目的：探讨脂肪肝与骨密度间的变化规律及关系。方法选自2013年在我院进行B超检查和骨密度测量的体检人群，共计1014例。以B超诊断脂肪肝为标准：脂肪肝组469例，男性370例、女性99例；非脂肪肝组545例，男性282例、女性263例。以BMI≥25kg／m2及BMI＜25 kg／m2为标准：肥胖组465例、男345例、女120例；非肥胖组549例，男307例、女242例。年龄20～85岁，平均49．8岁。按男、女性别，每十岁年龄段分为脂肪肝和非脂肪肝组、肥胖组和非肥胖组，分别计算各组、各年龄段骨密度和BMI。利用SPSS19．0统计软件对数据进行处理分析，计量资料采用x¯±s方式表示，两变量间相关性采用Pearson乘积－距相关分析，两组数据之间比较用独立样本T检验，P ＜0．05为差异有统计学意义。结果男性40－60岁，女性40－70岁脂肪肝组BMD高于非脂肪肝组BMD（ P ＜0．05），脂肪肝组的骨量丢失低于非脂肪肝组；男性20－70、女性30－70脂肪肝组BMI高于非脂肪肝组BMI（P＜0．05），由Pearson乘积－距相关分析，P ＜0．0001，脂肪肝与肥胖之间存在的直线相关关系具有统计学意义，两者正相关；男性20－60岁，女性40、50、70岁年龄段肥胖组BMD高于非肥胖组（ P ＜0．05），肥胖组的骨量丢失低于非肥胖组；各组男女峰值骨量在30岁年龄段，40岁开始丢失，男性肥胖组峰值骨量高于非肥胖组（ P＜0．05）。有统计学意义的男女各年龄段，脂肪肝组和肥胖组骨量减低发病率明显低于非脂肪肝组和非肥胖组。脂肪肝组和肥胖组发病率接近，非脂肪肝组和非肥胖组的发病率接近。结论脂肪肝与骨密度间可能通过BMI存在一定的影响关系，BMI对脂肪肝的影响明确，对骨密度的影响尚不明确，可能存在阈值，有必要进一步深入研究。%Objective To investigate the changes and relationship between fatty liver and bone mineral density.Methods A total of 1014 healthy screen people who had B-ultrasound examination and BMD measurement in our hospital in 2013 were selected. According to B-ultrasound standard of fatty liver, 469 cases were divided to fatty liver group, including 370 males and 99 females, and 549 cases were divided to non-fatty liver group, including 307 males and 242 females.According to BMI, 465 cases were divided to obese group ( BMI≥25 kg/m2 ) , including 345 males and 120 females, and 549 cases were divided to non-obese group ( BMI<25 kg/m2 ) , including 307 males and 242 females.They were 20-85 years old, with an average of 49.8 years old.Fatty liver and non-fatty liver group, obese and non-obese group were divided by gender and every 10-year-old of age.BMD and BMI of each group were calculated.Data were processed and analyzed with SPSS 19.0 software.The measurement data were represented as x¯±s.The correlation between the two variables was performed using Pearson correlation analysis.Data between the two groups were compared with independent sample t-test, and P<0.05 represented the difference was statistically significant.Results The BMD in fatty liver was higher than that in non-fatty liver group of 40-60-year-old males and 40-70-year-old females ( P<0.05), and the boss lose in fatty liver was lower than that in non-fatty liver group.BMI in fatty liver was higher than that in non-fatty liver group of 20-70-year-old males and 30-70-year-old females ( P<0.05 ) .Pearson correlation analysis showed that fatty liver was positively and linearly correlated with obesity (P<0.0001), with statistical significance.BMD in obese group was higher than that in non-obese group of 20-60-year-old males and 40-, 50-, and 70-year-old females.The boss lose in obese group was lower than that in non-obese group.The peak bone mass in each group of males and females appeared in 30-year group, and it began to lose on 40 years old.The peak bone mass of males in obese group was higher than that in non-obese group ( P<0.05).The incidence of osteopenia was significant lower in fatty liver group and obese group than that in non-fatty liver group and in non-obese group.The incidence in fatty liver group was close to that in obese group, and it was close in non-fatty liver group and in non-obese group.Conclusion Fatty liver may affect BMD through BMI.The effect of BMI on fatty liver was clear, but the effect on BMD is not clear.There may be a threshold existing.It is necessary to study further.
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