围绝经期与绝经早期妇女骨密度及身体成分分析  

An Analysis of Bone Mineral Density and Body Composition in Peri-menopausal and Early Postmenopausal Women

作　　者：陶敏芳[1] 朱洁萍[1] 章振林[2] 

机构地区：[1]上海交通大学附属第六人民医院妇产科,上海市200233 [2]上海交通大学附属第六人民医院骨质疏松科,上海市200233

出　　处：《中国全科医学》2009年第17期1587-1588,1591,共3页Chinese General Practice

基　　金：上海市卫生局资助项目(2008001)

摘　　要：目的探讨围绝经期与绝经早期妇女骨密度(BMD)和身体成分的变化,分析身体成分对BMD的影响。方法选择2008年3月在本院行健康体检的40～60岁围绝经期和绝经≤5年的妇女,记录身高和体质量,计算体质指数(BMI)。采用双能X线检测仪检测腰椎1～4和左侧股骨颈、大转子及全髋的BMD,以及全身脂肪含量和肌肉含量。结果符合条件的妇女共157例,其中围绝经期组69例,绝经早期组88例。绝经早期组身高明显低于围绝经期组〔(156.8±4.9)cm和(159.2±5.1)cm〕,BMI明显高于围绝经期组〔(24.2±2.8)kg/m2和(23.2±2.5)kg/m2〕;两组妇女的体质量、脂肪含量和肌肉含量间差别无统计学意义(P>0.05)。绝经早期组腰椎1～4的BMD和股骨颈BMD均显著低于围绝经期组〔分别为(1.09±0.14)g/cm2和(1.19±0.15)g/cm2,(0.90±0.11)g/cm2和(0.94±0.12)g/cm2,P<0.05〕;两组妇女其他部位BMD间差别无统计学意义(P>0.05)。逐步多元回归分析显示,各部位BMD与肌肉含量均有相关性(P<0.05),BMI和脂肪含量与各部位BMD均无相关性(P>0.05)。结论绝经早期腰椎和股骨颈的BMD明显降低,而脂肪含量和肌肉含量的变化不明显。绝经后骨质疏松症的预防工作应尽早开始。Objective To investigate the changes of bone mineral density （BMD） and body composition in peri - menopausal and early postmenopausal women, and to evaluate the impact of body composition on BMD. Methods The peri - menopausal and early post - menopausal women aged above 40, who underwent a physical check - up in our hospital in March 2008 were enrolled. Their height and weight were measured and body mass index （BMI） was calculated. Their bone mass density （BMD） of the 1 -4th lumbar vertebrae, left femoral neck, trochanter and total hip, and fat mass （FM） and lean body mass （LM） were measured by Dual energy X -ray absorptiometry （DEXA）. Results The subjects who were consistent with the criteria were 157. They were divided as peri - menopause group （ n = 69 ） and post - menopause group （ n = 88 ）. The early post - menopausal women showed significant lower height [ （ 156. 8 ±4. 9 ） cm vs （ 159. 2 ±5.1 ） cm and higher BMI （ 24. 2 ± 2. 8 ） kg/ m^2 vs （23.2 ± 2. 5 ） kg/m^2 ] than peri - menopausal women. There was no significant difference in BMI, FM and LM between the two groups （ P 〉 0. 05 ）. The BMD levels of the 1 - 4th lumbar vertebrae and femoral neck in early post - menopausal women [ （ 1.09 ± 0. 14） g/cm^2 and （ 1.19 ± 0. 15 ） g/cm^2 ] than those in peri - menopausal women [ （0. 90 ± 0. 11 ） g/cm^2 and （0. 94 ±0. 12） g/cm^2] （P 〈0. 05）. But there was no significant difference in BMI of other sites between the two groups （P 〉0. 05）. Stepwise regression showed a correlation between LM and BMD at all sites （P 〈0. 05 ）. However, BMI and FM show no correlation with BMD at all sites （ P 〉 0. 05 ）. Conclusion The BMD of lumbar spine and femoral neck declines apparently in early menopause, but the changes of FM and LBM are not evident. The prevention of post - menopausal osteoporosis should be done as early as possible.

关 键 词：骨质疏松 绝经后 骨密度 围绝经期 绝经早期 脂肪含量 肌肉含量 

分 类 号：R681.4[医药卫生—骨科学]