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目的腹部脂肪与腰椎骨质密度(BMD)关系密切,但大多研究未考虑年龄因素的影响。文中重点探讨腹部脂肪及年龄对女性腰椎BMD影响的协同作用,以加深对骨质疏松发生机制的认识。资料与方法收集2014年1-12月南方医科大学第三附属医院健康志愿者及慢性腰腿痛女性患者共79例,年龄25~76岁,平均(51.5±12.6)岁。所有研究对象均计算体重指数(BMI)。行定量CT(QCT)腹部扫描,测量腰椎(L_3)的BMD及相应层面的腹部皮下脂肪(SAT)与内脏脂肪(VAT)含量。根据79例患者的BMD分为骨质疏松组、骨量减少组和骨量正常组,比较各组间年龄、BMI、SAT及VAT差异,分析年龄与VAT的交互作用及相关性。结果 3组间比较,年龄、VAT差异均有统计学意义(F=65.715、13.546,P<0.05),3组间BMI、SAT比较差异无统计学意义(F=2.479、2.451,P>0.05);年龄对VAT影响腰椎BMD具有明显交互作用,控制年龄变量后,3组间VAT含量比较差异无统计学意义(F=0.575,P>0.05);年龄与BMD呈负相关性(r=-0.842,P<0.05),与VAT呈正相关性(r=0.566,P<0.05)。结论年龄是影响女性腰椎BMD的主要负性因素,对VAT影响女性腰椎BMD有交互作用。控制年龄变量后,VAT对女性腰椎BMD无明显影响。因此,在研究腹部脂肪与骨质疏松的关系时应考虑年龄的交互因素。
The purpose of abdominal fat and lumbar bone mineral density (BMD) are closely related, but most of the research did not consider the impact of age. This paper focuses on the synergy of abdomen fat and age on female lumbar BMD to deepen the understanding of the mechanism of osteoporosis. Materials and Methods A total of 79 healthy volunteers at the Third Affiliated Hospital of Southern Medical University and women with chronic low back pain from January 2014 to January 2014 were collected, ranging in age from 25 to 76 years with a mean of (51.5 ± 12.6) years. All subjects calculated body mass index (BMI). Quantitative CT (QCT) abdomen scanning was performed to measure the BMD of the lumbar spine (L_3) and the corresponding abdominal subcutaneous fat (SAT) and visceral fat (VAT) contents. According to the BMD of 79 patients, the BMD was divided into osteoporosis group, osteopenia group and normal bone mass group. The differences in age, BMI, SAT and VAT between groups were analyzed. The interaction and correlation between age and VAT were analyzed. Results There was no significant difference in BMI and SAT between the three groups (F = 2.479, 2.451, P> 0.05) There was a significant interaction between age and VAT on lumbar spine BMD. There was no significant difference in VAT content between the three groups after age control (F = 0.575, P> 0.05). Age was negatively correlated with BMD (r = -0.842 , P <0.05), and had a positive correlation with VAT (r = 0.566, P <0.05). Conclusion Age is the main negative factor affecting the lumbar spine BMD in female and interacts with VAT on lumbar spine BMD in women. After controlling for age variables, VAT had no significant effect on lumbar BMD in women. Therefore, in the study of the relationship between abdominal fat and osteoporosis should consider age interaction factors.