肥胖与绝经期女性居民骨密度的相关性研究

Obesity and Bone Mineral Density in Menopausal Women

目的利用不同人体测量参数研究成都地区50岁以上绝经期女性居民肥胖与骨质疏松的相关性。方法采集在四川大学华西医院进行健康体检的50岁以上绝经期女性受检者的临床资料,测量和计算不同人体测量指标。使用MetriScan手掌骨密度测量仪进行骨密度测定,并根据骨密度T值将受试者分为3组(正常骨密度组、骨量减少组和骨质疏松组)并进行相关统计分析。结果研究纳入4 938例成都地区50岁以上绝经期女性,肥胖症(BMI>28kg/m2)检出率为8.55%。骨质疏松组的体质量指数(BMI)、身体形态指数(ABSI)、体质量、腰围、臀围、身高等均与骨量减少与正常骨密度组差异有统计学意义(P<0.01)。经过对年龄调整后,T值与身高、体质量、腰围、臀围、腰臀比(WHR)、腰高比(WHtR)、体圆柱指数(BRI)呈正相关(P<0.05)。腰围和BMI与骨质疏松的ROC曲线的曲线下面积(AUC)最大,分别为0.540和0.568。结论对于绝经期女性,肥胖与骨质疏松可能存在一定的负相关。但这种负相关的临床意义需要更多基于人群的大样本纵向研究进一步验证。

Objective To determine the association between obesity and bone mineral density in menopausal women. Methods We recruited menopausal women aged 50 years and older who undertook health examinations in West China Hospital of Sichuan University in this study. Bone mineral density of the participants was measured by MetriScan Bone Densitometry. The participants were categorized into three groups according to the T value： normal density, osteopenia and osteoporosis. Results Of the 4 938 participants, 8. 55% had obesity [body mass index （BMI）〉28 kg/m2）. The three groups of participants were different in BMI, a body shape index （ABSI）, body mass, waist circumference, hip circumference and height （P〈0.01）. The age-adjusted T values were positively correlated with height, body mass, waist circumference, hip circumference, waist-hip ratio （WHR）, waist-height ratio （WHtR） and body roundness index （BRI） （P〈0. 05）. The areas under curves （AUC） of receiver operator characteristic （ROC） were 0. 540 and 0. 568, respectively, for waist circumference and BMI in those with osteoporosis. Conclusion Obesity in menopausal women is negatively associated with osteoporosis. The clinical significance of such an association requires further studies with a longitudinal design.