广州市儿童青少年健康生活行为指数与骨密度的关联分析

doi:10.12183/j.scjpm.2026.1033

摘要/Abstract

摘要： 目的探讨广州市儿童青少年健康生活行为指数与骨密度（bone mineral density,BMD）的关联。方法于2019年开展横断面调查,对广州市1所中学和1所小学6~18岁学生进行问卷调查,构建健康生活行为指数;采用双能X线吸收法测量BMD。采用线性回归分析行为指数与BMD Z值的关联,运用广义加性模型分析评估非线性关系。结果 1 695名学生平均年龄为（12.11±2.83）岁,男生占53.1%。多因素模型中,行为指数得分与去头全身、腰椎BMD Z值呈正关联（全身：β=0.06,95% CI=0.03~0.09;腰椎：β=0.04,95% CI=0.01~0.07）;高等级行为指数者的去头全身和腰椎BMD Z值比低等级指数者分别增加0.31和0.21个单位（均P<0.05）。行为指数得分与去头全身、腰椎BMD Z值之间存在非线性关系（均P-nonlinear<0.05）,阈值拐点分别为4分和5分。在拐点之后,行为指数得分对去头全身、腰椎BMD Z值的β分别为0.11和0.14（均P<0.01）。结论儿童青少年健康生活行为指数与BMD呈正关联,行为指数达到阈值后,对骨密度积极作用更为明显。

关键词: 儿童青少年, 生活行为, 骨密度

Abstract: Objective To investigate the association between a healthy lifestyle behavior index and bone mineral density (BMD) among children and adolescents in Guangzhou. Methods A cross-sectional study was conducted in 2019, enrolling students aged 6-18 years from one primary and one secondary school in Guangzhou. A healthy lifestyle behavior index was constructed based on questionnaire data. BMD was measured using dual-energy X-ray absorptiometry (DXA). Linear regression models were employed to analyze the association between the behavior index and BMD Z-scores, and generalized additive models were used to evaluate for non-linear relationships. Results The study included 1 695 students with a mean age of (12.11±2.83 )years; 53.1% were boys. In the multivariate models, the behavior index score was positively associated with total body less head (TBLH) and lumbar spine BMD Z-scores (TBLH: β=0.06, 95% CI=0.03-0.09; Lumbar spine: β=0.04, 95% CI=0.01-0.07). Participants with a high-level behavior index had TBLH and lumbar spine BMD Z-scores that were 0.31 and 0.21 units higher, respectively, than those with a low-level index (both P<0.05). A non-linear relationship was observed between the behavior index score and both TBLH and lumbar spine BMD Z-scores (both P for non-linearity <0.05), with threshold inflection points at scores of 4 and 5, respectively. Beyond these inflection points, the β coefficients for the association of the index score with TBLH and lumbar spine BMD Z-scores increased to 0.11 and 0.14, respectively (both P<0.01). Conclusion The healthy lifestyle behavior index is positively associated with BMD in children and adolescents. The beneficial effect of these behaviors on bone density becomes substantially more pronounced after a specific threshold score is achieved.

Key words: Children and adolescents, Lifestyle behaviors, Bone mineral density

中图分类号:

R179

纪吉婷, 程红, 龙佳仪, 刘军廷, 潘顺, 张泽辉, 刘丽. 广州市儿童青少年健康生活行为指数与骨密度的关联分析[J]. 华南预防医学, 2026, 52(9): 1033-1038.

Ji Jiting, Cheng Hong, Long Jiayi, Liu Junting, Pan Shun, Zhang Zehui, LiuLi. Association between healthy lifestyle behavior index and bone mineral density among children and adolescents in Guangzhou[J]. South China Journal of Preventive Medicine, 2026, 52(9): 1033-1038.

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