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| 肾功能正常的中老年人群血清肌酐水平与骨密度相关性研究 |
| Correlation between serum creatinine level and bone mineral density in middle-aged and elderly people with normal renal function |
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| DOI：10.3969/j.issn.1006-7108.2020.01.014 |
| 中文关键词: 肌酐 肾功能 骨密度 肌肉减少症 |
| 英文关键词:creatinine renal function bone density sarcopenia |
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| 中文摘要: |
| 目的 探讨肾功能正常的中老年人群血清肌酐水平与骨密度相关性。方法 数据来源于在我院接受治疗的864名 (457名男性和407名绝经后女性)年龄为45～75岁且估计肾小球滤过率＞60 mL(min· 1.73 m2)的患者。通过双能X射线吸收测定法测量受试者骨密度(bone mineral density，BMD)和附肢肌肉质量(appendicular skeletal muscle，ASM)。受试者工作特征曲线分析显示，肌肉减少症血清肌酐的切点在男性中低于0.88 mg/dL，在女性中低于0.75 mg/dL。根据肌肉减少症血清肌酐的临界值，将受试者分为两组：低肌酐组和高肌酐组。结果 在调整年龄的偏相关分析中，血清肌酸酐与BMD和ASM均呈正相关。低血清肌酐的受试者在调整混杂因素后，男性股骨颈、全髋和腰椎以及女性全髋、腰椎的低BMD(T值为-1.0)的风险较高。血清肌酐的增加与男女全髋和腰椎出现低BMD的可能性降低显著相关[男性：全髋，优势比(OR)= 0.84，95％CI=0.74～0.96；腰椎OR=0.8，95％CI=0.68～0.96；女性：全髋OR = 0.83，95％CI=0.73～0.95；腰椎OR=0.81，95％CI=0.67～0.99]。结论 低血清肌酐与肾功能正常受试者的低密度独立相关。 |
| 英文摘要: |
| Objective To study the correlation between serum creatinine level and bone mineral density in middle-aged and elderly people with normal renal function. Methods Data from a total of 864 participants (457 men and 407 postmenopausal women) aged 45–75 years with an estimated glomerular filtration rate>60 mL(min·1.73 m2) treated in our hospital were included. Bone mineral density (BMD) and appendicular skeletal muscle (ASM) were measured using dual-energy X-ray absorptiometry. Receiver operating characteristic curve analysis revealed that the cut points of serum creatinine for sarcopenia were below 0.88 mg/dl in men and 0.75 mg/dl in women. Subjects were divided into two groups: low creatinine and upper normal creatinine according to the cut point value of serum creatinine for sarcopenia. Results In partial correlation analysis adjusted for age, serum creatinine was positively associated with both BMD and ASM. Subjects with low serum creatinine were at a higher risk for low BMD (T-score<–1.0) at the femur neck, total hip and lumbar spine in men, and at the total hip and lumbar spine in women after adjustment for confounding factors. Each standard deviation increase in serum creatinine was significantly associated with reduction in the likelihood of low BMD at the total hip and lumbar spine in both sexes (men: OR=0.84 [95%CI=0.74?0.96] at the total hip, OR=0.8[95%CI=0.68?0.96] at the lumbar spine; women: OR=0.83 [95%CI=0.73–0.95] at the total hip, OR=0.81 [95%CI=0.67–0.99] at the lumbar spine). Conclusions Low serum creatinine was independently associated with low bone mineral density in subjects with normal kidney function. |
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