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目的分析5~7岁低体重和肥胖儿童体脂比(PBF)、全身脂肪含量(FM)、肌肉含量(LM)与全身和局部骨密度(BMD)的相关性。方法选择2010年2月至2012年2月于沈阳市儿童医院儿保门诊体检的5~7岁儿童311名,按体重指数(BMI)分低体重组、对照组和肥胖组,利用双能X线骨密度仪(DEXA)测量身体成分(PBF、FM、LM及局部和全身BMD),并进行组间比较及相关性分析。结果肥胖组男性儿童LM、上、下肢及全身BMD高于女性(P<0.05)。正常对照组女性PBF、FM高于男性;LM,上肢、下肢及全身BMD低于男性(P均<0.05)。低体重组男性、女性儿童调整FM后,全身LM与局部及全身BMD均正相关(P<0.01)。肥胖组女性儿童调整LM后,PBF、FM与下肢BMD正相关(P<0.01);调整FM后,LM与上肢、下肢BMD正相关(P<0.01)。肥胖组男性儿童调整FM后,LM与下肢BMD正相关(P<0.05),调整LM后,PBF、FM与躯干BMD正相关(P<0.05)。结论与正常儿童相比,低体重和肥胖儿童身体成分构成不同,各指标与全身及局部BMD的相关关系也不同。对于低体重和肥胖儿童,不仅要关注体重变化,还要关注PBF、FM、LM变化,从而促进骨骼健康发展。
Objective To analyze the correlation between body fat ratio (PBF), total body fat (FM), muscle content (LM) and total body and local bone mineral density (BMD) in underweight and obese children aged 5 to 7 years. Methods A total of 311 children aged 5 ~ 7 years from February 2010 to February 2012 in Shenyang Pediatric Hospital were selected and divided into two groups based on body mass index (BMI): low body weight group, control group and obesity group. Body composition (PBF, FM, LM, and local and systemic BMD) were measured by DEXA and compared between groups and correlation analysis. Results The BM, LM, upper extremity and whole body BMD of male children in obesity group were higher than those in female (P <0.05). The normal control group of women PBF, FM than men; LM, upper limbs, lower limbs and whole body BMD was lower than men (P all <0.05). After adjusting FM, the whole body LM was positively correlated with local and systemic BMD in low-weight group male and female children (P <0.01). After adjusting for LM, the levels of PBF and FM in obese children were positively correlated with BMD in lower extremities (P <0.01). After FM was adjusted, LM was positively correlated with upper extremity and lower extremity BMD (P <0.01). After adjustment of FM, LM was positively correlated with lower extremity BMD (P <0.05). After adjustment for LM, PBF and FM were positively correlated with trunk BMD (P <0.05). Conclusion Compared with normal children, body composition of children with low birth weight and obesity is different, and the correlation between each index and systemic and local BMD is also different. For low-weight and obese children, not only to focus on weight changes, but also pay attention to PBF, FM, LM changes, thereby promoting the healthy development of bone.