CAJ | 학술논문

目的：观察上海地区部分女性髋部骨几何结构指标随增龄的变化趋势，评估人体成分（骨骼、肌肉及脂肪）对其的影响，比较不同肌肉脂肪分布对骨结构影响的差异，探讨上海地区女性髋部骨结构与人体成分的相关性及影响因素。方法679名年龄为21～94岁的上海地区健康成年女性纳入本研究。受试者根据年龄分为青年组（21～40岁）、中年组（41岁～绝经）和绝经组。应用双能 X 线吸收仪（ DXA）检测骨密度、肌肉量、脂肪量，用DXA自带软件髋部骨结构分析系统（ HSA）测定股骨颈、转子间和股骨干3个部位的骨结构指标，包括横截面积（ CSA ）、平均皮质厚度（ ACT ）以及弯曲系数（ BR ）。采用Pearson （正态分布）或Spearman （非正态分布）进行相关性检验，采用多元回归Stepwise进行归因分析。结果上海地区部分女性腰椎和髋部骨密度、 CSA和ACT在31～40岁达峰值，随年龄增长逐渐下降，腰椎骨密度在60岁后上升；肌肉量在31～40岁达峰值，随后逐渐下降；脂肪量随年龄的增加上升。髋部骨密度与股骨颈、转子间、股骨干3个部位骨结构指标CSA、 ACT、 BR具有相关性；全身肌肉含量与股骨颈、转子间、股骨干CSA均呈正相关，与BR呈微弱负相关；全身脂肪对股骨颈、转子间、股骨干的CSA、ACT以及BR影响不一致。青年组全身脂肪含量与CSA和ACT呈微弱正相关，但随年龄增长，全身脂肪量对骨结构的正性作用逐渐增强。随着增龄，躯干部位肌肉量对女性骨结构影响始终显著大于四肢部位肌肉量。结论髋部骨密度与髋部骨几何结构指标相关性最强，肌肉含量与髋部骨几何结构指标也明显相关；不同年龄女性人群脂肪量对骨结构的影响程度不同，具有时间性差异；躯干肌肉量对骨结构影响程度显著高于四肢肌肉量，具有空间性差异。目的：觀察上海地區部分女性髖部骨幾何結構指標隨增齡的變化趨勢，評估人體成分（骨骼、肌肉及脂肪）對其的影響，比較不同肌肉脂肪分佈對骨結構影響的差異，探討上海地區女性髖部骨結構與人體成分的相關性及影響因素。方法679名年齡為21～94歲的上海地區健康成年女性納入本研究。受試者根據年齡分為青年組（21～40歲）、中年組（41歲～絕經）和絕經組。應用雙能 X 線吸收儀（ DXA）檢測骨密度、肌肉量、脂肪量，用DXA自帶軟件髖部骨結構分析繫統（ HSA）測定股骨頸、轉子間和股骨榦3箇部位的骨結構指標，包括橫截麵積（ CSA ）、平均皮質厚度（ ACT ）以及彎麯繫數（ BR ）。採用Pearson （正態分佈）或Spearman （非正態分佈）進行相關性檢驗，採用多元迴歸Stepwise進行歸因分析。結果上海地區部分女性腰椎和髖部骨密度、 CSA和ACT在31～40歲達峰值，隨年齡增長逐漸下降，腰椎骨密度在60歲後上升；肌肉量在31～40歲達峰值，隨後逐漸下降；脂肪量隨年齡的增加上升。髖部骨密度與股骨頸、轉子間、股骨榦3箇部位骨結構指標CSA、 ACT、 BR具有相關性；全身肌肉含量與股骨頸、轉子間、股骨榦CSA均呈正相關，與BR呈微弱負相關；全身脂肪對股骨頸、轉子間、股骨榦的CSA、ACT以及BR影響不一緻。青年組全身脂肪含量與CSA和ACT呈微弱正相關，但隨年齡增長，全身脂肪量對骨結構的正性作用逐漸增彊。隨著增齡，軀榦部位肌肉量對女性骨結構影響始終顯著大于四肢部位肌肉量。結論髖部骨密度與髖部骨幾何結構指標相關性最彊，肌肉含量與髖部骨幾何結構指標也明顯相關；不同年齡女性人群脂肪量對骨結構的影響程度不同，具有時間性差異；軀榦肌肉量對骨結構影響程度顯著高于四肢肌肉量，具有空間性差異。
목적：관찰상해지구부분녀성관부골궤하결구지표수증령적변화추세，평고인체성분（골격、기육급지방）대기적영향，비교불동기육지방분포대골결구영향적차이，탐토상해지구녀성관부골결구여인체성분적상관성급영향인소。방법679명년령위21～94세적상해지구건강성년녀성납입본연구。수시자근거년령분위청년조（21～40세）、중년조（41세～절경）화절경조。응용쌍능 X 선흡수의（ DXA）검측골밀도、기육량、지방량，용DXA자대연건관부골결구분석계통（ HSA）측정고골경、전자간화고골간3개부위적골결구지표，포괄횡절면적（ CSA ）、평균피질후도（ ACT ）이급만곡계수（ BR ）。채용Pearson （정태분포）혹Spearman （비정태분포）진행상관성검험，채용다원회귀Stepwise진행귀인분석。결과상해지구부분녀성요추화관부골밀도、 CSA화ACT재31～40세체봉치，수년령증장축점하강，요추골밀도재60세후상승；기육량재31～40세체봉치，수후축점하강；지방량수년령적증가상승。관부골밀도여고골경、전자간、고골간3개부위골결구지표CSA、 ACT、 BR구유상관성；전신기육함량여고골경、전자간、고골간CSA균정정상관，여BR정미약부상관；전신지방대고골경、전자간、고골간적CSA、ACT이급BR영향불일치。청년조전신지방함량여CSA화ACT정미약정상관，단수년령증장，전신지방량대골결구적정성작용축점증강。수착증령，구간부위기육량대녀성골결구영향시종현저대우사지부위기육량。결론관부골밀도여관부골궤하결구지표상관성최강，기육함량여관부골궤하결구지표야명현상관；불동년령녀성인군지방량대골결구적영향정도불동，구유시간성차이；구간기육량대골결구영향정도현저고우사지기육량，구유공간성차이。
Objective To investigate the correlation between hip geometric structure and body composition in-cluding bone mineral density (BMD), lean mass (LM) and fat mass (FM) in health women in Shanghai.Methods A total of 679 healthy women in Shanghai which were divided into three groups: young (2140y), middle-aged (41y-menopause ) , and postmenopausal .Women were evaluated by assessing BMD of lumber spine and total hip , total lean mass, total fat mass, and hip geometric parameters such as cross-sectional area (CSA), average cortical thickness (ACT), and bucking ratio (BR) at narrow neck (NN), intertrochanteric (IT), and shaft (FS).Correlation analysis was performed by Pearson ( normal distribution ) or Spearman ( abnormal distribution ) test, and attribution analysis was performed by stepwise test of multiple regressions .Results The peak BMD values of the spine and total hip were ob-served at age 31 to 40 years.The peak LM and FM were observed at age 31 to 40 years.The hip geometric parameters in-cluding CSA and ACT at NN , IT and FS both reached their peaks at 31 to 40 years, and valley BR at three regions above mentioned was observed at 31 to 40 years as well .The correlation between hip BMD and hip geometric structure were the strongest at all three regions .LM showed significantly positive correlations with CSA and negative correlation with BR .FM effect on hip geometric parameters at the three regions were inconsistent .The positive contribution produced by FM to hip geometric structure became stronger gradually with aging .The contribution produced by trunk LM was the largest positive contribution to CSA and ACT in all group .Conclusion Among all body composition parameters , hip BMD showed the best correlation with hip geometric structure .LM produced the second greatest contribution .The impact of FM and LM on hip geometry changed with aging and different distributions .