飲食及生活型態因子與成年人骨質狀況與之相關性

Correlations between dietary intake, lifestyle factors and bone health status in adults

許珉菘(Min-Sung Hsu)

指導教授 ： 林以勤

中山醫學大學/健康管理學院/營養學研究所/碩士(2016年)

摘要

人體骨骼健康由成骨與蝕骨作用所形成之骨再塑作用維持動態平衡。骨再塑作用容易受到先天遺傳或老化因素與後天環境因素影響而失衡，導致骨量流失而提高罹患骨質疏鬆症風險。骨質疏鬆症已成為各國重要公共衛生議題，其所衍生出相關醫療照護費用相當可觀。根據我國2005至2008年國民營養調查顯示，50歲以上國人在髖骨或股骨任一處患有骨質疏鬆症之盛行率男性為22.6%，女性則為41.2%，比例皆高於鄰近亞洲國家。國內除國民營養調查有關成年人飲食、生活型態與骨質健康之相關性的研究並不多見；本研究之目的為瞭解我國健康成年人其飲食及生活型態等相關因子與骨質健康狀況之相關性。
本研究於中山醫學大學鄰近社區招募239位19歲以上之健康成年人，並依據年齡分成19-30歲、31-44歲、45-64歲與65歲以上等四組。個案以雙能量X光吸收儀(dual-energy x-ray absorptiometry, DXA)進行骨質與體組成檢測，並以結構式問卷進行飲食與生活型態等資料蒐集。
分析結果顯示，腰椎或股骨頸任一部位骨質疏鬆症百分比男性為24.32%，女性則為13.43%。男、女性年齡與全身、腰椎與股骨頸BMC(bone mineral content)及BMD(bone mineral density)呈顯著負相關；體重則與全身、腰椎與股骨頸BMC及BMD呈顯著正相關。抽菸狀況方面，男性目前有抽菸者之股骨頸BMD 與Z-score顯著從未抽菸者。飲酒狀況方面，男性目前有飲酒習慣者相較於無飲酒習慣者有較高之全身與股骨頸BMC及BMD。女性則未觀察到因不同飲酒習慣而有顯著差異。男性高運動量運動組之全身與股骨頸BMD顯著高於輕運動量組。飲食攝取部分，鈉營養素密度與男性股骨頸BMC呈邊緣性顯著負相關。鈣營養素密度與男性股骨頸BMD及股骨頸BMD Z-score呈顯著正相關。鈣磷比與女性全身BMD呈邊緣性顯著負相關。經複回歸模式分析後，性別為全身BMD之顯著預測因子，年齡與體重為全身、腰椎與股骨頸BMD之顯著預測因子，抽菸習慣為股骨頸BMD之顯著預測因子，高運動量為全身、腰椎與股骨頸BMD顯著預測因子。本研究結果指出，年齡、體重與抽菸習慣為影響一般健康成年人骨質狀況之重要預測因子。

關鍵字

骨質疏鬆症 ； 骨礦物密度 ； 飲食攝取 ； 生活型態

並列摘要

Human bone health is maintained by bone remodeling process. However, the bone remodeling can be affected by a variety of factors, such as age, gene, and environmental factors. An imbalance of bone remodeling may lead to the development of osteoporosis. According to the results from 2005-2008 Nutrition and Health Surveys in Taiwan (NAHSIT), the prevalence rates of osteoporosis at any site were 22.6% in males and 41.2% in females, respectively. In addition to NAHSIT, few studies have examined the correlations between dietary intake, lifestyle factors and bone health status in Taiwanese adults. The purposes of this study were to identify dietary intake and lifestyle factors associated with bone health in Taiwanese adults.
A total of 239 healthy subjects were recruited from the neighboring communities in Chung Shan Medical University. Body compositions, bone mineral density (BMD) and bone mineral content (BMC) were measured by dual-energy x-ray absorptiometry. Dietary intake of foods and nutrients and lifestyle-related information were obtained from structured frequency questionnaire and 24-hour dietary recall.
The results showed that age was significantly inversely correlated with BMD and BMC at total body, lumbar spine and femoral neck. Body weight was significantly correlated with BMD and BMC at total body, lumbar spine and femoral neck. Compared to never and ex-smokers, femoral neck BMD Z-score was significantly lower in the current smokers in males. In males, higher BMC and BMD at total body and femoral neck in current drinker than never drinker were observed. BMD at total body, lumbar spine and femoral neck were significantly higher in males who engaged in higher amount of exercise. For nutrients intake, calcium nutrient density was correlated with BMD and BMD Z-score at femoral neck in males. Sodium nutrient density was inversely correlated with BMC at femoral neck in males. Calcium-phosphorus ratio was slightly inversely correlated with BMC at total body in females. In multiple regression analysis, gender, age, body weight, smoking status and higher amount of exercise were significant predictors to BMD at total body, lumbar spine or femoral neck. In conclusion, we observed that gender, age, body weight, smoking status and physical activity may influence bone status in healthy adults.

並列關鍵字

osteoporosis ； bone mineral density ； dietary intake ； lifestyle

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