松提供科学依据。方法调查柳州市区初中学生353名,年龄为12～17岁,男生164人,女生189人。采用24h回顾法了解膳食摄入、体力活动问卷了解体力活动情况。采用双能量X线骨密度测量仪(DEXA)测量全身骨量及体脂百分比。用Tanner五分期法评价第二性征发育。采用身高标准体重评价研究对象的营养状况。结果与男生全身BMD关系最大的是体重,其次是体力活动强度、Tanner期、膳食钙摄入量、年龄和碳水化合物,与BMC关系最大的是体重,其次是身高、Tanner期和体力活动强度;与女生全身BMD关系最大的是体重,其次是乳房发育分期、年龄、月经初潮、体力活动强度、膳食钙摄入量、身高和脂肪摄入量,与BMC关系最大的体重,其次是身高、乳房发育分期、营养状况、月经初潮、蛋白质摄入量、膳食钙摄入量和磷摄入量。结论影响青春期学生骨量主要决定因素为体重、青春发育状况、身高和体力活动强度,并且体力活动强度和膳食钙对男生全身骨量的影响大于对女生的影响。

Objective To examine the factors affecting the bone mass in adolescent students so as to provide the scientific basis for the prevention of osteoperosis. Methods Questionnaire type survey was performed to examine the eating habit and the physical activity of 164 male and 189 female subjects （aged 12-17） in Liuzhou District. Students were asked to complete the questionnaire using the 24 h recall method. Whole body bone mass and body fat were determined using Dual-energy X-ray absorptiometry （DEXA）. Secondary sexual characteristics were accessed using the 5-stage Tanner method. The nutritional condition was evaluated based on the body weight and the height of the body. Results In the male subjects, BMD is mostly associated with＇the body weight, followed by the physical activity, Tanner period, dietary calcium intake, age and carbohydrates. BMC is mostly associated with the body weight, followed by the height, Tanner stage and physical activity. Forthe female subjects, BMD is mostly associated wi, h the body weight, followed by the breast development, age, menarche, physical activity, dietary calcium intake, height and the fat intake. BMC is correlated mostly with the body weight, followed by the height, breast development, nutritional status, menarche, protein intake, dietary intake of calcium and phosphorus intake. Conclusion Body weight, puberty status, height and physical activity are the major factors affecting the bone mass in adolescent students. Intensive physical activity and dietary calcium intake had a greater impact on the male than the female students.