Page 85 - 2023-06-中国全科医学

·726· http: //www.chinagp.net E-mail: zgqkyx@chinagp.net.cn February 2023, Vol.26 No.6

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%）
2
（χ =58.849，P<0.001）. The prevalence of abnormal calcaneal BMD varied by daily sedentary time and time spent on physical
2
activity in one week in female students（χ =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（P trend =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（P trend =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

骨质疏松症及其所导致的骨折是严重影响老年人生 方医科大学不同年级大学生 781 名为研究对象，其中女
活质量的公共卫生问题。2018 年中国 50 岁以上人群骨 生 518 名、男生 263 名，年龄为 19~25 岁。纳入标准：
质疏松症患病率为 19.2%，且患病知晓率仅为 7.0% ［1］ 。 年龄≥ 18 岁的在校大学生；经项目成员讲解本研究内
越来越多的证据表明，老年人群骨质疏松症的发生与 容和目的后，被调查对象愿意参与本研究。排除标准：
青年时期的峰值骨量密切相关 ［2-3］ 。有研究显示，10% 有心脏病史、遗传代谢性疾病、恶性肿瘤、慢性肝肾功
的骨量会在 18 岁之后的骨骼巩固期获得 ［4］ 。因此，了 能疾病，近期发生过骨折，接受过或正在接受激素类药
解大学生的骨骼健康状况及影响因素对于预防老年人群 物治疗，因身体原因无法进行身体成分测量和有数据缺
骨质疏松症的发生具有现实意义。骨骼健康状况可以利 失者。本研究通过南方医科大学生物医学伦理委员会的
用骨密度（bone mineral density，BMD）进行衡量。既 审查（南医伦审［2021］第 007 号、南医伦审［2022］
往国外基于低龄人群的研究发现，久坐行为及体力活动 第 32 号）。
与骨骼健康状况相关，保持坐姿时间越长，BMD 越低， 1.2 研究方法
而轻体力活动有助于提升骨矿物质含量 ［5］ 。鉴于国外 1.2.1 一般资料及生活方式信息 由研究人员自行设计
人群在遗传、饮食习惯等多方面与我国人群存在较大差 调查问卷，并由接受过统一培训的调查员进行现场问卷
别，且目前专门针对青年群体、华裔或亚裔群体的研究 调查，受试大学生知情同意后，通过填写问卷的方式收
甚少，本研究旨在利用南方医科大学大学生跟骨 BMD 集其一般资料和生活方式信息。一般资料包括：性别、
的测量结果及相关影响因素调查结果，探究久坐行为 年龄。生活方式信息包括：久坐行为（日坐姿时长：过
及运动水平与跟骨 BMD 的相关性，为了解大学生的骨 去 6 个月内每日保持坐姿的时长），运动水平（周运动
骼健康状况和预防中老年骨质疏松症的发生提供参考 时长：每周进行运动的频率和每次的运动时长），乳制
依据。 品、碳酸饮料、茶水的摄入情况，钙剂补充情况，吸烟
1 对象与方法 情况，饮酒情况。
1.1 研究对象 本研究为观察性横断面研究。采用分 1.2.2 跟骨 BMD 测量方法 测量仪器：SONOST-2000
层整群抽样设计，于 2021 年 1 月至 2022 年 3 月选取南 超声骨密度测量仪（韩国 OsteoSys 有限公司）。测量