目的 分析儿童骨密度与性别、年龄、体质量指数(BMI)、血钙、血磷、血清碱性磷酸酶(ALP)和血清25-羟维生素D[25-(OH)D]的关系,为促进儿童骨骼健康提供科学依据。方法 选取2018年6月—2022年9月在浙江大学附属儿童医院儿童保健科健康管理中心体检的3 024名1~6岁儿童为研究对象,检测儿童的BMI、血清ALP、钙、磷与25-(OH)D水平,并采用超声骨密度仪检测骨密度指标。 结果 纳入3 024例儿童中骨密度偏低578例,检出率为19.11%;男童骨密度Z值高于女童(t=3.132,P＜0.01);不同年龄组儿童间骨密度Z值比较差异均有统计学意义(F=54.493,P＜0.001);骨密度正常组BMI低于骨密度偏低组(t=7.083,P＜0.001);骨密度偏低组血清钙、磷和25-(OH)D水平均低于骨密度正常组(t=8.659、3.479、16.440,P＜0.01)。相关分析显示,骨密度Z值与血清钙、磷、25-(OH)D水平呈正相关(r=0.146、0.051、0.240,P＜0.05);与BMI呈负相关(r=-0.128,P<0.05);与ALP无相关性(P=0.684)。Logistic多元回归分析显示BMI(OR=1.259)、血清钙(OR=0.025)、磷(OR=0.426)和25-(OH)D(OR=0.954)水平均为儿童骨密度的影响因素(P＜0.05)。结论 儿童骨密度与性别、年龄、血清钙、磷、BMI和25-(OH)D有关,与血清ALP无关。维持相对较高的血清钙、磷和25-(OH)D对维持正常骨密度有重要意义。
Abstract
Objective To analyze the relationship between bone mineral density (BMD) in children and factors including sex, age, body mass index (BMI), blood calcium, blood phosphorus, serum alkaline phosphatase (ALP), and serum 25-hydroxyvitamin D[25-(OH)D], in order to provide a scientific basis for promoting pediatric bone health. Methods A total of 3 024 children aged 1 - 6 years who underwent health examinations at the Child Health Care Center of the Children′s Hospital Affiliated to Zhejiang University School of Medicine from June 2018 to September 2022 were included.BMI, serum ALP, calcium, phosphorus, and 25-(OH)D levels were measured, and BMD was assessed using ultrasound bone densitometry. Results Among the3 024 participants, 578 children (19.11%) had low BMD.Male children exhibited higher BMD Z-scores than females (t=3.132, P<0.01).Significant differences in BMD Z-scores were observed across age groups (F=54.493, P<0.001).The normal BMD group had lower BMI than the low BMD group (t=7.083, P<0.001).Children with low BMD showed lower serum calcium, phosphorus, and 25-(OH)D levels compared to those with normal BMD (t=8.659, 3.479, 16.440, P<0.01).Correlation analysis revealed that BMD Z-scores were positively associated with serum calcium, phosphorus, and 25-(OH)D levels (r=0.146, 0.051, 0.240, P<0.05), negatively correlated with BMI (r=-0.128, P<0.05), and not correlated with ALP (P=0.684).Multivariate logistic regression identified BMI (OR=1.259), calcium (OR=0.025), phosphorus (OR=0.426), and 25-(OH)D (OR=0.954) levels as significant influencing factors of BMD (P<0.05). Conclusions Pediatric BMD is associated with sex, age, serum calcium, phosphorus, BMI, and 25-(OH)D, but not with serum ALP.Maintaining relatively high levels of serum calcium, phosphorus, and 25-(OH)D is crucial for sustaining normal BMD in children.
关键词
骨密度 /
骨代谢 /
25-羟维生素D /
儿童
Key words
bone mineral density /
bone metabolism /
25-(OH)D /
preschool children
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基金
浙江省教育厅一般科研项目(自然科学类)(Y202249557)
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