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| 通过QCT探讨体质成分对慢性肾脏病骨密度的影响 |
| The impact of body composition on bone mineral density in patients with chronic kidney disease based on QCT analysis |
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| DOI：10.3969/j.issn.1006-7108.2025.05.012 |
| 中文关键词: 慢性肾脏病 QCT 骨质疏松症 |
| 英文关键词:chronic kidney disease QCT osteoporosis |
| 基金项目:甘肃省科技计划资助项目（18JR2FA001） |
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| 中文摘要: |
| 目的 通过QCT探讨体质成分对慢性非透析肾脏病患者骨量的影响，为预防慢性肾脏病(chronic kidney disease,CKD)患者因骨量减少造成跌倒、骨折的发生提供临床参考和指导。方法 对97例慢性肾脏病非透析患者进行回顾性分析；采用QCT进行腰椎椎体扫描后获取骨密度、身体成分，记录临床基线数据和收集相关生化指标；根据CKD患者的骨密度值分为正常组、骨量减少组、骨质疏松症组；采用单因素方差分析比较三组间的临床资料、生化指标和身体成分差异，通过多元线性回归分析慢性肾脏病骨密度的影响因素。结果 本研究中骨密度正常组为39例、骨量减少组为36例、骨质疏松症的患者22例；年龄、性别、体质量指数(body mass index, BMI)值、甘油三酯、血红蛋白、尿酸、骨骼肌质量（SAM）、骨骼肌质量指数（SAMI）及内脏、皮下脂肪面积比（V/S）值在三组间存在统计学差异；经过多元线性回归得出年龄是慢性肾脏病患者骨密度的危险因素（P＜0.05, β＞0）、血红蛋白、尿酸、SAMI及V/S值是骨密度的保护因素（P＜0.05, β＜0）。结论 本研究提示年龄是慢性肾脏病患者骨密度的危险因素，但血红蛋白、尿酸、SAMI及V/S值是慢性肾脏病非透析患者骨量的保护因素。 |
| 英文摘要: |
| Objective To investigate the impact of body composition on bone mass in patients with chronic non-dialysis kidney disease (CKD) using quantitative computed tomography (QCT), in order to provide clinical reference and guidance for preventing falls and fractures due to reduced bone mass in CKD patients. Methods A retrospective analysis was conducted on 97 non-dialysis patients with chronic kidney disease. Bone mineral density and body composition were measured using QCT after lumbar vertebral scanning. Clinical baseline data and relevant biochemical markers were also recorded. Patients were categorized into three groups based on their bone mineral density values: normal bone mineral density, reduced bone mass, and osteoporosis. A one-way analysis of variance was employed to compare the differences in clinical data, biochemical indicators, and body composition among the three groups. Multiple linear regression was employed to analyze the factors influencing bone mineral density in CKD patients. Results The study included 39 patients in the normal bone mineral density group, 36 in the reduced bone mass group, and 22 in the osteoporosis group. Significant statistical differences were found among the groups in terms of age, gender, BMI, triglycerides, hemoglobin, uric acid, skeletal muscle mass (SAM), skeletal muscle mass index (SAMI), and visceral/subcutaneous fat ratio (V/S). Multiple linear regression analysis identified age as a risk factor for bone mineral density (P<0.05, β>0), while hemoglobin, uric acid, SAMI, and V/S were protective factors (P<0.05, β<0). Conclusion This study suggests that age is a risk factor for bone mineral density in patients with chronic kidney disease, whereas hemoglobin, uric acid, SAMI, and V/S values are protective factors for bone mass in patients with chronic non-dialysis kidney disease. |
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