围绝经期及绝经后女性体成分对骨密度影响的研究

doi:10.3969/j.issn.1006-7795.2026.04.007

首都医科大学学报

• 更年期妇科内分泌与生育力保护 • 上一篇下一篇

围绝经期及绝经后女性体成分对骨密度影响的研究

李凯茵¹,阮祥燕^1,2*,王泽铖¹,张明珍¹,柳岸鸣¹,王月姣¹,Alfred O. Mueck^1,2

1首都医科大学附属北京妇产医院/北京妇幼保健院内分泌科,北京 100026; 2德国图宾根大学妇产医院妇女健康部与妇女健康研究中心,图宾根D-72076

收稿日期:2026-04-09 修回日期:2026-05-13 出版日期:2026-08-21 发布日期:2026-06-30
通讯作者: 阮祥燕 E-mail:ruanxiangyan@ccmu.edu.cn
基金资助:
北京市医院管理中心“登峰”计划专项经费资助项目(DFL20181401)，国家外国专家个人类项目，生育力保护与妇科内分泌疑难病研究会诊中心的建立项目(S20240236)。

Study on the effect of body composition on bone mineral density in perimenopausal and postmenopausal women

Li Kaiyin1,Ruan Xiangyan1,2*,Wang Zecheng1 , Zhang Mingzhen1, Liu Anming1, Wang Yuejiao1, Alfred O. Mueck1,2

1.Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China; 2.Department of Women’s Health, Research Centre for Women’s Health and University Women’s Hospital of Tuebingen, University Hospitals of Tuebingen, Tuebingen D-72076, Germany

Received:2026-04-09 Revised:2026-05-13 Online:2026-08-21 Published:2026-06-30
Supported by:
This study was supported by the Beijing Hospitals Authority's Ascent Plan （DFL20181401），the National Foreign Experts Individual Project, Establishment of Fertility Preservation and Consultation Center for Gynecological Endocrine Difficult Diseases （S20240236）.

摘要/Abstract

摘要： 目的探讨围绝经期及绝经后女性体质量、脂肪指数（fat mass index，FMI）、瘦体重（fat-free mass, FFM）与骨密度（bone mineral density，BMD）的关系。方法募集2024年3月至2026年2月于首都医科大学附属北京妇产医院就诊的40~65岁围绝经期及绝经后女性153名。测量身高、体质量，采用生物电阻抗的方法对体成分（包括全身体脂率、脂肪分布）进行测定，并计算FFM；采用双能X线吸收法（dual-energy X-ray absorptiometry，DXA）测定腰椎、股骨颈及全髋BMD，对测得的BMD及体成分数据进行Spearman相关性分析、线性回归分析及中介分析。结果 Spearman相关性分析，体质量、体质量指数（body mass index, BMI）、FFM、FMI、全身体脂率、脂肪分布与各部位BMD呈显著正相关（P均＜0.05）；多元线性回归分析显示，FFM加入模型后体质量对各部位BMD的正面影响消失；中介分析也证实了体质量对腰椎BMD产生的影响是通过 FFM 产生的。结论对于围绝经期及绝经后女性，对骨密度起保护作用的是体质量中的瘦体重，而非体质量，维持有利的体成分结构有助于保护骨健康

关键词: 围绝经期, 绝经后期, 骨密度, 人体体成分, 脂肪指数, 瘦体重, 骨质疏松症

Abstract: ObjectiveTo investigate the relationship between body weight, fat mass index (FMI), fat-free mass (FFM), and bone mineral density (BMD) in perimenopausal and postmenopausal women.MethodsA total of 153 perimenopausal and postmenopausal women aged 40–65 years, who visited our hospital between March 2024 and February 2026, were recruited. Height and body weight were measured. Body composition (including total body fat percentage and fat distribution) was assessed using bioelectrical impedance analysis to calculate FFM. BMD in the lumbar spine, femoral neck, and total hip was measured using dual-energy X-ray absorptiometry (DXA). Spearman correlation analysis, linear regression analysis, and mediation analysis were performed on the obtained BMD and body composition data.ResultsSpearman correlation analysis showed that body weight, body mass index (BMI), FFM, FMI, total body fat percentage, and fat distribution were significantly positively correlated with BMD in different areas (all P < 0.05). Multivariate linear regression analysis revealed that after including FFM in the model, the positive effect of body weight on BMD in different areas disappeared. Mediation analysis further confirmed that the effect of body weight on lumbar spine BMD was mediated by FFM.ConclusionIn perimenopausal and postmenopausal women, FFM, rather than total body mass, exerts a protective effect on bone mineral density. Therefore, maintaining a favorable body composition structure is beneficial for bone health.

Key words: perimenopausal period, , postmenopausal period, bone mineral density, body composition, fat mass index, fat-free mass, osteoporosis

中图分类号:

李凯茵, 阮祥燕, 王泽铖, 张明珍, 柳岸鸣, 王月姣, Alfred O. Mueck. 围绝经期及绝经后女性体成分对骨密度影响的研究[J]. 首都医科大学学报, doi: 10.3969/j.issn.1006-7795.2026.04.007.

Li Kaiyin, Ruan Xiangyan, Wang Zecheng , Zhang Mingzhen, Liu Anming, Wang Yuejiao, Alfred O. Mueck, . Study on the effect of body composition on bone mineral density in perimenopausal and postmenopausal women[J]. Journal of Capital Medical University, doi: 10.3969/j.issn.1006-7795.2026.04.007.

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围绝经期及绝经后女性体成分对骨密度影响的研究

Study on the effect of body composition on bone mineral density in perimenopausal and postmenopausal women

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