怀孕和哺乳后骨密度的恢复——一项针对25岁女性的10年前瞻性观察研究。

IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Lisa Egund, Linnea Malmgren, Anthony D Woolf, Fiona E McGuigan, Kristina E Akesson
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引用次数: 0

摘要

怀孕和哺乳期需要大量的钙,可能会消耗年轻成人的骨骼。这项研究调查了PEAK-25队列中胎次和哺乳期导致的骨密度和骨密度波动,这是一项前瞻性观察研究,纳入时年龄为25岁,随访时年龄为35岁。分析使用基线时未生育的妇女和10年后未生育(n = 573)或未生育(n = 177)的妇女。胎次,无论怀孕次数,没有负面影响,确实35岁时脊柱骨密度更高(2.1%;p = .043)。同样,在母乳喂养、非哺乳期或未生育的妇女中,骨密度也没有差异。即使是母乳喂养的累积时间也没有影响。总体而言,无论胎次如何,在队列中,到35岁时BMD已经下降,股骨颈(∆- 3.4%)和全髋(∆- 2.7%)的总体损失;虽然不是脊柱(∆0.9%)。然而,骨密度波动与怀孕、哺乳期和断奶相关,在短期内可见。比较DXA前妊娠大于24米和小于24米的妇女,最近怀孕妇女的骨密度最低(FN -2.2%, TH -2.7%)。与超过36米的孕妇相比,在12米内怀孕的妇女TH骨密度低4% (p =。054, padj = 0.032)。母乳喂养的累计持续时间与骨质流失有关,特别是超过15个月(FN∆-4.3%;TH(-3.7%)和下脊柱骨密度增加。尽管有这样一段时间的损失,BMD恢复,从断奶到DXA的时间证明了这一点。与间隔超过24个月的妇女相比,在测量后6个月内断奶的妇女FN骨密度较低(6.6% vs 1.7%, p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Recovery of BMD after pregnancy and breastfeeding-a 10-yr prospective observational study of 25-yr-old women.

Pregnancy and lactation require large amounts of calcium potentially depleting the young adult bone. This study investigated BMD and fluctuations of BMD resulting from parity and lactation in the PEAK-25 cohort, a prospective observational study of women all aged 25 at inclusion and 35 at follow-up. The analyses use women who were nulliparous at baseline and parous (n = 573) or nulliparous (n = 177) 10-yr later. Parity, regardless of number of pregnancies, had no negative impact, indeed spine BMD at age 35 was higher (2.1%; p = .043). Likewise, BMD did not differ in women who breastfed, were non-lactating or nulliparous. Even the cumulative duration of breastfeeding did not make a difference. Overall, and regardless of parity, in the cohort, by age 35 BMD is already decreasing, with overall losses at femoral neck (∆ - 3.4%) and total hip (∆ - 2.7%); although not spine (∆0.9%). Yet, BMD fluctuations associated with pregnancy, lactation and weaning were seen in the short term. Comparing those pregnant more than 24 m with those less than 24 m prior to DXA, BMD was lowest in women more recently pregnant (FN -2.2%, TH -2.7%). Women pregnant within 12 m had 4% lower TH BMD compared to more than 36 m (p = .054, padj = 0.032). Cumulative duration of breastfeeding was associated with bone loss, particularly beyond 15 mo (FN ∆-4.3%; TH ∆-3.7%) and lower spine BMD accretion. Despite such periods of loss, BMD recovers, evidenced by time-from-weaning to DXA. Women weaning within 6 mo of measurement had lower FN BMD compared to those where the interval was more than 24 mo (6.6% vs 1.7%, p < .001). In conclusion and despite repeated fluctuations in BMD resulting from the physiological demands of multiple pregnancies and periods of breastfeeding, BMD recovers and ultimately doesn't differ from that of identically aged women without children.

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来源期刊
Journal of Bone and Mineral Research
Journal of Bone and Mineral Research 医学-内分泌学与代谢
CiteScore
11.30
自引率
6.50%
发文量
257
审稿时长
2 months
期刊介绍: The Journal of Bone and Mineral Research (JBMR) publishes highly impactful original manuscripts, reviews, and special articles on basic, translational and clinical investigations relevant to the musculoskeletal system and mineral metabolism. Specifically, the journal is interested in original research on the biology and physiology of skeletal tissues, interdisciplinary research spanning the musculoskeletal and other systems, including but not limited to immunology, hematology, energy metabolism, cancer biology, and neurology, and systems biology topics using large scale “-omics” approaches. The journal welcomes clinical research on the pathophysiology, treatment and prevention of osteoporosis and fractures, as well as sarcopenia, disorders of bone and mineral metabolism, and rare or genetically determined bone diseases.
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