儿童BMI与骨密度及血糖血脂水平的关系
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摘要
目的探讨儿童身体质量指数(BMI)与其骨密度、血糖及血脂水平的关系。方法选取2017年1月至2018年6月某小学175名学龄儿童作为本次研究对象,根据儿童BMI将其分为过轻组(40例)、正常组(90例)和超重组(45例)。采用骨密度仪测量左胫骨儿童骨密度,清晨空腹取儿童静脉血后,采用全自动生化仪测量儿童血糖血脂水平,比较三组不同BMI儿童骨密度、血糖及血脂水平;同时对儿童BMI与其骨密度、血糖、血脂水平的相关性进行分析。结果正常组和超重组儿童的骨密度、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、低密度脂蛋白(LDL)、三酰甘油(TG)及总胆固醇(TC)均显著高于过轻组(F值分别为95.652、33.988、14.013、79.091、100.645、14.007,均P<0.05),超重组儿童骨密度、FBG、HbA1c、LDL、TG及TC显著高于正常组(t值分别为6.708、3.280、2.092、6.708、8.719、8.188、2.995,均P<0.05),正常组儿童高密度脂蛋白(HDL)显著高于过轻组和超重组(F=57.515,P<0.05)。相关性分析显示儿童BMI与骨密度、FBG、HbA1c、LDL、TG及TC均存在显著正相关关系(r分别为0.723、0.523、0.374、0.690、0.719、0.364,均P<0.05),儿童BMI与HDL存在负相关关系(r=-0.221,P<0.05)。结论体重会对骨量产生一定的保护作用,但过度肥胖可能会造成骨骼损伤。儿童BMI与其骨密度、血糖、血脂水平有显著相关性,超重可能成为儿童糖尿病、高血脂、心血管疾病的危险因素。因而需要加强对儿童体重的有效控制,帮助儿童健康成长。
Objective To study the relationship among body mass index(BMI), bone mineral density, blood glucose and blood lipid in children. Methods From January 2017 to June 2018, 175 school-aged children in a primary school were selected as subjects. According to BMI, they were divided into three groups: underweight group(40 cases), normal group(90 cases) and overweight group(45 cases). Bone mineral density of underweight children was measured by bone mineral density instrument, blood glucose and blood lipid levels were measured by automatic biochemical instrument with fasting venous blood in the morning. Bone mineral density, blood glucose and blood lipid levels were compared among three groups of children with different BMI. At the same time, Spearman correlation analysis was conducted to analyze the correlation between BMI and bone mineral density, blood glucose and blood lipid level in children. Results The bone mineral density, fasting blood-glucose(FBG), hemoglobin A1 c(HbA1 c), low density lipoprotein(LDL), triacylglycerol(TG), total cholesterol(TC) of children in normal group and overweight group were significantly higher than those of underweight group(F value was 95.652, 33.988, 14.013, 79.091, 100.645 and 14.007, respectively, all P<0.05). The bone mineral density, FBG, HbA1 c, LDL, TG and TC of children in overweight group were significantly higher than those of normal group(t value was 6.708, 3.280, 2.092, 6.708, 8.719, 8.188 and 2.995, respectively, all P<0.05). The high density lipoprotein(HDL) of normal group was significantly higher than that of underweight and overweight group(F=57.515, P<0.05). Correlation analysis showed a significantly positive correlation between BMI and the bone mineral density, FBG, HbA1 c, LDL, TG and TC(r value was 0.723, 0.523, 0.374, 0.690, 0.719 and 0.364, respectively, all P<0.05) and a negative correlation between BMI and HDL(r=-0.221, P<0.05). Conclusion Weight protects bone mass, but obesity may cause bone damage. BMI is significantly correlated with bone mineral density, blood glucose and blood lipid levels. Overweight may be a risk factor for diabetes, hyperlipidemia and cardiovascular disease in children. Therefore, it is necessary to strengthen the effective control of children's weight to help them grow up healthily.
Objective To study the relationship among body mass index(BMI), bone mineral density, blood glucose and blood lipid in children. Methods From January 2017 to June 2018, 175 school-aged children in a primary school were selected as subjects. According to BMI, they were divided into three groups: underweight group(40 cases), normal group(90 cases) and overweight group(45 cases). Bone mineral density of underweight children was measured by bone mineral density instrument, blood glucose and blood lipid levels were measured by automatic biochemical instrument with fasting venous blood in the morning. Bone mineral density, blood glucose and blood lipid levels were compared among three groups of children with different BMI. At the same time, Spearman correlation analysis was conducted to analyze the correlation between BMI and bone mineral density, blood glucose and blood lipid level in children. Results The bone mineral density, fasting blood-glucose(FBG), hemoglobin A1 c(HbA1 c), low density lipoprotein(LDL), triacylglycerol(TG), total cholesterol(TC) of children in normal group and overweight group were significantly higher than those of underweight group(F value was 95.652, 33.988, 14.013, 79.091, 100.645 and 14.007, respectively, all P<0.05). The bone mineral density, FBG, HbA1 c, LDL, TG and TC of children in overweight group were significantly higher than those of normal group(t value was 6.708, 3.280, 2.092, 6.708, 8.719, 8.188 and 2.995, respectively, all P<0.05). The high density lipoprotein(HDL) of normal group was significantly higher than that of underweight and overweight group(F=57.515, P<0.05). Correlation analysis showed a significantly positive correlation between BMI and the bone mineral density, FBG, HbA1 c, LDL, TG and TC(r value was 0.723, 0.523, 0.374, 0.690, 0.719 and 0.364, respectively, all P<0.05) and a negative correlation between BMI and HDL(r=-0.221, P<0.05). Conclusion Weight protects bone mass, but obesity may cause bone damage. BMI is significantly correlated with bone mineral density, blood glucose and blood lipid levels. Overweight may be a risk factor for diabetes, hyperlipidemia and cardiovascular disease in children. Therefore, it is necessary to strengthen the effective control of children's weight to help them grow up healthily.
引文
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[13]Fu S, Luo L, Ye P, et al.Overall and abdominal obesity indicators had different association with central arterial stiffness and hemodynamics independent of age, sex, blood pressure, glucose, and lipids in Chinese community-dwelling adults[J].Clinical Interventions in Aging,2013,8(default):1579-1584.
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[15]Sonestedt E, Hellstrand S, Drake I, et al.Diet quality and change in blood lipids during 16 years of follow-up and their Interaction with genetic risk for dyslipidemia[J].Nutrients,2016,8(5):274.
[16]王晓霞,杨惠兰.肥胖儿童脂代谢紊乱与血管早期病变关联分析[J].中国妇幼健康研究,2012,23(5):605-607.
[2]唐咏梅,刘为甜,任琦,等.唐山市青少年骨密度变化趋势及相关因素分析[J].中国学校卫生,2014,35(5):694-696.
[3]Hoffmann S, Rupprecht M, Stücker R.Orthopedic Problems in Overweight and Obese Children[J].Klinische Padiatrie,2015,228(2):55.
[4]Zou Z Y, Yang Y D, Wang S, et al.The importance of blood lipids in the association between BMI and blood pressure among Chinese overweight and obese children[J].British Journal of Nutrition,2016,116(1):45-51.
[5]邱申伟.我国儿童生长发育和营养状况评价标准的应用进展[J].中国学校卫生,2014,35(1):158-160.
[6]Haddaway M J, Davie M W, Mccall I W.Bone mineral density in healthy normal women and reproducibility of measurements in spine and hip using dual-energy X-ray absorptiometry[J].British Journal of Radiology,2014,65(771):213.
[7]Dey S, Jahan A, Yadav T P, et al.Measurement of bone mineral density by dual energy X-ray absorptiometry in juvenile ldiopathic arthritis[J].Indian Journal of Pediatrics,2014,81(2):126-132.
[8]Ismael Forte Freitas Júnior, Cardoso J R, Christofaro D G D, et al.The relationship between visceral fat thickness and bone mineral density in sedentary obese children and adolescents[J].Bmc Pediatrics,2013,13(1):37.
[9]张晟,闫鲜鹏.儿童体质指数定期检测及骨密度测试在儿童保健发育中应用分析[J].陕西医学杂志,2018,47(7):846-848.
[10]廖新,文江舸,宋亮亮,等.5～14岁儿童的体格发育与骨密度的相关性分析[J].中国妇幼健康研究,2012,23(1):76-78.
[11]Cui R, Zhou L, Li Z, et al.Assessment risk of osteoporosis in Chinese people: relationship among body mass index, serum lipid profiles, blood glucose, and bone mineral density[J].Clinical Interventions in Aging,2016,11(Issue 1):887-895.
[12]双家兵,彭页,陈宇飞.探析1 200例健康体检人群血糖、血脂及血压与肥胖、超重的关系[J].医学研究杂志,2016,45(9):81-84.
[13]Fu S, Luo L, Ye P, et al.Overall and abdominal obesity indicators had different association with central arterial stiffness and hemodynamics independent of age, sex, blood pressure, glucose, and lipids in Chinese community-dwelling adults[J].Clinical Interventions in Aging,2013,8(default):1579-1584.
[14]于平,杜雪平,董建琴,等.2型糖尿病患者社区规范化管理后血糖指标变化及慢性并发症发生情况分析[J].中国全科医学,2014,17(12):1423-1426.
[15]Sonestedt E, Hellstrand S, Drake I, et al.Diet quality and change in blood lipids during 16 years of follow-up and their Interaction with genetic risk for dyslipidemia[J].Nutrients,2016,8(5):274.
[16]王晓霞,杨惠兰.肥胖儿童脂代谢紊乱与血管早期病变关联分析[J].中国妇幼健康研究,2012,23(5):605-607.