中国骨质疏松杂志

肌肉含量指标预测社区人群骨质疏松症风险研究

Screening on muscle mass indexes for predicting osteoporosis risk in community residents

DOI：10.3969/j.issn.1006-7108.2022.02.003

英文关键词:muscle mass indexes osteoporosis risk predication

基金项目:甘肃省科学技术厅技术引导创新计划项目（20CX9ZA115）；甘肃省教育厅高等学校创新基金项目（2020B-072）；兰州市城关区科技计划项目（2018-7-18）；西北民族大学中央高校基本科研业务费资助项目（31920190207，31920170002，31920190007）

作者	单位
杨秀琳1,2 马斌1,2 莫晓丹1,2 马力扬1,2 海向军1,2*	1. 西北民族大学医学部，甘肃兰州 730030 2. 西北民族地区环境生态与人群健康国家民委重点实验室，甘肃兰州 730030

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中文摘要:

目的评价肌肉含量指标与骨质疏松症（ osteoporosis，OP）的关联性，筛选预测社区人群OP风险的良好肌肉含量指标。方法选取来自甘肃省四个市、县的3 151名社区居民，用超声骨密度仪测量研究对象的骨强度、T值，运用生物电阻抗体成分分析仪分别测量四肢肌肉量，并计算四肢骨骼肌量（appendicular skeletal muscle mass，ASM）、四肢骨骼肌指数（appendicular skeletal muscle mass index，ASMI）、四肢骨骼肌体重比(skeletal muscle index,SMI)及四肢骨骼肌BMI比（ASM-to-BMI ratio）。应用ROC曲线及Logistic 回归分析评价各肌肉量指标与OP风险的关联强度。结果男、女性ASM、ASMI、SMI、ASM-to-BMI ratio预测OP的ROC 曲线下面积均有统计学意义（P＜0.05），最佳切点值：ASM：男19.550 kg，女16.350 kg；ASMI：男7.523 3 kg/m2，女6.463 3 kg/m2；SMI：男0.327 5，女0.281 6；ASM-to-BMI ratio：男0.898 6，女0.708 8。多因素Logistic 回归分析显示，男性ASM与ASMI，女性ASM、ASMI与ASM-to-BMI ratio是预测OP风险有意义的肌肉量指标；男性ASM与AMSI均（+）组与均（–）组OP检出率分别为26.60 %及4.38 %；女性ASM、AMSI、ASM-to-BMI ratio均(–)组与均（+）组OP检出率分别为0.88 %与23.78 %。结论男性ASM与ASMI，女性ASM、ASMI与ASM-to-BMI是预测OP风险的良好肌肉量指标；指标联合应用能显著提高预测OP风险的效果。

英文摘要:

Objective To assess relationships of muscle mass indexes and osteoporosis, and identify muscle mass indexes for predicting risk of osteoporosis in community residents. Methods Bone strength, T value, appendicular skeletal muscle mass（ASM）on a sample of 3151 Gansu community dwellers in 4 cities/counties were tested by Ultrasonic bone mineral density meter and bioelectric impedance technique; three other muscle mass indexes include appendicular skeletal muscle mass index（ASMI）, skeletal muscle index（SMI）and ASM/BMI（ASM-to-BMI ratio）were calculated. ROC curve and Logistic analysis were used to analyze the relationship of muscle mass indexes and the risk of osteoporosis. Results ASM、ASMI、SMI and ASM-to-BMI ratio were significant muscle mass index in predicting OP risk in both male and female according to the results of ROC curves analysis, the optimal cut-off values were: ASM（male 19.550kg，female 16.350kg）, ASMI（male 7.5233 kg/m2，female6.4633 kg/m2）, SMI（male 0.3275，female0.2816）, ASM-to-BMI ratio（male 0.8986，female 0.7088）; Multivariate logistic analysis showed that ASM and ASMI were significant indexes for predicting OP risk for male whereas ASM,ASMI and ASM-to-BMI ratio were significant indexes for female; the incidence of OP in ASM(–), ASMI(–) group and ASM(+), ASMI(+) group of male were 4.38% and 26.60% respectively whereas the incidence of OP in ASM(–), ASMI(–), ASM-to-BMI ratio(–) group and ASM(+), ASMI(+), ASM-to-BMI ratio(+) group were 0.88% and 23.78% respectively of female. Conclusion ASM and ASMI in male and ASM, ASMI and ASM-to-BMI ratio in female were significant muscle mass indexes for OP risk prediction; the combination of indicators can significantly improve the effect of predicting OP risk.

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