肥胖青年骨密度状况分析

Bone mineral density in obese young adults

目的分析肥胖青年骨密度(bone mineral density,BMD)的变化。方法 60例诊断为单纯性肥胖的患者,其中男性26例,女性34例。对照组青年与肥胖青年年龄相仿(出生日期相差<6个月)。所有入选对象均排除继发性肥胖与骨代谢性疾病患者。全身诸骨扇束扫描行全身及上肢、肋骨,胸椎、腰椎、骨盆、下肢和头部7个部位骨量、骨密度测定。结果肥胖组全身的骨量、骨密度均高于志愿者组(P<0.05)。肋骨、胸椎及头部这些非承重骨肥胖组的BMC要高于志愿者组,而BMD在两组之间差异没有统计学意义;上下肢、腰椎、骨盆这些承重骨的骨量及骨密度肥胖组均明显高于志愿者组(P<0.05)。结论肥胖青年承重骨骨量及骨密度与其体质量相关,在平衡体脂因素后肥胖者与对照组骨密度无显著差别。提示肥胖患者在进行体重控制的同时应加强运动来减少体质量减轻所造成的骨量流失。

Objective To evaluate the bone mineral density （BMD） in obese young adults. Methods Sixty obese adolescents （26 males and 34 females ） who visited outpatient clinic for obesity were enrolled in study （obese group ） and 60 age- and sex-matched normal medical students served as control group. Subjects with secondary obesity and metabolic bone disease were excluded from the study. The BMD and bone mineral contents （BMC） were measured by dual-energy X-ray absorptiometry for whole body, at arms, fibs, thoracic spines, lumbar spines, pelvis, legs and head. Results The overall BMC and BMD of obese group was higher than those of control group （P 〈 0.05 ）. BMC in non-load-bearing bones （fibs, thoracic spine and head） of obese was higher than that of control group （ P 〈 0.05 ）, but there was no difference in BMD between two groups （ P 〉 0.05 ）. Both BMC and BMD in load-bearing bones （ arms, lumbar spine, pelvis, legs） of obese group was higher than those of control group （ P 〈 0.05 ）. Conclusion The BMC and BMD of load-bearing bones in obese adolescent are related to their body weight; after adjustment for lean mass, there are no differences in BMC and BMD between obese and normal young adults. The results suggest that obesepatients should reinforce exercise during body weight control, in order to reduce the loss of bone mass caused by weight loss.