中国医科大学学报2025，Vol.54Issue(5)：425-430,6.DOI:10.12007/j.issn.0258-4646.2025.05.008
不同肥胖程度学龄期儿童骨密度的影响因素及与体成分的关系
Influencing factors of bone mineral density and their relationship with body composition in school-stage children with different degrees of obesity
摘要
Abstract
Objective To investigate the influencing factors of bone mineral density(BMD)in school-stage children with different degrees of obesity and their relationship with body composition.Methods A total of 271 obese children aged 6-12 years who underwent pediatric health checkups in our hospital between October 2018 and December 2023 were selected.The children were divided into two groups according to their degree of obesity:a simple obesity group(n=171)and an extreme obesity group(n=100).All children were examined for metabolic indicators,body composition,BMD,and abdominal ultrasonography.Comparisons of various indicators between the two groups were made using the independent samplesttest,Mann-Whitney Utest,or chi-square test.The relationship between BMD and body composition was analyzed using multiple linear regression and Spearman correlation analyses.Results Compared with simple obesity group,the body weight,body mass index(BMI)z-score,body fat index,muscle mass index,fat-free body mass index,body fat percentage,waist-to-hip ratio,fasting insulin level,insulin resistance index,uric acid,and fatty liver incidence were significantly higher in extreme obesity group(all P<0.05).No statistically significant differences in height,BMD,BMD z-score,25-hydroxy-vitamin D,blood sugar,calcium,phosphorus,alkaline phosphatase,or rate of puberty development were observed between the two groups(all P>0.05).The results of the Spearman correlation analysis showed that the BMI z-score,body fat index,muscle mass index,and fat-free BMI were pos-itively correlated with the BMD z-scores of all participants and in girls(all P<0.05).In boys,the BMD z-score was positively correlated with muscle mass index and fat-free mass index(both P<0.05).The results of multiple linear regression analysis of BMD z-scores and body composition showed that in boys and the simple obesity group,body fat percentage and body fat index were independent influencing factors of BMD z-scores(both P<0.05).Conclusion Higher body fat percentage and body fat index may be adverse factors influencing BMD in school-stage children with obesity.Meanwhile,the BMD of school-age children with obesity increased with an increase in fat-free mass index.关键词
肥胖/学龄期儿童/骨密度/体成分Key words
obesity/school-stage children/bone mineral density/body composition分类
临床医学引用本文复制引用
张金,张田,孙慧慧,万乃君..不同肥胖程度学龄期儿童骨密度的影响因素及与体成分的关系[J].中国医科大学学报,2025,54(5):425-430,6.基金项目
北京市医院管理局儿科学科协同发展中心儿科专项重点项目(XTZD20180401) （XTZD20180401）
