肥胖男性体成分与骨密度的相关性

The relationship between body composition and bone mineral density in obese men

目的探讨成年肥胖男性体成分与骨密度(BMD)的关系。方法选取89名20～50岁男性为研究对象,根据体重指数分为体重正常组(25名)、超重组(31名)和肥胖组(33名)。应用双能X线骨密度仪进行BMD及体成分测定。结果肥胖组受试者总体脂肪质量、总体肌肉质量和BMD均高于对照组(P<0.05)。BMD与总体脂肪质量(r=0.296)、总体肌肉质量(r=0.392)、上肢脂肪质量(r=0.355)、大腿脂肪质量(r=0.334)和躯干脂肪质量(r=0.256)均呈正相关(P<0.05)。BMD与躯干/总体脂肪(r=-0.197,P=0.068)呈负相关趋势。以BMD为因变量,行多元线性回归分析结果显示,总体肌肉质量(β=0.005,P=0.000)和躯干/总体脂肪(β=-0.399,P=0.010)被引入方程。结论成年肥胖男性BMD高于非肥胖男性。肥胖者BMD增加与肌肉质量关系更为密切。建议成年肥胖男性加强体育锻炼,减少脂肪含量,增加肌肉含量,以预防骨质疏松症。

Objective This study was to explore the relationship between body composition and bone mineral density （BMD） in obese men. Methods 89 men were investigated. They were assigned to 3 groups based on body mass index. BMD and body composition were measured by dual-energy X-ray absorptiometry. Results Total body fat mass, total body lean mass and BMD were higher in obese group than thai in control group （ P 〈 0. 05 ）. BMD was closely positively correlated with total body fat mass （ r = 0. 296 ）, total body lean mass （ r = 0. 392 ）, arm fat mass （ r = 0. 355 ）, leg fat mass （ r = 0. 334） and trunk fat mass （ r = O. 256） （ P 〈 0. 05 ）, and negatively correlated with the ratio of trunk/total body fat mass （r = - 0. 197, P = O. 068）. In multiple regression analysis, total body lean mass （ 13 = 0. 005, P =0. 000） and the ratio of trunk/total body fat mass （ 13 = -0. 399, P =0. 010） were significant independent predictors for BMD. Conclusion The level of BMD was higher in obese men. Lean mass was more closely related to BMD than fat mass. To prevent osteoporosis, exercise should be recommended and central obesity should be avoided in youth and middle age men.