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目的利用不同人体测量指标,调查分析成都地区50岁以上男性居民中肥胖与骨质疏松的相关性。方法采集在四川大学华西医院进行健康体检的50岁以上男性受检者的临床资料,并测量和计算不同人体测量参数。使用MetriScan手掌骨密度测量仪进行骨密度测定,并根据T值将受试者分为3组(正常骨密度组、骨量减少组和骨质疏松组),比较各组间肥胖的检出率。将体质量指数(BMI)、体圆柱指数(BRI)、腰围、腰高比(WHtR)、腰臀比(WHR)、身体形态指数(ABSI)和身高等人体测量参数分别按四分位数等分为Q1、Q2、Q3、Q4四组,均以Q1组为参照组,采用单因素及年龄矫正后的多元logistic回归分析上述人体测量参数与骨质疏松检出风险的关系。同时计算各指标受试者操作特征(ROC)曲线的曲线下面积(AUC)。结果共纳入9 135例成都地区50岁以上男性居民,其中骨质疏松症的检出率为5.75%(525例)。骨质疏松组各种人体测量参数(BMI、WHR、WHtR、体质量、腰围、臀围、ABSI、BRI等)与骨量减少组和正常骨密度组比较差异具有统计学意义(P<0.01)。与最低四分位数(Q1)组相比,BMI、BRI、WHtR、WHR、ABSI、腰围和身高的最高四分位数(Q4)组受检者合并骨质疏松的经年龄矫正的比值比分别为0.443〔95%可信区间(CI):0.342~0.574〕、0.580(95%CI:0.454~0.740)、0.587(95%CI:0.460~0.751)、0.664(95%CI:0.516~0.854)、1.369(95%CI:1.069~1.751)、0.634(95%CI:0.497~0.809)、1.357(95%CI:1.047~1.758)。ROC曲线分析显示,BMI对骨质疏松的AUC为0.606(95%CI:0.580~0.632)。结论肥胖与男性骨质疏松呈一定的负相关,利用BMI测量的肥胖对男性骨质疏松有潜在的预测价值,需要进一步的纵向研究明确其临床意义。
Objective To investigate the correlation between obesity and osteoporosis among over 50-year-old male residents in Chengdu using different anthropometric indexes. Methods The clinical data of 50-year-old male subjects who had taken physical examination in West China Hospital of Sichuan University were collected and measured and calculated by different human body parameters. The bone mineral density (BMD) was measured using a MetriScan palm bone density meter. According to the T value, the subjects were divided into three groups (normal BMD group, osteopenia group and osteoporosis group). The detection rate of obesity . Body mass index (BMI), body mass index (BRI), waist circumference, waist-to-hip ratio (WHtR), waist-hip ratio (WHR), body shape index (ABSI) and height were measured by quartiles The four groups of Q1, Q2, Q3 and Q4 were all treated with Q1 group as reference group. The multivariate logistic regression after single factor and age correction was used to analyze the relationship between the above anthropometric parameters and the risk of osteoporosis. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve for each indicator was also calculated. Results A total of 9 135 male residents over the age of 50 in Chengdu were included. The detection rate of osteoporosis was 5.75% (525 cases). There was significant difference between osteoporosis group and normal bone mineral density group (P <0.01). The body mass index (BMI, WHR, WHtR, body mass, waist circumference, hip circumference, ABSI, . Compared to the lowest quartile (Ql) group, odds ratios for age-adjusted osteoporosis with BMI, BRI, WHtR, WHR, ABSI, waist circumference and height in the highest quartile (Q4) (95% confidence interval CI: 0.342-0.574), 0.580 (95% CI: 0.454-0.740), 0.587 (95% CI: 0.460-0.751) and 0.664 (95% CI 0.516-0.854) , 1.369 (95% CI: 1.069-1.751), 0.634 (95% CI: 0.497-0.809), 1.357 (95% CI: 1.047-1.758). ROC curve analysis showed that AUC of BMI for osteoporosis was 0.606 (95% CI: 0.580-0.632). Conclusion Obesity has a certain negative correlation with osteoporosis in males. The obesity predicted by BMI has potential value in predicting osteoporosis in males. Further studies are needed to determine its clinical significance.