身体活动水平与6~9岁儿童骨矿含量及骨密度的关联

张天宏; 罗洁玲; 陈菊; 谢志泳; 陈耿东

doi:10.11852/zgetbjzz2026-0112

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中国儿童保健杂志 ›› 2026, Vol. 34 ›› Issue (10) : 1093-1098. DOI: 10.11852/zgetbjzz2026-0112

慢性病的生命早期预防

身体活动水平与6~9岁儿童骨矿含量及骨密度的关联

张天宏¹, 罗洁玲², 陈菊², 谢志泳², 陈耿东³

作者信息 +

Association of physical activity levels with bone mineral content and bone mineral density among children aged 6-9 years

ZHANG Tianhong¹, LUO Jieling², CHEN Ju², XIE Zhiyong², CHEN Gengdong³

Author information +

文章历史 +

摘要

目的探讨身体活动水平与6~9岁儿童全身骨矿含量(BMC)和骨密度(BMD)的关联。方法采用横断面研究设计,纳入广州市452名6~9岁儿童。采用双能X线吸收法测量全身BMC和BMD;通过监护人协助完成连续3 d的24 h身体活动记录,计算日总活动能量消耗(MET·h/d)及不同强度身体活动时间。采用限制性立方样条和协方差分析评估身体活动与BMC、BMD的关联,并校正年龄、性别、体质量指数、膳食摄入及家庭社会经济因素等潜在混杂因素。结果研究对象平均年龄为(8.01±0.93)岁。校正潜在混杂因素后,日总活动能量消耗和高强度身体活动时间均与全身BMC、BMD呈正向关联趋势(P_趋势＜0.01)。与最低三分位组(T1)相比,日总活动能量消耗最高三分位组(T3)的全身BMC和BMD分别高3.39%和2.20%(P<0.05);高强度身体活动时间T3组的全身BMC和BMD分别高3.33%和1.94%(P<0.05)。结论较高的日总活动能量消耗,尤其是高强度身体活动时间与6~9岁儿童全身BMC和BMD呈正向关联。

Abstract

Objective To examine the associations of physical activity levels with total-body bone mineral content (BMC) and bone mineral density (BMD) among children aged 6-9 years. Methods This cross-sectional study included 452 children aged 6-9 years from Guangzhou, China. Total-body BMC and BMD were measured using dual-energy X-ray absorptiometry. Physical activity was estimated from parent-assisted 24-hour activity records completed on three consecutive days and expressed as total daily energy expenditure (MET·h/day) and time spent at different intensity levels. Restricted cubic spline models and analysis of covariance were used to evaluate the associations after adjustment for potential confounders. Results The mean age was (8.01±0.93) years. Higher total daily energy expenditure and longer time spent in vigorous physical activity were positively associated with total-body BMC and BMD (P_{for trend}<0.01). Compared with the lowest tertile (T1), the highest tertile (T3) of total daily energy expenditure had 3.39% higher BMC and 2.20% higher BMD (P＜0.05); the corresponding differences for vigorous physical activity were 3.33% and 1.94% (P＜0.05), respectively. Conclusion Higher total daily energy expenditure and more time spent in vigorous physical activity are associated with higher total-body BMC and BMD among children aged 6-9 years.

导出引用

张天宏, 罗洁玲, 陈菊, 谢志泳, 陈耿东. 身体活动水平与6~9岁儿童骨矿含量及骨密度的关联[J]. 中国儿童保健杂志. 2026, 34(10): 1093-1098 https://doi.org/10.11852/zgetbjzz2026-0112

ZHANG Tianhong, LUO Jieling, CHEN Ju, XIE Zhiyong, CHEN Gengdong. Association of physical activity levels with bone mineral content and bone mineral density among children aged 6-9 years[J]. Chinese Journal of Child Health Care. 2026, 34(10): 1093-1098 https://doi.org/10.11852/zgetbjzz2026-0112

中图分类号： R179

参考文献

[1] GBD 2021 Low Bone Mineral Density Collaborators. The global, regional, and national burden attributable to low bone mineral density, 1990-2020: An analysis of a modifiable risk factor from the Global Burden of Disease Study 2021[J]. Lancet Rheumatol, 2025, 7(12): e873-e894.
[2] Tan J, Ng CA, Hart NH, et al. Reduced peak bone mass in young adults with low motor competence[J]. J Bone Miner Res, 2023, 38(5):665-677.
[3] Zemel BS, Kalkwarf HJ, Gilsanz V, et al. Revised reference curves for bone mineral content and areal bone mineral density according to age and sex for black and non-black children: Results of the bone mineral density in childhood study[J]. J Clin Endocrinol Metab, 2011, 96(10):3160-3169.
[4] Jang MJ, Shin C, Kim S, et al. Factors affecting bone mineral density in children and adolescents with secondary osteoporosis[J]. Ann Pediatr Endocrinol Metab, 2023, 28(1):34-41.
[5] Nowak A, Ogurkowska M. Bone health and physical activity-the complex mechanism[J]. Aging Dis, 2024, 16(6): 3400-3420.
[6] Nissen FI, Esser VFC, Bui M, et al. Is there a causal relationship between physical activity and bone microarchitecture? A study of adult female twin pairs[J]. J Bone Miner Res, 2023, 38(7): 951-957.
[7] Pageau AG, Burt LA, Gabel L, et al. The association between physical activity during growth and bone microarchitecture at peak bone mass[J]. J Bone Miner Res, 2025, 40(10):1156-1164.
[8] Zhao Z, Yan K, Guan Q, et al. Mechanism and physical activities in bone-skeletal muscle crosstalk[J]. Front Endocrinol, 2024, 14:1287972.
[9] Chang X, Xu S, Zhang H. Regulation of bone health through physical exercise: Mechanisms and types[J]. Front Endocrinol, 2022, 13:1029475.
[10] Ng CA, Gandham A, Mesinovic J, et al. Effects of moderate-to high-impact exercise training on bone structure across the lifespan: A systematic review and meta-analysis of randomized controlled trials[J]. J Bone Miner Res, 2023, 38(11): 1612-1634.
[11] Casey C, Kemp BJ, Cassidy L, et al. The influence of diet and physical activity on bone density of children aged 5-7 years: The Belfast HAPO family study[J]. Bone, 2023, 172: 116783.
[12] McCaskie C, Siafarikas A, Cochrane Wilkie J, et al. The benefits to bone health in children and pre-school children with additional exercise interventions: A systematic review and meta-analysis[J]. Nutrients, 2023, 15(1): 127.
[13] Ferrer P, Iglesia I, Muniz-Pardos B, et al. Is it important to achieve physical activity recommendations at early stages of life to improve bone health?[J]. Osteoporos Int, 2022, 33(5): 1017-1026.
[14] Proia P, Amato A, Drid P, et al. The impact of diet and physical activity on bone health in children and adolescents[J]. Front Endocrinol, 2021, 12: 704647.
[15] Nestares T, Martín-Masot R, de Teresa C, et al. Influence of Mediterranean diet adherence and physical activity on bone health in celiac children on a gluten-free diet[J]. Nutrients, 2021, 13(5): 1636.
[16] García-Hermoso A, Ezzatvar Y, Ramírez-Vélez R, et al. Is device-measured vigorous physical activity associated with health-related outcomes in children and adolescents? A systematic review and meta-analysis[J]. J Sport Health Sci, 2021, 10(3): 296-307.
[17] Constable AM, Vlachopoulos D, Barker AR, et al. The independent and interactive associations of physical activity intensity and vitamin D status with bone mineral density in prepubertal children: The PANIC Study[J]. Osteoporos Int, 2021, 32(8): 1609-1620.
[18] Zürcher SJ, Jung R, Monnerat S, et al. High impact physical activity and bone health of lower extremities in childhood cancer survivors: A cross-sectional study of SURfit[J]. Int J Cancer, 2020, 147(7): 1845-1854.
[19] Yang X, Zhai Y, Zhang J, et al. Combined effects of physical activity and calcium on bone health in children and adolescents: A systematic review of randomized controlled trials[J]. World J Pediatr, 2020, 16(4): 356-365.
[20] Bouchard C. Bouchard three-day physical activity record[J]. Med Sci Sports Exerc, 1997, 29: 19-24.
[21] 杨月欣, 王光亚, 潘兴昌. 中国食物成分表-第一册, Book 1[M]. 2版. 北京: 北京大学医学出版社, 2009: 4-308.
[22] Chen G, Li Y, Liang S, et al. Associations of dietary anthocyanidins intake with body composition in Chinese children: A cross-sectional study[J]. Food Nutr Res, 2021, 65:1029219/fnr.065.4428.
[23] Marin-Puyalto J, Mäestu J, Gómez-Cabello A, et al. Frequency and duration of vigorous physical activity bouts are associated with adolescent boys' bone mineral status: A cross-sectional study[J]. Bone, 2019, 120: 141-147.
[24] Muñoz-Hernandez V, Arenaza L, Gracia-Marco L, et al. Influence of physical activity on bone mineral content and density in overweight and obese children with low adherence to the Mediterranean dietary pattern[J]. Nutrients, 2018, 10(8): 1075.
[25] Bruyère O, Scott D, Papaioannou A, et al. The impact of sedentary behavior and physical activity on bone health: A narrative review from the rehabilitation working group of the international osteoporosis foundation[J]. Calcif Tissue Int, 2025, 116(1):109.
[26] Hu L, Chen W, Qian A, et al. Wnt/β-catenin signaling components and mechanisms in bone formation, homeostasis, and disease[J]. Bone Res, 2024, 12(1):39.
[27] Zhang H, Wu X, Liang J, et al. Irisin, an exercise-induced bioactive peptide beneficial for health promotion during aging process[J]. Ageing Res Rev, 2022, 80: 101680.
[28] Kim JM, Yang YS, Xie J, et al. Regulation of sclerostin by the SIRT1 stabilization pathway in osteocytes[J]. Cell Death Differ, 2022, 29(8):1625-1638.
[29] Tsourdi E, Anastasilakis AD, Hofbauer LC, et al. Irisin and bone in sickness and in health: A narrative review of the literature[J]. J Clin Med, 2022, 11(22): 6863.
[30] Chaabene H, Ramirez-Campillo R, Moran J, et al. The era of resistance training as a primary form of physical activity for physical fitness and health in youth has come[J]. Sports Med, 2025, 55(9): 2073-2090.