肥胖对绝经后妇女骨量的双向影响  

Effect of obesity on bone mass in postmenopausal women: two sides of a coin

作　　者：李万根[1] 宫雅南[1] 朱沛庄[1] 邓煜辉[1] 

机构地区：[1]广州医学院第二附属医院内分泌科,510260

出　　处：《中国骨质疏松杂志》2005年第1期80-82,共3页Chinese Journal of Osteoporosis

基　　金：广东省自然科学基金资助项目 (0 0 0 3 3 3 )

摘　　要：目的　深入探讨肥胖对绝经后妇女骨量的影响及机理。方法　绝经年限 (YSM) 1～ 10年的妇女 85例 ,测量身高、体重 ,计算体重指数 (BMI) ;测量空腹及糖负荷后 2h胰岛素 ;空腹血甘油三酯(TG)、总胆固醇、瘦素 ;测定腰椎及股骨颈的骨密度。结果　多元逐步回归分析显示 ,腰椎骨密度 =1 0 85 0 0 2 2YSM ,股骨颈骨密度 = 0. 371+0. 6 33身高 +0 . 0 11BMI 0 . 0 0 7YSM 0 . 0 5 3lnTG ;BMI与TG成正相关 (r=0 . 2 4 4 ,P =0. 0 2 7) ;如果把人群分为BMI<2 3kg/m2 和BMI≥ 2 3kg/m2 两组 ,则两组之间腰椎骨密度的差异无显著性 ,而股骨颈骨密度的差异有显著性 ,BMI≥ 2 3kg/m2 组大于BMI <2 3kg/m2组 (t=3 4. 96 ,P =0 . 0 0 1)。结论　肥胖对腰椎骨量无保护作用 ,对股骨颈骨量总的影响是保护作用 ,但深入分析发现其影响呈双向性 ,其保护作用与体重负荷有关 ,而损害作用与血TG水平有关。Objective To investigate the effect of obesity on bone mass in postmenopausal women.Methods Eighty-five postmenopausal women were included. Height, weight, BMI, fasting insulin, 2 hour insulin after glucose challenge, triglyceride(TG), total cholesterol, leptin, bone mineral density(BMD) at lumbar spine and femoral neck were measured.Results The formulae of BMD were as follows: lumbar BMD=1.085-0.022YSM, femoral neck BMD=-0.371+0.633 height+0.011 BMI-0.007YSM-0.053 lnTG. BMI was positively corralated with TG (r=0.244, P=0.027). There was no difference in lumbar BMD between group of BMI<23 kg/m^2 and group of BMI≥23 kg/m^2. However, the femoral BMD was higher in group of BMI≥23 kg/m^2 than that in group of BMI<23 kg/m^2 (t=3.496, P=0.001). Conclusion Obesity has both positive and negative effects on bone mass in postmenopausal women. The former is related to mechanical stress of body weight, and the latter is related to the level of TG; the net effect is protective.

关 键 词：骨量 BMI 股骨颈 肥胖 TG 绝经后妇女 腰椎骨密度 保护作用 空腹 影响 

分 类 号：R681[医药卫生—骨科学] R589.2[医药卫生—外科学]