仫佬族绝经前与绝经后女性体成分和骨密度的相关性研究

The relationship between body composition and bone mineral density in pre-and postmenopausal Mulam women

目的研究仫佬族绝经前与绝经后女性体成分和骨密度的相关关系,探讨体成分的变化对骨密度的影响。方法随机选取广西仫佬族成年女性200名,追溯其三代均为仫佬族,应用TANITA-MC180人体成分分析仪测定其肌肉量、脂肪量等体成分指标,采用SONOT3000超声骨密度仪测定其右侧跟骨的骨硬度指数。结果 (1)绝经前女性的体重、去脂体重、肌肉量、皮下脂肪量、躯干脂肪量、四肢肌肉量、推定骨量、骨硬度指数和T值等均显著高于绝经后女性(P<0.01);而绝经前女性的内脏脂肪面积、腰臀比显著低于绝经后女性(P<0.01)。(2)绝经前女性和绝经后女性的骨质疏松检出率分别为6%和45%,差异具有统计学意义(P<0.01)。(3)相关分析发现肌肉量、四肢肌肉量和躯干肌肉量与骨密度之间存在显著的正相关关系(P<0.01或P<0.05),而当控制年龄和绝经状态后体成分和骨密度之间没有相关性;根据年龄分组后发现,≥50岁组的肌肉量各指标与骨密度存在较显著的关联(P<0.05),而<50岁组的体成分与骨密度不存在关联性(P>0.05)。(4)多重逐步回归分析发现只有绝经状态、躯干肌肉量和内脏脂肪量与骨密度相关,而躯干肌肉量对骨密度影响最大。结论仫佬族绝经后女性的骨质疏松症发生率显著高于绝经前女性;控制年龄和绝经因素后,只有躯干肌肉量与骨密度较显著相关,结果可为骨质疏松症的预防和诊断提供理论依据。

Objective To investigate the relationship between body composition and bone mineral density（ BMD） in pre-and post-menopausal Mulam women,and to explore the impact of body composition change on BMD. Methods A total of 200 Mulam women were randomly selected from Guangxi province as participants,and they were Mulam tracing back up to three generations.Their body composition indices including muscle mass,fat mass,etc.,were assessed with TANITA-MC180. The stiffness index（ SI） of the right calcaneus was determined with SONOT3000. Results（1） Compared with premenopausal women,postmenopausal women had lower weight,fat-free mass（ FFM）,muscle mass（ MM）,subcutaneous fat content（ SFC）,trunk-fat mass（ TFM）,limb muscle mass（ LMM）,presumption of bone mass（ Po BM）,and T-score,but higher visceral fat area（ VFA）and waist-to-hip ratio（ WHR）（ P 〈 0. 01）.（2） The prevalence of osteoporosis were 6% and 45% in pre-and post-menopausal women,respectively,and the differences were significant（ P 〈 0. 01）.（3） MM,LMM,and trunk-muscle mass（ TMM） were positively correlated with BMD（ P 〈 0. 01 or P 〈 0. 05）. Body composition was not correlated with BMD after adjusting age and menopausal status. All the muscle mass indices were closely correlated with BMD（ P 〈 0. 05） in over 50 years old group,but not in below50 years old group.（4）Multiple stepwise regression analyses indicated that only menopausal status,TMM,and visceral fat content（ VFC） were significantly related with BMD,and TMMhad the most significant impact on BMD. Conclusion The prevalence of osteoporosis is higher in postmenopausal Mulam women than that in premenopausal women. However,after adjusting age and menopausal status,only TMMis significantly related with BMD. This research provides reference data for preventing and diagnosing osteoporosis in clinic.