CLINICAL AND ANTHROPOMETRIC CORRELATES OF BONE-MINERAL ACQUISITION IN HEALTHY ADOLESCENT GIRLS
CLINICAL AND ANTHROPOMETRIC CORRELATES OF BONE-MINERAL ACQUISITION IN HEALTHY ADOLESCENT GIRLS
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DOI：
10.1210/jcem-73-6-1332
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发表时间：
1991-12-01
影响因子：
5.8
通讯作者：
MARCUS, R
中科院分区：
文献类型：
--
作者：
KATZMAN, DK;BACHRACH, LK;MARCUS, R
我们研究了45名健康的青春期前和青春期女孩骨矿物质的获取，以及骨量与年龄、体重、青春期状态、钙摄入量和运动的相关变化。一个由12名女孩组成的小组进行了纵向随访。采用双能x线骨密度仪和单光子骨密度仪分别测定腰椎、全身和股骨颈的骨矿物质含量（BMC）。为了比较，脊柱和全身矿物质含量也用双光子吸收测定法测定。骨量用常规的BMC和面积密度（BMD）表示。然而，我们发现骨密度不能解释骨厚度的差异。由于青春期骨尺寸增加，我们提出了一个新的表达，骨矿物质表观密度（BMAD），它是BMC归一化为衍生的骨参考体积。这个术语最大限度地减少了骨骼几何形状的影响，并允许比较形状相似但大小不同的骨骼之间的矿物质状态。BMC随年龄增长而增加。这些增长在青少年早期最为迅速，在16岁之后趋于平稳。当所有地点的骨矿物质值与年龄、身高、体重或青春期阶段进行回归时，出现了一致的关系，其中BMC相关性最强，BMD相关性中等，而BMAD相关性较弱或无显著性。膳食钙和运动水平与骨量无显著相关。根据这些关系，我们将青春期50%的脊柱矿物质增加和99%的全身矿物质变化归因于骨扩张，而不是单位体积骨矿物质的增加。在多元回归中，青春期对矿物质状态的预测最为一致。这项研究强调了青春期发育和身体大小作为女孩骨骼获得的决定因素的重要性。BMAD可能在骨骼快速生长期间的骨获取研究中特别有用。
We studied the acquisition of bone mineral in 45 healthy prepubertal and pubertal girls and related changes in bone mass to age, body mass, pubertal status, calcium intake, and exercise. A subgroup of 12 girls was followed longitudinally. Bone mineral content (BMC) of the lumbar spine, whole body, and femoral neck was measured by dual energy x-ray absorptiometry and that at the midradius by single photon absorptiometry. For comparison, spine and whole body mineral contents were also measured by dual photon absorptiometry. Bone mass was expressed in conventional terms of BMC and area density (BMD). However, we show that BMD fails to account for differences in bone thickness. Since bone size increases during adolescence, we present a new expression, bone mineral apparent density (BMAD), which is BMC normalized to a derived bone reference volume. This term minimizes the effect of bone geometry and allows comparisons of mineral status among bones of similar shape but different size. BMC increased with age at all sites. These increases were most rapid in the early teens and plateaued after 16 yr of age. When bone mineral values at all sites were regressed against age, height, weight, or pubertal stage, consistent relationships emerged, in which BMC was most strongly correlated, BMD was correlated to an intermediate degree, and BMAD correlated only modestly or without significance. Dietary calcium and exercise level did not correlate significantly with bone mass. From these relationships, we attribute 50% of the pubertal increase in spine mineral and 99% of the change in whole body mineral to bone expansion rather than to an increase in bone mineral per unit volume. In multiple regressions, pubertal stage most consistently predicted mineral status. This study emphasizes the importance of pubertal development and body size as determinants of bone acquisition in girls. BMAD may prove to be particularly useful in studies of bone acquisition during periods of rapid skeletal growth.