中国骨质疏松杂志

原发性骨质疏松症患者不同部位骨密度与肌少症的相关性分析

Correlation analysis between bone mineral density in different parts and sarcopenia in patients with primary osteoporosis

DOI：10.3969/j.issn.1006-7108.2023.11.008

中文关键词: 骨质疏松症肌少症髋部骨密度 T值

英文关键词:osteoporosis sarcopenia hip bone mineral density T value

基金项目:江苏省卫生健康委员会老年健康科研项目（LR2022012，LD2022008）

作者	单位
傅琪刘芬芬刘萍滕若凌张翠萍杨玉娇丁怡*	常州市第一人民医院（苏州大学附属第三医院）老年医学科，江苏常州 213000

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中文摘要:

目的探究原发性骨质疏松症患者不同部位骨密度与肌少症之间的相关性。方法选取2020年11月至2023年3月于常州市第一人民医院老年医学科就诊的162例≥50岁的原发性骨质疏松症患者。记录每位患者的一般情况、腰椎和髋部的BMD和T值、肌少症评估指标[握力、5次起坐时间、6 m步速、简易机体功能评估得分（short physical performance battery，SPPB）、四肢骨骼肌质量指数（appendicular skeletal muscle mass index，ASMI）等]，并将研究对象分为无肌少症组、有肌少症风险组、一般肌少症组和重度肌少症组。采用ANOVA方差分析或非参数检验分析不同分组肌少症之间的差异性；Pearson/Spearman相关性分析计算髋部BMD和T值与肌少症评估指标之间的相关性；二元及多元Logistic回归分析计算骨质疏松患者中髋部T值与不同分组肌少症之间的关系。结果无肌少症、有肌少症风险、一般肌少症和重度肌少症的患病率分别为27.16%、30.86%、20.37%、21.61%。股骨颈和全髋的BMD和T值与握力、SPPB得分、ASMI呈正相关（r=0.351、0.319、0.360、0.284；r=0.246、0.248、0.251、0.248；r=0.349、0.392、0.320、0.337，P＜0.05），与5次起坐时间呈负相关（r=-0.241、-0.176、-0.262、-0.187，P＜0.05），与6 m步速不相关（P＞0.05）。低水平的髋部T值是促使肌少症发生发展的危险因素，T值越小，骨质疏松程度越高，发生肌少症（OR=0.363、0.415）尤其是重度肌少症（OR=0.229、0.286）的风险越大；在校正了性别、年龄、身高、体重、体质量指数后，这一情况仍存在（OR=0.405、0.427；OR=0.389、0.359）。结论原发性骨质疏松症患者中髋部的骨密度值与肌少症的发生发展密切相关。

英文摘要:

Objective To investigate the correlation between bone mineral density in different parts and sarcopenia in patients with primary osteoporosis. Methods A total of 162 over 50-year-old patients with primary osteoporosis who visited the Geriatrics Department of Changzhou First People's Hospital from November 2020 to March 2023 were enrolled. The general condition of each patient, bone mineral density and T value of the lumbar spine and hip, sarcopenia assessment indicators (grip strength, 5-time chair stand test, 6-m walk, short physical performance battery score, appendicular skeletal muscle mass index, etc.) were recorded. The study subjects were divided into sarcopenia-free group, sarcopenia risk group, general sarcopenia group, and severe sarcopenia group. ANOVA or non-parametric test was used to analyze the differences between different groups of sarcopenia. Pearson/Spearman correlation analysis was used to calculate the correlation between hip bone mineral density and T values and sarcopenia assessment indicators. Binary and multivariate logistic regression analysis were used to calculate the relationship between hip T and different groups of sarcopenia in patients with osteoporosis. Results The prevalence of sarcopenia-free, sarcopenia risk, general sarcopenia, and severe sarcopenia was 27.16%, 30.86%, 20.37%, and 21.61%, respectively. Bone mineral density and T values of the femoral neck and total hip were positively correlated with grip strength, SPPB score, and ASMI (r=0.351, 0.319, 0.360, 0.284; r=0.246, 0.248, 0.251, 0.248; r=0.349, 0.392, 0.320, 0.337, P<0.05, respectively), negatively correlated with 5-time chair stand test (r=-0.241, -0.176, -0.262, -0.187, P<0.05), and were not correlated with a 6-m walk (P>0.05). Low hip T value was a risk factor for the development of sarcopenia. The smaller the T-value, the higher the degree of osteoporosis, and the greater the risk of sarcopenia (OR=0.363, 0.415) and severe sarcopenia (OR=0.229, 0.286). This result persisted after adjusting for sex, age, height, weight, and BMI (OR=0.405, 0.427; OR=0.389, 0.359). Conclusion Bone mineral density of the hip in patients with primary osteoporosis is closely related to the occurrence and development of sarcopenia.

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