浙江省桐乡市成年人体质指数和跟骨骨密度关联的研究  

Association between body mass index and calcaneus bone mineral density in adults in a cross-sectional study in Tongxiang,Zhejiang Province

作　　者：王浩[1] 谢开婿[2] 陈玲琍 许皓[2] 沈钲杰 吕筠[3,4,5] 余灿清[3,4,5] 孙点剑一 裴培 钟节鸣 俞敏[1] Wang Hao;Xie Kaixu;Chen Lingli;Xu Hao;Shen Zhengjie;Lyu Jun;Yu Canqing;Sun Dianjianyi;Pei Pei;Zhong Jieming;Yu Min(Department of Chronic and Non-communicable Disease Control and Prevention,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China;Department of Chronic and Non-communicable Disease Control and Prevention,Tongxiang County Center for Disease Control and Prevention,Tongxiang 314599,China;Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China;Peking University Center for Public Health and Epidemic Preparedness&Response,Beijing 100191,China;Key Laboratory of Epidemiology of Major Diseases(Peking University),Ministry of Education,Beijing 100191,China)

机构地区：[1]浙江省疾病预防控制中心慢性非传染性疾病预防控制所,杭州310051 [2]桐乡市疾病预防控制中心慢病科,桐乡314599 [3]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [4]北京大学公众健康与重大疫情防控战略研究中心,北京100191 [5]重大疾病流行病学教育部重点实验室(北京大学),北京100191

出　　处：《中华流行病学杂志》2025年第3期448-454,共7页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(82192900,82192901,82192904,81390540,91846303);国家重点研发计划“精准医学研究”重点专项(2016YFC0900500);中国香港Kadoorie Charitable基金;英国Wellcome Trust(202922/Z/16/Z,088158/Z/09/Z,104085/Z/14/Z)。

摘　　要：目的探讨体质指数(BMI)和成年人跟骨骨密度的关联。方法使用中国慢性病前瞻性研究浙江省桐乡市第二次重复调查数据,纳入分析44~84岁2896名研究对象。超重/肥胖采用WHO西亚太地区标准(23.0 kg/m^(2)≤BMI<25.0 kg/m^(2)为超重,BMI≥25.0 kg/m^(2)为肥胖)。采用多重线性回归模型探讨BMI和成年人跟骨骨密度的关联。采用限制性立方样条方法探索BMI和成年人跟骨骨密度的剂量反应关系。结果研究对象跟骨骨密度水平(x±SE):宽带超声衰减(109.4±12.1)dB/MHz,超声声速为(1545.9±33.8)m/s,强度指数为85.7±15.8。调整社会人口学因素、行为/生活方式、腰围、患高血压和患糖尿病等多种危险因素后,在非超重/肥胖人群中,BMI和跟骨强度指数有统计学关联[男性(β=2.30,95%CI:1.11~3.49)(P<0.001),女性(β=1.08,95%CI:0.38~1.78)(P=0.003)];在超重/肥胖女性中有统计学关联(β=0.90,95%CI:0.38~1.42)(P<0.001),而在超重/肥胖男性中无统计学关联(β=0.06,95%CI:-0.92~1.04)(P=0.900)。限制性立方样条模型显示,BMI和跟骨强度指数呈非线性剂量反应关系。结论BMI和成年人跟骨骨密度呈非线性关系。Objective To evaluate the association between body mass index(BMI)and bone mineral density of calcaneus in adults.Methods Data of the second resurvey of China Kadoorie Biobank study from Tongxiang of Zhejiang Province were used.A total of 2896 participants aged 44-84 years were included in the final analysis.Overweight was defined as 23.0 kg/m^(2)≤BMI<25.0 kg/m^(2),and obesity was defined as BMI≥25.0 kg/m^(2) based on the criteria recommended by WHO/West Pacific Region.Multiple linear regression model was used to evaluate the association between BMI and calcaneus bone mineral density.Restricted cubic splines were used to investigate the dose-response relationship between BMI and calcaneus bone mineral density.Results The calcaneus bone mineral density in the study subjects were as follow(x±SE):the broadband ultrasound attenuation was(109.4±12.1)dB/MHz,the speed of ultrasound was(1545.9±33.8)m/s,and the stiffness index was 85.7±15.8.After adjusting for socio-demographic factors,lifestyle,waist circumference,diabetes and hypertension prevalence,BMI was positively associated with calcaneus stiffness index in non-overweight and non-obese adults,withβof 2.30(95%CI:1.11-3.49)for men(P<0.001)and 1.08(95%CI:0.38-1.78)for women(P=0.003),respectively.In addition,BMI was positively associated with calcaneus stiffness index in overweight and obese women(β=0.90,95%CI:0.38-1.42)(P<0.001),and null association was found in overweight and obese men(β=0.06,95%CI:-0.92-1.04)(P=0.900).Restricted cubic spline model showed a nonlinear dose-response relationship between BMI and calcaneus stiffness index.Conclusion Non-linear association was found between BMI with calcaneus bone mineral density in adults.

关 键 词：骨密度 体质指数 强度指数 横断面研究 

分 类 号：R58[医药卫生—内分泌]