Generalized low bone mass of girls with adolescent idiopathic scoliosis is related to inadequate calcium intake and weight bearing physical activity in peripubertal period
Generalized low bone mass of girls with adolescent idiopathic scoliosis is related to inadequate calcium intake and weight bearing physical activity in peripubertal period
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DOI：
10.1007/s00198-004-1792-1
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发表时间：
2005-09-01
影响因子：
4
通讯作者：
Cheng, JCY
中科院分区：
文献类型：
--
作者：
Lee, WTK;Cheung, CK;Cheng, JCY
青少年特发性脊柱侧凸（AIS）患者普遍存在低骨量。然而，缺乏将钙摄入量（CA）、负重体力活动（PA）和AIS骨量联系起来的研究。我们的目的是研究AIS女孩的CA、PA和骨量之间的关系，并与青春期前后健康的非AIS对照组进行比较。在一项横断面研究中，招募年龄在11-16岁且Cobb角>= 10度的新诊断AIS女孩（n=596）与年龄匹配的健康女孩（n=302）进行比较。评估人体测量参数、青春期状态、CA和PA。分别采用双能X线骨密度仪和外周定量计算机断层扫描测定腰椎和股骨颈的面积骨量以及桡骨远端和胫骨的体积骨量。结果表明，AIS组体重和体重指数（BMI）低于对照组（P < 0.05）。从13岁起AIS组矫正身高、臂距均大于对照组（P < 0.02）。各年龄组AIS的中位CA < 410 mg/天，与对照组无差异（P=0.063）。AIS组的中位PA（1.6 h/d）低于对照组（1.8 h/d）（P=0.025）。AIS组各年龄段骨量平均低于对照组6.5%（P < 0.05）。CA、PA与AIS患者骨量呈显著正相关（P < 0.04）。多变量分析显示，AIS与女孩骨量降低相关，CA和PA均为AIS骨量的独立预测因子。总之，发现AIS女孩的体重和BMI较低，节段长度较长，骨量普遍较低。钙摄入不足和负重体力活动与青春期前后AIS女孩的低骨量显著相关。在围产期预防全身性骨质减少对控制AIS进展的重要性值得进一步研究。
Generalized low bone mass has been well documented in patients with adolescent idiopathic scoliosis (AIS). However, studies linking calcium-intake (CA), weight-bearing physical-activity (PA) and bone mass of AIS are lacking. We aimed to study the relationship between CA, PA and bone mass in AIS girls and compared to those of healthy non-AIS controls during the peripubertal period. Newly diagnosed AIS girls (n=596) aged 11-16 years with Cobb angle >= 10 degrees were recruited to compare with age-matched healthy girls (n=302) in a cross-sectional study. Anthropometric parameters, pubertal status, CA and PA were assessed. Areal bone mass of lumbar spine and femoral neck, and volumetric bone mass of distal radius and tibia were determined by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, respectively. The results showed that weight and body mass index (BMI) of AIS were lower than the controls (P < 0.05). Corrected height and arm span of AIS were longer than those of controls from 13 years onwards (P < 0.02). Median CA of AIS was < 410 mg/day across the ages and did not differ from the controls (P=0.063). Median PA of AIS (1.6 h/day) was lower than the controls (1.8 h/day) (P=0.025). Bone mass of AIS was on average 6.5% lower than controls across the ages (P < 0.05). CA and PA were significantly correlated with bone mass of AIS (P < 0.04). Multivariate analysis showed that AIS in girls was associated with lower bone mass, and that both CA and PA were independent predictors of bone mass in AIS. In conclusion, AIS girls were found to have lower body weight and BMI, longer segmental lengths and generalized low bone mass. Inadequate calcium intake and weight-bearing physical activity were significantly associated with low bone mass in AIS girls during the peripubertal period. The importance of preventing generalized osteopenia in the control of AIS progression during the peribubertal period warrants further study.