肥胖和失糖症对年轻人骨微观结构和强度的不良影响:与性别有关的差异
Fida Bacha1, Pranav K Saha2, Reina Armamento-Villareal3
1USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.
The Journal of clinical endocrinology and metabolism
|February 28, 2026
概括
青少年肥胖和胰岛素耐药性对骨健康产生负面影响,特别是在男性中. 这些发现强调了代谢健康对儿科骨发育的重要性.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 代谢健康 代谢健康
- 骨生物学 骨生物学 骨生物学
背景情况:
- 肥胖,2型糖尿病 (T2D) 和青少年骨健康之间的相互作用仍然不清楚.
- 了解这些关系对于解决年轻人的代谢和骨健康至关重要.
研究的目的:
- 在青少年中研究脂肪和葡萄糖代谢与骨矿物质含量 (BMC) 和骨质 (微观结构,强度) 的关联.
- 为了评估跨血糖谱的这些关系中的潜在的性别特异性差异.
主要方法:
- 一项涉及92名体重状况和葡萄糖耐受性不同 (正常体重,超重与正常葡萄糖耐受性,超重与葡萄糖调节受损,包括糖尿病前期/T2D) 的青少年的横截面研究.
- 用高分辨率的外围定量计算断层扫描 (HRpQCT) 来评估骨质.
- 分析了身体成分,体质量 (DXA),人体测量,口服葡萄糖耐受性测试 (OGTT) 和代谢标志物.
主要成果:
- 与正常体重的男性相比,超重和葡萄糖调节受损或正常葡萄糖耐受度较差的青少年表现出较差的骨微观结构和强度,但女性没有.
- 多变量分析显示,较高的胰岛素抵抗 (HOMA-IR) 和身高与骨体积骨矿物质密度 (vBMD) 有负相关性,而年龄和瘦肉量则与之有积极相关性.
- 在半径和骨的胰岛素抵抗和骨参数之间观察到类似的反向关系,禁食葡萄糖与椎厚度相反相关.
结论:
- 在青少年中,肥胖,胰岛素耐药性和骨微型结构/强度之间存在显著的负相关性,无论年龄,性别,身高和肌肉质量如何.
- 有证据表明性二态,男性在脂肪和失糖症对骨质的负面影响更明显.
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