The association between body mass index and osteoporosis in patients referred for a bone mineral density examination
The association between body mass index and osteoporosis in patients referred for a bone mineral density examination
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DOI：
10.1089/jwh.2006.15.1028
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发表时间：
2006-11-01
影响因子：
3.5
通讯作者：
Pekow, Penelope S.
中科院分区：
文献类型：
--
作者：
Asomaning, Kofi;Bertone-Johnson, Elizabeth R.;Pekow, Penelope S.
目的：美国有400万-600万(13%-18%)绝经后白人妇女患有骨质疏松症。到目前为止，大多数关于骨质疏松症危险因素的研究都只认为体重指数(BMI)是一个可能的混杂因素。在这项研究中，我们评估了BMI与骨质疏松症的直接关系。方法：我们在1998年10月至2000年9月期间对50-84岁的女性进行了横断面研究，这些女性是由她们的医生推荐进行骨密度(BMD)检查的。在临床进行骨密度检查前测定BMI。关于其他危险因素的信息是通过邮寄的问卷获得的。结果：BMI与骨密度呈负相关，BMI与骨质疏松呈负相关。在调整了年龄、激素替代治疗和其他因素后，低、高、陆地肥胖女性与中等体重指数女性相比，优势比(OR)分别为1.8%(95%可信区间1.2-2.7%)、0.46%(95%可信区间0.29-0.71)和0.22(95%可信区间0.14-0.36)，在体重指数类别中存在显著的线性趋势(p<；0.0001)。将BMI作为一个连续变量进行评估，BMI每增加一个单位，骨丢失的风险降低12%(OR=0.88，95%CI 0.85~0.91)。结论：BMI低的女性患骨质疏松的风险增加。与体重指数每变化1个单位相关的风险变化(类似于5-8磅)比大多数其他可改变的风险因素更大。为了帮助降低骨质疏松症的风险，应该建议患者保持正常的体重。
Purpose: Osteoporosis affects 4-6 million (13%-18%) postmenopausal white women in the United States. Most studies to date on risk factors for osteoporosis have considered body mass index (BMI) only as a possible confounder. In this study, we assess the direct relationship between BMI and osteoporosis.Methods: We conducted a cross-sectional study among women aged 50-84 years referred by their physicians for a bone mineral density (BMD) examination at Baystate Medical Center between October 1998 and September 2000. BMI was determined prior to the BMD examination in the clinic. Information on other risk factors was obtained through a mailed questionnaire. Ordinal logistic regression was used to model the association between BMI and osteoporosis, controlling for confounding factors.Results: BMI was inversely associated with BMD status. After adjustment for age, prior hormone replacement therapy (HRT) use, and other factors, odds ratios ( OR) for low, high, land obese compared with moderate BMI women were 1.8 (95% CI 1.2-2.7), 0.46 (95% CI 0.29-0.71), and 0.22 (95% CI 0.14-0.36), respectively, with a significant linear trend (p < 0.0001) across BMI categories. Evaluating BMI as a continuous variable, the odds of bone loss decreased 12% for each unit increase in BMI (OR = 0.88, 95% CI 0.85-0.91).Conclusions: Women with low BMI are at increased risk of osteoporosis. The change in risk associated with a 1 unit change in BMI (similar to 5-8 lb) is of greater magnitude than most other modifiable risk factors. To help reduce the risk of osteoporosis, patients should be advised to maintain a normal weight.