身体成分与绝经后女性人群腰椎体积骨密度的相关性研究

Study on the Correlation between Body Composition and Lumbar Spine Volumetric Bone Mineral Density in Postmenopausal Women

摘要: 目的：本研究旨在探讨未接受抗骨质疏松治疗的绝经后女性中，瘦体重(Lean Mass, LM)和脂肪量(Fat Mass, FM)对腰椎体积骨密度(Lumbar Spine vBMD)的相对贡献，以期为骨质疏松症的早期诊断和干预提供科学依据。方法：本研究纳入113名绝经后女性(平均年龄63.81 ± 7.34岁)，通过双能X线吸收测定法(DXA)评估身体成分(包括LM、FM及其指数)，并通过定量CT (QCT)测定腰椎L1~L3的平均骨密度。采用Pearson相关性分析和多重线性回归分析，探讨身体成分参数与腰椎体积骨密度之间的关系。结果：研究发现腰椎体积骨密度与年龄、绝经年限呈显著负相关(p < 0.001)，与体重、瘦体重(LM)和瘦体重指数(LMI)呈显著正相关(p < 0.05)。回归分析显示，LM是腰椎体积骨密度的唯一显著预测因子(p = 0.018)，而脂肪质量(FM)与腰椎体积骨密度无显著相关性(p > 0.05)。此外，随着骨密度的降低，LM和LMI均显著下降，而FM及其相关指数在三组(正常组、骨质减少组和骨质疏松组)之间无显著差异。结论：瘦体重(LM)是绝经后女性腰椎体积骨密度的重要预测指标。鼓励包括体育活动在内的有利于增强骨骼健康和LM的生活方式，对预防骨质疏松症或肌肉减少症等疾病是十分必要的。

Abstract: Objective: This study aimed to investigate the relative contributions of lean mass (LM) and fat mass (FM) to lumbar spine volumetric bone mineral density (vBMD) in postmenopausal women without anti-osteoporotic treatment, providing scientific evidence for the early diagnosis and intervention of osteoporosis. Methods: A total of 113 postmenopausal women (mean age: 63.81 ± 7.34 years) were included in the study. Body composition parameters, including LM, FM, and their respective indices, were assessed using dual-energy X-ray absorptiometry (DXA). Additionally, the average bone mineral density of the lumbar spine (L1-L3) was measured using quantitative computed tomography (QCT). Pearson correlation analysis and multiple regression analysis were performed to explore the relationships between body composition parameters and lumbar spine vBMD. Results: Lumbar spine vBMD was significantly negatively correlated with age and years since menopause (p < 0.001) and significantly positively correlated with weight, lean mass (LM), and lean mass index (LMI) (p < 0.05). Regression analysis revealed that LM was the only significant predictor of lumbar spine vBMD (p = 0.018), whereas FM showed no significant correlation with lumbar spine vBMD (p > 0.05). Additionally, LM and LMI decreased significantly with lower vBMD, while FM and its related indices did not differ significantly among the three groups (normal, osteopenia, and osteoporosis). Conclusion: Lean mass (LM) is a crucial predictor of lumbar spine vBMD in postmenopausal women. It is necessary to encourage lifestyles, including sports activities, which are beneficial for enhancing bone health and lean mass, in order to prevent diseases such as osteoporosis or sarcopenia.