青少年體能活動量與體組成及骨質健康狀況之相關性

Correlations between physical activity, body composition and bone health status in adolescents

趙雪安(Hsueh-An Chao)

指導教授 ： 林以勤

中山醫學大學/健康管理學院/營養學系/碩士(2019年)

https://doi.org/10.6834/CSMU201900198

摘要

骨質疏鬆症好發於老年人群及停經後的婦女，特徵為骨量減少和骨骼結構惡化，容易導致骨折進而造成嚴重的疼痛，並可能影響行動能力和生活品質，甚至造成死亡。青少年期間所達到的巔峰骨量與成年後期的骨量息息相關。國際骨質疏鬆基金會（International Osteoporosis Foundation, IOF） 指出在年輕時期多增加10%的骨密度，就可以使骨質疏鬆症的發生延後13年；美國國家衛生院（National Institutes of Health, NIH）表示，高達90%的骨量是在青春期時累積的，因此青少年時期為累積骨量的最佳時機。許多文獻指出運動和飲食皆為影響骨量的重要因素，故本研究以台灣國高中生為研究對象，探討體能活動量等因素與骨質健康狀況的關聯性。
本研究使用2010-2011年的台灣國民營養健康狀況變遷調查（Nutrition and Health Survey in Taiwan, NAHSIT）中所收集之受試者的基本資料、體位測量、體能活動量、飲食頻率問卷和骨質密度測量數值。
本研究結果顯示，在調整年齡、BMI、身高及飲食頻率後，青少年體能活動量與骨密度及骨礦物含量具有顯著之關聯性，而青少女體能活動量亦與多數的骨質測量結果呈顯著之正向關聯性。另外，本研究以腰椎骨密度Z-score分組後發現，Z-score ≤ -2的組別於除瘦體率之各項體組成、體能活動量、負重運動及全身、股骨頸和腰椎骨密度及骨礦物含量之平均值皆為最低（p < 0.05）；而腰椎骨密度Z-score > -1的組別，其於除瘦體率外之各項測量結果皆有較高之平均值（p < 0.05）。在體能活動量與負重運動的部分，可觀察到運動量較高者其骨質健康狀況較同年齡者為佳。
本研究結果顯示，不論男女青少年的體能活動量及負重運動與各部位之骨密度及骨礦物量皆具正向顯著關聯性，且各部位骨密度（全身：男性β=0.03897, p <.0001；女性β=0.01741, p <.0001、股骨頸：男性β=0.04274, p <.0001；女性β=0.01648, p <.0001、腰椎：男性β=0.06052, p <.0001；女性β=0.02459, p <.0001）及骨礦物含量（全身：男性β=181.43448, p <.0001；女性β=70.21593, p <.0001、股骨頸：男性β=0.30087, p <.0001；女性β=0.09712, p <.0001、腰椎：男性β=3.99154, p <.0001；女性β=1.44110, p <.0001）隨年齡而增加並呈線性趨勢，表示運動量的增加可能有助於骨量的積累，並使其與同年齡層者相比有較好的骨量。

關鍵字

青少年 ； 代謝當量（METs) ； 骨密度 ； 國民營養調查（NAHSIT)

並列摘要

Osteoporosis often occurs in the elderly and postmenopausal women. The disease is characterized by decreased bone mass and deterioration of bone structure, which may lead to fragility fractures that would result in disability and compromise quality of life or even increase the risk of death. The development of peak bone mass during adolescence is critical to bone mass in late adulthood. The International Osteoporosis Foundation (IOF) suggests that an increase of 10% in bone density during younger age may delay the onset of osteoporosis for 13 years. The National Institutes of Health (NIH) indicate that up to 90% of bone mass is accumulated during puberty, and adolescence is the critical. Numerous studies have reported that both exercise and diet affect the accumulation of bone mass. The current study was conducted to investigate the influences of physical activity and/or other important factors on bone health status in the junior and senior high school students in Taiwan.
The data of anthropometry, physical activity and dietary intake were obtained from the participants in the Nutrition and Health Survey in Taiwan 2010-2011. Data of those who completed both questionnaire interview and physical examination sessions were included in the current analysis.
The results showed that after adjusting for age, body mass index, height and dietary intake (by food frequency questionnaire), the level of physical activity of adolescents was significantly correlated with bone mineral density (BMD) and bone mineral content (BMC), and similar results were also observed in teenage girls. The subjects were further grouped by lumbar spine BMD Z-score, and the results showed that the body composition parameters except for lean mass percentage, level of physical activity, level of weight-bearing exercise as well as the bone measurements were significantly higher than those with Z-score > -1 (p < 0.05), whereas the above mentioned variables were significantly lower in those with Z-score ≤ -2 (p < 0.05). In addition, we also observed that bone measurements appeared to be better in those adolescents with higher levels of physical activity or weight-bearing exercise.
In conclusion, the results of this study showed that both physical activity and weight-bearing exercise of adolescents were positively correlated with BMD (TB BMD: Maleβ=0.03897, p <.0001; Female β=0.01741, p <.0001、FN BMD: Maleβ=0.04274, p <.0001; Femaleβ=0.01648, p <.0001、LS 2-4 BMD: Maleβ=0.06052, p <.0001; Femaleβ=0.02459, p <.0001) and BMC (TB BMC: Maleβ=181.43448, p <.0001; Femaleβ=70.21593, p <.0001、FN BMC: Maleβ=0.30087, p <.0001; Femaleβ=0.09712, p <.0001、LS 2-4 BMC: Maleβ=3.99154, p <.0001; Femaleβ=1.44110, p <.0001). Higher level of physical activity may contribute to the better accumulation of bone mass for adolescents in Taiwan.

並列關鍵字

adolescents ； Metabolic Equivalent of Task(METs) ； bone mineral density(BMD) ； Nutrition and Health Survey in Taiwan(NAHSIT)

參考文獻

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