[Analysis of association between appendicular skeletal muscle mass index and main anthropometric parameters among overweight and obese adults in China].

Objective: To investigate the associations between the appendicular skeletal muscle mass index and main anthropometric parameters, and to provide clues for preventing the reduction of skeletal muscle mass among overweight and obese adults in China. Methods: 1 488 volunteered participants who resided in Beijing longer than one year, between 22 and 55 years old, with self-report BMI ≥24 kg/m(2) were recruited from April to May 2014. 171 participants whose BMI ≤24 kg/m(2) or with organic diseases at the first physical examination were excluded, finally 1 317 overweight/obese participants (male and female were 507, and 810, respectively) were enrolled into the present study. After measuring the anthropometric parameters and body composition by the DXA, Pearson correlation analysis and multiple linear regression models were used to analyze the associations between the appendicular skeletal muscle mass index and main anthropometric parameters. Results: The average age of males and females was (35.6±8.4) and (38.2±9.4) years old, respectively. The females' mean levels of body fat percentage, BMI, waist circumference, hip circumference, and bone mineral density were (41.59±4.14)%, (29.00±3.75) kg/m(2), (92.56±9.00) cm, (101.74±6.75) cm, and (1.20±0.10) g/cm(2), respectively; and the males' mean levels were (34.22±4.61)%, (30.07±4.12) kg/m(2), (99.63±9.49) cm, (102.93±7.28) cm, and (1.28±0.11) g/cm(2), respectively. The mean level of appendicular skeletal muscle mass and skeletal muscle mass index in males were (26.98±3.88), and (8.96±1.02) kg, respectively, which were significantly higher than it in females ((18.57±2.61), and (7.26±0.83) kg, respectively) (P<0.001). For male, the correlation coefficients of skeletal muscle mass index with BMI, waist circumference, hip circumference, body fat percentage and bone mineral density were 0.814, 0.601, 0.637, 0.558, and 0.434, respectively; for female, the correlation coefficients of skeletal muscle mass index with BMI, waist circumference, hip circumference, body fat rate and bone mineral density were 0.761, 0.534, 0.585, 0.610, and 0.304, respectively. The correlations were statistically significant (P<0.001). Multiple linear regression analysis showed that the skeletal muscle mass index of male decreased with the increase of age (β=-0.01, 95%CI:-0.01-0.00) and body fat percentage (β=-0.13, 95%CI:-0.15--0.12) (P<0.05), while increased with the increase of BMI (β=0.31, 95%CI: 0.29-0.32) and bone mineral density (β=0.54, 95%CI: 0.10-1.01) (P<0.05). The skeletal muscle mass index of female decreased with the increase of age (β=-0.01, 95%CI:-0.01-0.00) and body fat percentage (β=-0.12, 95%CI:-0.14--0.12) (P<0.05), while increased with the increase of BMI (β=0.26, 95%CI: 0.25-0.28) and hip circumference (β=0.01, 95%CI: 0.00-0.02) (P<0.05). Conclusion: The skeletal muscle mass index of male was higher than it of female. For male, the skeletal muscle mass index might be associated with age, BMI, body fat percentage and bone mineral density. While for female, the skeletal muscle mass index might be associated with age, BMI, body fat percentage and hip circumference.目的： 探讨我国超重肥胖人群四肢骨骼肌质量指数与主要体测指标的关联，为预防超重肥胖人群骨骼肌含量的下降提供线索。 方法： 于2014年4—5月期间，以志愿招募的形式，选取在北京居住满1年，22~55岁、自报BMI≥24 kg/m(2)的志愿者1 488名。排除首次体检时BMI≤24 kg/m(2)或存在器质性疾病的171名志愿者后，本研究共纳入1 317名研究对象（男女分别为507名和810名）。对所有研究对象进行体格测量和双能X线吸收法（DXA）测量体成分后，采用Pearson相关分析和多元线性回归模型分析我国超重肥胖人群四肢骨骼肌质量指数与主要体测指标的关联。 结果： 男、女年龄分别为（35.6±8.4）、（38.2±9.4）岁；女性的体脂率、BMI、腰围、臀围和骨密度分别为（41.59±4.14）%、（29.00±3.75）kg/m(2)、（92.56±9.00）cm、（101.74±6.75）cm、（1.20±0.10）g/cm(2)，男性分别为（34.22±4.61）%、（30.07±4.12）kg/m(2)、（99.63±9.49）cm、（102.93±7.28）cm、（1.28±0.11）g/cm(2)。男性四肢骨骼肌含量和骨骼肌质量指数分别为（26.98±3.88）和（8.96±1.02）kg，均高于女性[分别为（18.57±2.61）和（7.26±0.83）kg]（P值均<0.001）。男性超重肥胖者骨骼肌质量指数与BMI、腰围、臀围、体脂率和骨密度的相关系数分别为0.814、0.601、0.637、0.558和0.434，女性超重肥胖者骨骼肌质量指数与BMI、腰围、臀围、体脂率和骨密度的相关系数分别为0.761、0.534、0.585、0.610和0.304，相关性均有统计学意义（P<0.001）。多元线性回归模型结果显示：男性骨骼肌质量指数随年龄（β=-0.01，95%CI：-0.01~0.00）和体脂肪率（β=-0.13，95%CI：-0.15~-0.12）的增加而下降（P<0.05），随BMI（β=0.31，95%CI：0.29~0.32）和骨密度（β=0.54，95%CI：0.10~1.01）的增加而增加（P<0.05）。女性骨骼肌质量指数随年龄（β=-0.01，95%CI：-0.01~0.00）和体脂肪率（β=-0.12，95%CI：-0.14~-0.12）的增加而下降（P<0.05），随BMI（β=0.26，95%CI：0.25~0.28）和臀围（β=0.01，95%CI：0.00~0.02）的增加而增加（P<0.05）。 结论： 男性的骨骼肌质量指数高于女性。男性超重肥胖者的骨骼肌质量指数与年龄、BMI、体脂肪率和骨密度相关，而女性超重肥胖者的骨骼肌质量指数与年龄、BMI、体脂肪率和臀围相关。.