中国全科医学 ›› 2023, Vol. 26 ›› Issue (06): 725-733.DOI: 10.12114/j.issn.1007-9572.2022.0635

所属专题: 运动相关研究最新文章合集

• 重点人群健康研究 • 上一篇    下一篇

久坐行为及运动水平对大学生跟骨骨密度的影响研究

李仕田, 吕晓港, 朱晓祺, 王嘉烨, 卢晓翠*()   

  1. 510515 广东省广州市,南方医科大学公共卫生学院
  • 收稿日期:2022-08-11 修回日期:2022-09-27 出版日期:2023-02-20 发布日期:2022-10-13
  • 通讯作者: 卢晓翠
  • 李仕田,吕晓港,朱晓祺,等.久坐行为及运动水平对大学生跟骨骨密度的影响研究[J].中国全科医学,2023,26(6):725-733.[www.chinagp.net]
    作者贡献:李仕田提出研究选题方向,负责研究的统计方法设计,数据录入及论文初稿撰写;吕晓港负责数据录入及项目数据库的管理工作;朱晓祺、王嘉烨负责论文语句通顺性审查并提出修改意见;卢晓翠负责研究项目的总体规划,现场调查的协调、实施与开展,论文终稿的修改、质量控制及内容审查,提供基金支持,对论文负责。
  • 基金资助:
    南方医科大学大学生创新创业训练计划项目(201812121226)

Association of Sedentary Behavior and Physical Activity with Calcaneal Bone Mineral Density among College Students

LI Shitian, LYU Xiaogang, ZHU Xiaoqi, WANG Jiaye, LU Xiaocui*()   

  1. School of Public Health, Southern Medical University, Guangzhou 510515, China
  • Received:2022-08-11 Revised:2022-09-27 Published:2023-02-20 Online:2022-10-13
  • Contact: LU Xiaocui
  • About author:
    LI S T, LYU X G, ZHU X Q, et al. Association of sedentary behavior and physical activity with calcaneal bone mineral density among college students[J]. Chinese General Practice, 2023, 26 (6) : 725-733.

摘要: 背景 目前国内鲜有文章探讨久坐行为及运动水平对人群骨密度(BMD)的影响。外文文献中针对亚裔人群的相关研究目前较少,且研究对象主要为低龄儿童。鉴于国外人群在遗传、饮食习惯等多方面与我国人群存在较大差别,有必要开展相关研究。 目的 分析大学生久坐行为及运动水平对跟骨BMD的影响,为了解大学生的骨骼健康状况和预防中老年骨质疏松症的发生提供参考依据。 方法 采用分层整群抽样设计,于2021年1月至2022年3月选取南方医科大学不同年级大学生781名为研究对象,其中女生518名、男生263名,年龄为19~25岁。收集大学生一般资料和体格检查资料(性别、年龄、身高、体质量、脂肪体质量指数和去脂体质量指数)及生活方式信息(日坐姿时长,周运动时长,乳制品、碳酸饮料、茶水的摄入频率,钙剂补充情况,吸烟情况,饮酒情况),并测定跟骨BMD,然后对不同体格和生活方式的大学生的跟骨BMD进行比较。采用多元线性回归分析探讨大学生久坐行为、运动水平与跟骨BMD的关系;采用二分类Logistic回归分析探讨大学生久坐行为、运动水平对跟骨BMD的影响。 结果 781名大学生中,BMD正常率为50.3%(393/781),BMD异常率为49.7%(388/781);其中女大学生BMD异常率(59.5%)高于男大学生BMD异常率(30.4%)(χ2=58.849,P<0.001)。女大学生不同日坐姿时长、周运动时长BMD异常率比较,差异有统计学意义(χ2=6.670、6.559,P<0.05)。在控制潜在混杂因素后,多元线性回归分析和趋势性检验结果显示,女大学生跟骨BMD(T值)随着每日保持坐姿时间的减少而增大,二者之间存在线性关系,且女大学生日坐姿时长与跟骨BMD呈负相关(β=-0.17,P趋势=0.011);女大学生的跟骨T值随着每周运动时长的增加而增大,二者之间存在线性关系,且女大学生周运动时长与跟骨BMD呈正相关(β=0.15,P趋势=0.004)。在控制潜在混杂因素后,二分类Logistic回归分析结果显示,相对于日坐姿时长>8 h,日坐姿时长<4 h为女大学生发生跟骨BMD异常的保护因素〔OR=0.17,95%CI(0.04,0.68),P<0.05〕;相对于周运动时长<90 min,周运动时长90~150 min为女大学生发生跟骨BMD异常的保护因素〔OR=0.66,95%CI(0.44,1.00),P<0.05〕。 结论 女大学生跟骨BMD异常率高于男大学生,且久坐行为及运动水平与女大学生跟骨BMD相关,在男大学生中未发现相关性。女大学生日坐姿时长<4 h、周运动时长90~150 min可有效保护跟骨健康,且每日保持坐姿的时间越短越有利于预防BMD异常的发生。

关键词: 骨密度, 跟骨, 骨质疏松, 久坐行为, 运动水平, 大学生, 影响因素分析, 趋势性检验

Abstract:

Background

The association of sedentary behavior and physical activity with bone mineral density (BMD) in Chinese population has been rarely studied in China, and also seldom studied in Asian populations (mainly limited in young children) by foreign countries. Considering there are great discrepancies between foreign populations and Chinese populations in genetics, dietary habits and other aspects, it is necessary to carry out relevant research in China.

Objective

To assess the association of sedentary behavior and physical activity with calcaneal BMD in college students, offering a reference for understanding the bone health status of college students, and for preventing osteoporosis in middle-aged and old people.

Methods

By use of stratified cluster sampling, 781 college students aged 19-25 years (including 518 females and 263 males) of different grades were selected from a medical university in Guangzhou from January 2021 to March 2022. Demographic and anthropometric characteristics (including sex, age, height, weight, fat mass index and fat free mass index) and lifestyle information (including daily sedentary time, time spent on physical activity in one week, frequency of dairy products, carbonated drinks and tea consumption, calcium supplement, smoking status, alcohol use status) were collected. Calcaneal BMD was measured, and compared across college students by physique and lifestyle. Multiple linear regression and binary Logistic regression were used to investigate the association of sedentary behaviors and physical activity with calcaneal BMD.

Results

The prevalence of normal and abnormal calcaneal BMD in all students was 50.3% and 49.7%, respectively. The prevalence of abnormal calcaneal BMD in female college students (59.4%) is higher than that in male college students (30.4%) (χ2=58.849, P<0.001). The prevalence of abnormal calcaneal BMD varied by daily sedentary time and time spent on physical activity in one week in female students (χ2=6.670, 6.559, P<0.05). After controlling for potential confounders, multiple linear regression analysis and test for trend showed that in female students, the T-score value of calcaneal BMD increased with the decrease of daily sedentary time (β=-0.17), and there was an obvious negative linear trend between them (Ptrend=0.011). And the T-score value of calcaneal BMD increased with the increase of time spent on physical activity in one week (β=0.15), and there was an obvious positive linear trend between them (Ptrend=0.004). Further analysis based on binary Logistic regression models showed that in female students, sedentary time <4 hours per day was associated with lower risk of abnormal calcaneal BMD compared with sedentary time >8 hours per day〔OR=0.17, 95%CI (0.04, 0.68), P<0.05〕, and 90-150 minutes of physical activity in one week was associated with lower risk of abnormal calcaneal BMD compared with less than 90 minutes of physical activity in one week〔OR=0.66, 95%CI (0.44, 1.00), P<0.05〕.

Conclusion

The prevalence of abnormal calcaneal BMD in female college students is higher than that in male college students. Both sedentary behavior and physical activity are associated with calcaneal BMD in female college students, no correlation found among male college students. Daily duration of sedentary behavior <4 hours and 90-150 minutes of physical activity in one week are associated with lower risk of abnormal calcaneal BMD. Furthermore, the shorter time spent on daily sedentary behaviors, the lower the risk of abnormal BMD.

Key words: Bone density, Calcaneus, Osteoporosis, Sedentary behavior, Physical activity, College students, Root cause analysis, Tests for trend