儿童青少年身体不同部位脂肪分布与全身骨密度的关联

陈璟然; 陈曼曼; 何辉明; 李梦龙; 孙梦洋; 胡翼飞

doi:10.16835/j.cnki.1000-9817.2025201

儿童青少年身体不同部位脂肪分布与全身骨密度的关联

doi: 10.16835/j.cnki.1000-9817.2025201

陈璟然¹,
陈曼曼^{2, 3},
何辉明⁴,
李梦龙⁴,
孙梦洋⁴,
胡翼飞^4, ,

1.
首都医科大学燕京医学院, 北京 101300
2.
中国医学科学院/北京协和医学院群医学及公共卫生学院
3.
北京大学公共卫生学院儿童青少年卫生研究所
4.
首都医科大学公共卫生学院儿少卫生与妇幼保健学系

基金项目:

首都医科大学2025年基础科研创新项目 XSKY2025094

详细信息

作者简介:
陈璟然(2002-), 女, 山东新汶人, 在读本科生

通讯作者:
胡翼飞, E-mail: huyifei@yahoo.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R336 Q954.65⁺⁵
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- PDF下载量: 6
- 被引次数: 0
出版历程
- 收稿日期: 2025-03-28
- 修回日期: 2025-05-06
- 网络出版日期: 2025-08-02
- 刊出日期: 2025-07-25

Association between different regional fat distribution and total body bone mineral density in children and adolescents

1.
Yanjing Medical College, Capital Medical University, Beijing 101300, China

摘要

摘要: 目的分析北京市7~17岁儿童青少年身体各部位脂肪量与全身骨密度的关联，为实施干预提供理论依据和实践指导。方法 2020年9—12月，采用分层整群随机抽样方法选取1 423名北京市通州区7~17岁儿童青少年为研究对象，使用双能X线吸收法测量评估各部位体成分及全身骨密度，采用多元线性回归分析各部位脂肪量与全身骨密度的关联。结果儿童青少年全身脂肪量、上肢脂肪量、腹部脂肪量、臀部脂肪量、大腿脂肪量分别为13.51(8.84，19.21)，1.59(1.08，2.23)，0.73(0.39，1.29)，2.32(1.46，3.26)，5.29(3.59，7.21)kg。多元线性回归分析结果显示，调整协变量后，儿童青少年全身、腹部、臀部脂肪量与全身骨密度之间具有一定相关性(β值分别为0.010，-0.100，0.104，P值均 < 0.01)。分性别分析，男生全身脂肪量(β=0.008)和臀部脂肪量(β=0.058)与全身骨密度均呈正相关，大腿脂肪量(β=-0.038)与全身骨密度呈负相关(P值均 < 0.05)；女生全身脂肪量(β=0.013)、臀部脂肪量(β=0.163)、大腿脂肪量(β=0.023)与全身骨密度均呈正相关，腹部脂肪量(β=-0.196)与全身骨密度呈负相关(P值均 < 0.05)。体脂率低于标准范围、标准范围、高于标准范围儿童青少年的全身脂肪量与全身骨密度均呈正相关(β值分别为0.021，0.016，0.015)，在体脂率标准范围内的儿童青少年的上肢、腹部、大腿脂肪量与全身骨密度均呈负相关(β值分别为-0.042，-0.067，-0.018)，臀部脂肪量与全身骨密度呈正相关(β=0.082)(P值均 < 0.05)。结论儿童青少年身体不同部位脂肪量与全身骨密度相关，且关联受性别、体脂率影响。
- 脂肪组织 /
- 骨密度 /
- 回归分析 /
- 儿童 /
- 青少年
Abstract: Objective To analyze the association between each regional fat mass and total body bone mineral density (BMD) in children and adolescents aged 7-17 years in Beijing, so as to provide theoretical basis and practical guidance for implementing interventions. Methods From September to December 2020, a stratified cluster random sampling method was used to select 1 423 children and adolescents aged 7-17 years in Tongzhou District, Beijing. Dual-energy X-ray absorptiometry (DXA) was employed to measure regional body composition and total body BMD. Multiple linear regression was used to analyze the association between regional fat mass and total body BMD. Results The median (interquartile range) fat mass values for total body, upper limbs, abdomen, hips, and thighs were 13.51(8.84, 19.21), 1.59(1.08, 2.23), 0.73(0.39, 1.29), 2.32(1.46, 3.26), 5.29(3.59, 7.21)kg, respectively. After adjusting for covariates, the results of multiple linear regression analysis showed that total body fat mass (β=0.010), abdominal fat mass (β=-0.100), and hip fat mass (β=0.104) were significant associations with total body BMD (all P < 0.01). Sex-stratified analysis revealed that in boys, total body fat mass (β=0.008) and hip fat mass (β=0.058) were positively associated with BMD, while thigh fat mass (β=-0.038) showed a negative association with total body BMD (all P < 0.05). In girls, total body fat mass (β=0.013), hip fat mass (β=0.163), and thigh fat mass (β=0.023) were positively associated with total body BMD, whereas abdominal fat mass (β=-0.196) showed a negative association with total body BMD (all P < 0.05). Among children and adolescents with body fat percentage below the standard range, within the standard range and above the standard range, total body fat masses were positively associated with total body BMD (β=0.021, 0.016, 0.015); among children and adolescents with body fat percentage within the standard range while upper limb (β=-0.042), abdominal (β=-0.067), and thigh fat mass (β=-0.018) showed negative associations with total body BMD, and hip fat mass demonstrated a positive association with total body BMD (β=0.082) (all P < 0.05). Conclusion Regional fat distribution is associated with total body BMD in children and adolescents, with the nature of these associations varying by sex and body fat percentage.
- Adipose tissue /
- Bone density /
- Regression analysis /
- Child /
- Adolescent
注释:

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表 1 不同性别儿童青少年体成分及健康行为特征比较[M(P₂₅，P₇₅)]

Table 1. Comparison of body composition and health behavior characteristics among children and adolescents by genders[M(P₂₅, P₇₅)]

性别	人数	全身脂肪量/kg		上肢脂肪量/kg	腹部脂肪量/kg	臀部脂肪量/kg	大腿脂肪量/kg	全身骨密度/(g·cm^-3)^a
男	715	12.09(8.18, 18.29)		1.43(1.01, 2.09)	0.67(0.34, 1.27)	2.00(1.32, 2.98)	4.63(3.33, 6.83)	0.93±0.17
女	708	14.50(9.98, 20.01)		1.70(1.21, 2.35)	0.79(0.46, 1.29)	2.63(1.76, 3.52)	5.73(4.11, 7.60)	0.94±0.17
总体	1 423	13.51(8.84, 19.21)		1.59(1.08, 2.23)	0.73(0.39, 1.29)	2.32(1.46, 3.26)	5.29(3.59, 7.21)	0.94±0.17
t/Z值		-4.78		-5.28	-2.89	-7.38	-5.98	-0.91
P值		< 0.01		< 0.01	< 0.01	< 0.01	< 0.01	0.36

性别	人数	体质量指数/(kg·m^-2)^a	睡眠时间/(h·d^-1)^a	每日中高强度体力活动时间/h	每日蔬菜摄入量/份	每周含糖饮料摄入量/份	每周肉类摄入量/份	每日水果摄入量/份
男	715	20.65±4.76	7.68±1.20	0.64(0.38, 1.29)	1.71(1.00, 2.00)	1.00(0.00, 3.00)	7.00(6.00, 14.00)	1.00(0.57, 1.71)
女	708	20.25±4.64	7.59±1.29	0.57(0.29, 0.95)	2.00(1.00, 2.00)	1.00(0.00, 3.00)	7.00(6.00, 10.50)	1.00(0.71, 2.00)
总体	1 423	20.45±4.70	7.64±1.25	0.62(0.36, 1.13)	2.00(1.00, 2.00)	1.00(0.00, 3.00)	7.00(6.00, 14.00)	1.00(0.57, 1.71)
t/Z值		1.88	1.36	-3.95	-1.83	-2.52	-3.18	-2.88
P值		0.06	0.17	< 0.01	0.07	0.01	< 0.01	< 0.01
注：^a数据符合正态分布，采用(x ± s)描述。

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表 2 分性别儿童青少年各部位脂肪量与全身骨密度的关联[β值(95%CI)]

Table 2. Association between regional fat mass and total body BMD among children and adolescents of different genders[β(95%CI)]

脂肪量部位	男(n=715)	女(n=708)	总体(n=1 423)
全身	0.008(0.006~0.009)^**	0.013(0.012~0.014)^**	0.010(0.009~0.011)^**
上肢	-0.036(-0.078~0.006)	0.009(-0.024~0.041)	-0.005(-0.032~0.021)
腹部	-0.006(-0.064~0.052)	-0.196(-0.247~-0.145)^**	-0.100(-0.136~-0.064)^**
臀部	0.058(0.014~0.102)^**	0.163(0.135~0.191)^**	0.104(0.081~0.127)^**
大腿	-0.038(-0.054~-0.022)^**	0.023(0.009~0.038)^**	-0.009(-0.020~-0.002)
注：^{* *}P < 0.01。

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表 3 不同体脂率儿童青少年各部位脂肪量与骨密度的关联[β值(95%CI)]

Table 3. Association between regional fat mass and total body BMD in children and adolescents grouped by body fat percentage[β(95%CI)]

脂肪量部位	低于标准范围(n=233)	标准范围(n=927)	高于标准范围(n=263)
全身	0.021(0.015~0.027)^**	0.016(0.014~0.017)^**	0.015(0.014~0.017)^**
上肢	0.092(-0.006~0.190)	-0.042(-0.076~-0.007)^*	0.028(-0.010~0.066)
腹部	-0.115(-0.267~0.038)	-0.067(-0.119~-0.016)^*	-0.041(-0.092~0.010)
臀部	-0.119(-0.221~-0.017)^*	0.082(0.052~0.113)^**	0.071(0.037~0.105)^**
大腿	-0.046(-0.085~-0.006)^*	-0.018(-0.031~-0.004)^*	0.006(-0.011~0.023)^*
注：^P < 0.05，^*P < 0.01。

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