Relation of body composition, fat mass, and serum lipids to osteoporotic fractures and bone mineral density in Chinese men and women.
Relation of body composition, fat mass, and serum lipids to osteoporotic fractures and bone mineral density in Chinese men and women.
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DOI：
10.1093/ajcn/83.1.146
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发表时间：
2006
期刊：
影响因子：
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通讯作者：
Y. Hsu;S. Venners;H. Terwedow;Yan Feng;T. Niu;Zhiping Li;N. Laird;Joseph D. Brain;S. Cummings;M. Bouxsein;C. Rosen;Xiping Xu
中科院分区：
文献类型：
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作者：
Y. Hsu;S. Venners;H. Terwedow;Yan Feng;T. Niu;Zhiping Li;N. Laird;Joseph D. Brain;S. Cummings;M. Bouxsein;C. Rosen;Xiping Xu
背景：高脂肪可能是骨质疏松和骨质疏松性骨折的独立危险因素。目的：我们旨在确定脂肪量对骨质疏松症的独立贡献，并估计与体重、瘦体重和其他混杂因素相关的骨质疏松性骨折的风险。设计：这是一项以社区为基础的横断面研究，包括7137名男性、4585名绝经前女性和2248名绝经后女性，年龄在25-64岁之间。采用双能X线骨密度仪测量全身和髋部骨矿含量（BMC）、骨密度（BMD）和身体成分。测定血脂。应用性别和绝经特异性多重广义线性模型。结果：在5公斤体重的分层中，脂肪量与全身和全髋的BMC呈显著负相关。当我们比较男性、绝经前女性和绝经后女性脂肪质量百分比的最高四分位数和最低四分位数时，由髋部BMD定义的骨质疏松症的校正比值比（95%CI）分别为5.2（2.1，13.2）、5.0（1.7，15.1）和6.9（4.3，11.2）。脂肪量百分比越高，骨质疏松症、骨量减少和非脊柱骨折的风险越高，存在显著的线性趋势。各组大鼠全身BMC与胆固醇、三酰甘油、LDL及HDL/LDL比值呈显著负相关。结论：与体重、体力活动和年龄无关，体脂百分比较高的受试者发生骨质疏松、骨量减少和非脊柱骨折的风险明显较高。因此，与负重本身的积极作用相比，脂肪量对骨量有负面影响。
BACKGROUND Higher fat mass may be an independent risk factor for osteoporosis and osteoporotic fractures. OBJECTIVE We aimed to determine the independent contribution of fat mass to osteoporosis and to estimate the risk of osteoporotic fractures in relation to body weight, lean mass, and other confounders. DESIGN This was a community-based, cross-sectional study of 7137 men, 4585 premenopausal women, and 2248 postmenopausal women aged 25-64 y. Total-body and hip bone mineral content (BMC) and bone mineral density (BMD) and body composition were measured by dual-energy X-ray absorptiometry. Serum lipids were measured. Sex- and menopause-specific multiple generalized linear models were applied. RESULTS Across 5-kg strata of body weight, fat mass was significantly inversely associated with BMC in the whole body and total hip. When we compared the highest quartile with the lowest quartile of percentage fat mass in men, premenopausal women, and postmenopausal women, the adjusted odds ratios (95% CIs) of osteoporosis defined by hip BMD were 5.2 (2.1, 13.2), 5.0 (1.7, 15.1), and 6.9 (4.3, 11.2), respectively. Significant linear trends existed for higher risks of osteoporosis, osteopenia, and nonspine fractures with higher percentage fat mass. Significant negative relations were found between whole-body BMC and cholesterol, triacylglycerol, LDL, and the ratio of HDL to LDL in all groups. CONCLUSIONS Risks of osteoporosis, osteopenia, and nonspine fractures were significantly higher for subjects with higher percentage body fat independent of body weight, physical activity, and age. Thus, fat mass has a negative effect on bone mass in contrast with the positive effect of weight-bearing itself.