定量CT测量青年人群腰椎骨密度与脂肪分布的关系
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摘要
背景:诊断骨质疏松症主要依靠骨密度测量,骨密度与遗传、环境、脂肪分布等多项因素有关。目前双能X射线骨密度仪和定量CT为测量骨密度的主要方法。目的:探讨定量CT测量青年人群腰椎骨密度与脂肪分布的关系。方法:严格按照筛选方案,选择北京市区、北京郊区20-40岁青年志愿者262名,所有志愿者对测量方案均知情同意。利用定量CT测量L2-L4椎体骨密度及L4椎体中间层面腹内脂肪面积、皮下脂肪面积及腹部总脂肪面积,采用Pearson相关及多元线性回归分析法对骨密度及相关脂肪指标进行相关性分析。结果与结论:①北京地区青年人群腹内脂肪面积与骨密度呈负相关(P <0.05);②而皮下脂肪面积、腹部总脂肪面积与骨密度无相关性;③建议测量青年人群腰椎松质骨骨密度,控制青年人群过度肥胖,以利于骨质疏松的预防和早期诊断工作。
BACKGROUND: Bone mineral density is used for the diagnosis of osteoporosis, and bone mineral density is related to genetic, environment and fat distribution factors. Dual energy X-ray absorptiometry and quantitative CT are main methods of measuring bone mineral density.OBJECTIVE: To investigate the relationship between lumbar spine bone mineral density and fat distribution in young adults by quantitative CT.METHODS: Totally 262 young adults aged 20-40 years in Beijing urban and suburb areas were screened based on inclusion and exclusion criteria, and all volunteers provided written informed consents. Quantitative CT was used to measure the intra-abdominal fat area, subcutaneous fat area and total abdominal fat area of L2-L4 bone mineral density and L4 vertebrae. The relationship between bone mineral density and fat distribution was analyzed by Pearson correlation analysis and multivariate linear regression.RESULTS AND CONCLUSION:(1) The area of intra-abdominal fat was negatively correlated with bone mineral density in young adults in Beijing(P < 0.05).(2) The area of subcutaneous fat and total abdominal fat were not correlated with bone mineral density.(3) Therefore, it is suggested to measure the bone mineral density of lumbar spondylous bone in young people and control obesity, so as to prevent osteoporosis and make early diagnosis.
BACKGROUND: Bone mineral density is used for the diagnosis of osteoporosis, and bone mineral density is related to genetic, environment and fat distribution factors. Dual energy X-ray absorptiometry and quantitative CT are main methods of measuring bone mineral density.OBJECTIVE: To investigate the relationship between lumbar spine bone mineral density and fat distribution in young adults by quantitative CT.METHODS: Totally 262 young adults aged 20-40 years in Beijing urban and suburb areas were screened based on inclusion and exclusion criteria, and all volunteers provided written informed consents. Quantitative CT was used to measure the intra-abdominal fat area, subcutaneous fat area and total abdominal fat area of L2-L4 bone mineral density and L4 vertebrae. The relationship between bone mineral density and fat distribution was analyzed by Pearson correlation analysis and multivariate linear regression.RESULTS AND CONCLUSION:(1) The area of intra-abdominal fat was negatively correlated with bone mineral density in young adults in Beijing(P < 0.05).(2) The area of subcutaneous fat and total abdominal fat were not correlated with bone mineral density.(3) Therefore, it is suggested to measure the bone mineral density of lumbar spondylous bone in young people and control obesity, so as to prevent osteoporosis and make early diagnosis.
引文
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[22]Ambrose T,Sharkey LM,Louis-Auguste J,et al.Prevalence of low bone mineral density in patients undergoing intestinal or multivisceral transplantation at addenbrooke’s hospital,cambridge.Gut.2015;64(Suppl 1):A316.
[23]林慧榕.福建沿海地区超重及肥胖人群血压、血脂现状分析[J].心血管康复医学杂志,2016,25(1):6-11.
[24]韩雪莉,吴艳,郭华,等.定量CT测定人体腹部脂肪分布、肝脏脂肪含量与肥胖的相关性[J].中国医学影像技术,2017,33(s1):90-92.
[25]Takeoka A,Tayama J,Yamasaki H,et al.Intra-abdominal fat accumulation is a hypertension risk factor in young adulthood:Across-sectional study.Medicine.2016;95(45):e5361.
[2]杨丽君,吴永华,张俐.肌少症、骨质疏松症的关系及研究进展[J].中国骨质疏松杂志,2017,23(8):1112-1116.
[3]刘灵洁,林芳.青年肾移植后骨质疏松症的护理[J].中国中西医结合肾病杂志,2011,12(7):634-635.
[4]桂继琮,刘兴党,高光琦.健康中青年男性体检者骨密度现状研究[J].中国骨质疏松杂志,2008,14(10):729-732.
[5]T?nnesen R,Schwarz P,Hovind PH,et al.Physical exercise associated with improved BMD independently of sex and vitamin D levels in young adults.Eur J Appl Physiol.2016;116(7):1297-1304.
[6]Wills JW,Long AS,Johnson GE,et al.Empirical analysis of BMDmetrics in genetic toxicology part II:in vivo potency comparisons to promote reductions in the use of experimental animals for genetic toxicity assessment.Mutagenesis.2016;31(3):265-275.
[7]袁淑燕,李彩霞,林贞,等.学龄前儿童骨密度水平变化及环境和膳食等影响因素分析[J].医药论坛杂志,2015,36(5):29-30.
[8]Lv S,Zhang A,Di W,et al.Assessment of fat distribution and bone quality with trabecular bone score(tbs)in healthy chinese men.Sci Rep.2016;6:24935.
[9]K?lvesten J,Lui LY,Brismar T,et al.Digital X-ray radiogrammetry in the study of osteoporotic fractures:Comparison to dual energy X-ray absorptiometry and FRAX.Bone.2016;6:30-35.
[10]Zhi-Kai LI,Sha L.Analysis of correlation between lumbar disc herniation and bone mineral density detecting by quantitative CT in elderly patients.Pract Geriatr.2018.
[11]Islamian JP,Garoosi I,Fard KA,et al.Comparison between the MDCTand the DXA scanners in the evaluation of BMD in the lumbar spine densitometry.Egypt J Radiol Nucl Med.2016;47(3):961-967.
[12]黄英,张慧,蔡跃,等缺牙区松质骨密度的定量CT法测量[J].中国组织工程研究,2017,21(36):5775-5780.
[13]Wei S,Jianjun Z,Junjie F,et al.Measurement of BMD in lumbar bone with QCT and analysis of BMD value with related laboratory indexes.JMed Imaging.2018.
[14]Hasegawa Y,Ariyasu D,Izawa M,et al.Gradually increasing ethinyl estradiol for Turner syndrome may produce good final height but not ideal BMD.Endocr J.2016;64(2):221-227.
[15]Gába A,Cuberek R,Svoboda Z,et al.The effect of brisk walking on postural stability,bone mineral density,body weight and composition in women over 50 years with a sedentary occupation:a randomized controlled trial.BMC Womens Health.2016;16(1):63.
[16]Palermo A,Tuccinardi D,Defeudis G,et al.BMI and BMD:the potential interplay between obesity and bone fragility.Int J Environ Res Public Health.2016;13(6).pii:E544.
[17]Choi MJ.Taurine may modulate bone in cholesterol fed estrogen deficiency-induced rats.Adv Exp Med Biol.2017;975 Pt 2:1093-1102.
[18]Soon G,Quintin A,Scalfo F,et al.PIXImus bone densitometer and associated technical measurement issues of skeletal growth in the young rat.Calcif Tissue Int.2006;78(3):186-192.
[19]孙微,郑建军,方军杰,等.QCT对腰椎BMD值的测量及BMD值与相关实验室指标分析[J].医学影像学杂志,2018,28(1):141-144.
[20]Wokke BH,Van Den Bergen JC,Hooijmans MT,et al.T2 relaxation times are increased in skeletal muscle of DMD but not BMD patients.Muscle Nerve.2016;53(1):38-43.
[21]宋敏,刘小钰,蒋林博,等.肌肉微环境与骨质疏松[J].中国骨质疏松杂志,2017,23(12):1654-1659.
[22]Ambrose T,Sharkey LM,Louis-Auguste J,et al.Prevalence of low bone mineral density in patients undergoing intestinal or multivisceral transplantation at addenbrooke’s hospital,cambridge.Gut.2015;64(Suppl 1):A316.
[23]林慧榕.福建沿海地区超重及肥胖人群血压、血脂现状分析[J].心血管康复医学杂志,2016,25(1):6-11.
[24]韩雪莉,吴艳,郭华,等.定量CT测定人体腹部脂肪分布、肝脏脂肪含量与肥胖的相关性[J].中国医学影像技术,2017,33(s1):90-92.
[25]Takeoka A,Tayama J,Yamasaki H,et al.Intra-abdominal fat accumulation is a hypertension risk factor in young adulthood:Across-sectional study.Medicine.2016;95(45):e5361.