目的 分析儿童青少年骨矿物质含量(BMC)与肥胖之间的关系,为预防儿童青少年骨质疏松提供更有力的依据。方法 于2017—2020年以整群随机抽样的方法从银川市随机抽取1 578名儿童青少年作为研究对象,进行问卷调查、体格检查、骨矿物质含量测定,采用二元Logistic回归分析不同定义的肥胖指标与骨矿物质含量之间的关系。 结果 不同指标体重指数(BMI),腰围(WC),腰围身高比(WHtR)和体脂百分比(FMP)肥胖组的BMC均高于正常组(P<0.01);男、女生不同肥胖指标与BMC均呈正相关(P<0.01),其中男生WC,女生BMI与BMC的相关性最高(r=0.749和0.684);二元Logistic回归分析结果显示,在调整年龄后发现,对男生中,以FMP,WHtR定义的肥胖与BMC增加呈正相关(FMP:OR=1.53,95%CI:1.04~2.27, WHtR:OR=4.39,95%CI:1.55~12.44);女生中,以FMP定义的肥胖与BMC增加呈正相关(OR=3.46,95%CI:1.59~7.51)。结论 基于FMP,WHtR分别定义的肥胖类型对儿童青少年预防骨质疏松有一定的公共卫生价值,但过度肥胖可能会造成骨骼损伤。
Abstract
Objective To analyze the relationship between body mineral content (BMC) and obesity in children and adolescents, so as to provide more powerful basis for preventing osteoporosis in children and adolescents. Methods A total of 1 578 children and adolescents were randomly selected from Yinchuan city by cluster sampling from 2017 to 2020, and conducted questionnaire survey. Their physical examination and bone mineral content were measured. The relationship between obesity of different definitions and bone mineral content was analyzed by binary Logistic regression. Results BMC of obese children at different body mass index (BMI), waist circumference (WC), waist height ratio (WHtR) and percentage of body fat (FMP) groups were significantly higher than that of normal group (P<0.01). There was a positive correlation between BMC and different obesity indicators in boys and girls (P <0.01). WC in boys and BMI in girls had the highest correlation with BMC (r=0.749, 0.684). Binary Logistic regression analysis showed that after adjusting for age, it was found that obesity defined by FMP and WHtR was significantly associated with the increase of BMC in boys (FMP:OR=1.53, 95%CI:1.04 - 2.27; WHtR:OR=4.39, 95%CI:1.55 - 12.44). For girls, obesity defined by FMP was significantly associated with the increase of BMC (OR=3.46, 95%CI:1.59 - 7.51). Conclusion Obesity defined by FMP and WHtR have a certain public health value for children and adolescents to prevent osteoporosis, but excessive obesity may cause bone injury.
关键词
骨矿物质含量 /
肥胖 /
体脂百分比 /
儿童青少年
Key words
bone mineral content /
obesity /
fat mass percent /
children and adolescents
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 张垚. 北京市通州区2012—2017年7～17岁儿童青少年超重肥胖流行趋势及预测研究[J]. 中国儿童保健杂志, 2020, 28(2):178-182.
[2] NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in children's and adolescents'body mass index, underweight and obesity, in comparison with adults, from 1975 to 2016:a pooled analysis of 2 416 population-based measurement studies with 128.9 million participants[J]. Lancet, 2017, 390:2627-2642.
[3] Lobstein T, Jackson-Leach R. Planning for the worst:estimates of obesity and comorbidities in school-age children in 2025[J]. Pediatr Obes, 2016, 11(5):321-325.
[4] 季成叶. 儿童少年卫生学[M]. 7版.北京:人民卫生出版社, 2012.
[5] Maffeis C, Morandi A. Body composition and insulin resistance in children[J]. Eur J Clin Nutr, 2018, 72(9):1239-1245.
[6] 曹志娟, 陈瑶, 叶周丰, 等. 上海市某区7～13岁学生超重和肥胖流行趋势[J]. 中国儿童保健杂志, 2020, 28(2):128-130.
[7] 张亨菊, 管晓丽, 李耀. 济南市7～13岁儿童骨矿物质含量及其影响因素分析[J]. 预防医学文献信息, 2000, 6(1):9-10.
[8] 董虹孛, 闫银坤, 米杰. 儿童肥胖与骨量的双重性关系[J]. 中华骨质疏松和骨矿盐疾病杂志, 2019, 12(4):406-412.
[9] 中国肥胖问题工作组. 中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J]. 中华流行病学杂志, 2004, 25(2):97-102.
[10] Deurenberg P, Yap M, Van Staveren WA. Body mass index and percent body fat:A meta analysis among different ethnic groups[J]. Int J Obes Relat Metab Disord, 1998, 22(12):1164-1171.
[11] Ma GS, Ji CY, Ma J, et al. Waist circumference reference values for screening cardiovascular risk factors in Chinese children and adolescents[J]. Biomed Environ Sci, 2010, 23(1):21-31.
[12] 戴阳丽, 傅君芬, 梁黎, 等. 中国6省市儿童青少年代谢综合征相关腰围身高比切点值的研究[J]. 中华流行病学杂志, 2014, 35(8):882-885.
[13] 李静, 赵海萍, 吴文军, 等. 银川市中小学生骨密度和骨矿含量[J]. 中国学校卫生, 2017, 38(6):885-887.
[14] 王政和, 付连国, 阳益德, 等. 双能X线吸收法和生物电阻抗法测量成年超重和肥胖人群骨矿含量的一致性分析[J]. 卫生研究, 2016, 45(3):362-366.
[15] 王文志, 杨定焯, 徐健, 等. 健康青年人体重与骨矿含量和骨密度关系的研究[C]. 太原:中华医学会第七次全国骨质疏松和骨矿盐疾病学术会议论文汇编, 2013:258-260.
[16] Kindler JM, Lobene AJ, Vogel KA, et al. Adiposity, insulin resistance, and bone mass in children and adolescents[J]. J Clin Endocrinol Metab, 2019, 104(3):892-899.
[17] 檀倩影. 2002年和2009年北京郊区少年骨量差异的影响因素分析[D]. 南宁:广西医科大学, 2011.
[18] 韦荣耀. 百色市壮族大学生骨矿物质含量与体成分相关分析[J]. 右江民族医学院学报, 2011, 33(6):752-754.
[19] Hansen MA, Overgaard K, Riis BJ, et al. Role of peak bone mass and bone loss in postmenopausal osteoporosis:12 year study[J]. BMJ, 1991, 303(6808):961-964.
[20] Mccormack SE, Cousminer DL, Chesi A, et al. Association between linear growth and bone accrual in a diverse cohort of children and adolescents[J]. JAMA Pediatr, 2017, 171(9):e171769.
[21] 杜伟江, 曹巧华. 儿童BMI与骨密度及血糖血脂水平的关系[J]. 中国妇幼健康研究, 2019, 30(3):325-328.
[22] Van Leeuwen J, Koes BW, Paulis WD, et al. Differences in bone mineral density between normal-weight children and children with overweight and obesity:a systematic review and meta-analysis[J]. Obes Rev, 2017, 18(5):526-546.
[23] Ferrer FS, Castell EC, Marco FC, et al. Influence of weight status on bone mineral content measured by DXA in children[J]. BMC Pediatr, 2021, 21:185.
[24] Greco EA,Fornari R, Rossi F, et al. Is obesity protective for osteoporosis? Evaluation of bone mineral density in individuals with high body mass index[J]. Int J Clin Pract, 2010, 64:817-820.
[25] Kopiczko A, Adamczyk JG, Gryko K, et al. Bone mineral density in elite masters' athletes:The effect of body composition and long-term exercise[J]. Eur Rev Aging Phys Act, 2021, 18(7):1-10.
[26] 李海波. 中国六城市儿童青少年维生素D营养状况及其与骨骼和心血管健康的研究[D].北京:北京协和医学院, 2020.
基金
国家自然科学基金(82160641);2021年宁夏医科大学优势学科群建设项目
PDF(679 KB)
