绝经前后女性身体成分和骨密度变化及相关性分析

Changes of Body Composition and Bone Mineral Density in Premenopausal and Postmenopausal Women and the Correlation

目的探讨绝经前后女性身体成分和骨密度变化及其相关性分析。方法回顾性分析2006年2月—2012年1月668例40~65岁绝经前后女性,分为绝经前组、绝经后1组(绝经后1~5年)、绝经后2组(绝经后6~10年)及绝经后3组(绝经10年以上),比较各组的身体成分和骨密度(BMD)。将体质量指数(BMI)、肌肉指数(LMI)和脂肪指数(FMI)按四分位数进行分组,比较腰椎L1~4、股骨颈(FN)和全髋(TH)部位BMD的变化情况。结果绝经后各组较绝经前组身高下降;绝经后2组和绝经后3组BMI大于绝经前组,绝经后各组FMI均大于绝经前组,绝经后3组LMI大于绝经前组(P<0.05)。绝经后各组脂肪量百分比(FM%)较绝经前组增加,肌肉量百分比(LM%)下降,骨矿含量百分比(BMC%)下降。绝经后各组L1~4、FN及TH的BMD均较绝经前组下降,各组躯干脂肪较绝经前组增加。随着BMI、FMI、LMI增高,各部位的BMD均增加,>第75百分位数者BMI、FMI和LMI的L1~4、FN、TH部位BMD高于<第25百分位数者。结论绝经年限和年龄影响女性身体成分和BMD;BMI、FMI和LMI对绝经前后女性腰椎、股骨颈和全髋BMD有保护作用。

Objective To explore the changes of body composition and bone mineral density(BMD) in premenopausal and postmenopausal women and to perform a correlative analysis. Methods A retrospective analysis was made to the data of 668 premenopausal and postmenopausal women aged from 40 to 65 years, who were divided into 4 groups: pre-menopause group,post-menopause group 1(menopause for 1 to 5 years), post-menopause group 2(menopause for 6 to 10 years) and postmenopause groups 3(menopause over 10 years), the body composition and BMD of cases in each group were compared;the body mass index(BMI), the lean mass index(LMI) and the fat mass index(FMI) were grouped according to quartiles, and the BMD changes in lumbar spine(L1 to L4), femoral neck(FN) and the total hip(TH) were compared. ResultsThe body height of the cases in each post-menopause groups decreased compared with cases in pre-menopause group(P<0.05);the BMI of the cases in post-menopause group 2 and post-menopause group 3 were higher than those in pre-menopause group(P<0.05);the FMI of the cases in each post-menopause group were higher than those of the cases in pre-menopause group(P<0.05);the LMI of the cases in post-menopause group 3 were higher than those in pre-menopause group(P<0.05);compared with that in pre-menopause group, the fat mass percentage(FM%) increased while the lean mass percentage(LM%) and the bone mass content percentage(BMC%) decreased in each post-menopause group(P<0.05);compared with that in pre-menopause group,the BMD of L1 to L4, FN and TH decreased while the trunk fat mass increased in each of post-menopause group(P<0.05);the BMD of L1 to L4, FN and TH kept increasing along with the increase of BMI, FMI and LMI, the BMD of L1 to L4, FN and TH in cases with BMD>75 th percentile was higher than that in cases with BMD<25 th percentile. Conclusions The time length of menopause and the age are of certain impact on female body composition and BMD;BMI, FMI and LMI are of protective effect on lumbar spinal, FN and TH of premenopausal and postmenopausal women.