定量CT分析成人椎后肌群脂肪含量与腰椎骨密度的相关性

Correlation between fat content of the posterior vertebral muscles and bone mineral density of the lumbar spine in adults by quantitative CT

目的探讨成人椎后肌群脂肪含量与腰椎骨密度的相关性。方法根据纳入标准收集2019年1月至6月在贵州医科大学附属医院健康体检者1847名,其中男性1057名,女性790名,平均年龄分别为(50.92±9.79)岁和(51.67±9.87)岁,行胸部CT扫描时获取腰椎定量CT(quantitative computed tomography,QCT)数据,测量椎后肌群脂肪含量和腰1-2椎体骨密度(bone mineral density,BMD)。将受检者按年龄进行分组后,对男女组间体质量指数(body mass index,BMI)、腰围、BMD、患骨质疏松的人数和比例、椎后肌群平均脂肪含量进行比较。受检者按BMI分组后采用方差分析比较各组椎后肌群平均脂肪含量,两两比较采用Games-Howell检验。将资料按照男女进行分组后,应用一般线性回归分析椎后肌群脂肪含量与腰椎BMD之间的相关性。结果随年龄的增加,椎后肌群脂肪含量增加,且女性(9.66%±3.92%)椎后肌群脂肪含量高于男性(7.06%±2.91%);随着BMI增加,椎后肌群脂肪含量逐渐增加(F=35.051,P<0.001)。成人椎后肌群平均脂肪含量每增加一个单位,骨密度值在男性降低2.13(95%CI:-3.07,-1.18)个单位,在女性降低1.62(95%CI:-2.55,-0.68)个单位。结论椎后肌群脂肪含量与腰椎BMD呈负相关。

Objective To investigate the relationship between the fat content of the posterior vertebral muscles and the lumbar spine bone mineral density(BMD)in adults.Methods According to the inclusion criteria,1847 people which included 1057 male(mean age:50.92±9.79 years)and 790 female(mean age,51.67±9.87 years)were collected from January to June 2019 at the Affiliated Hospital of Guizhou Medical University for health checkups.And lumbar spine quantitative computed tomography(QCT)data were obtained at the time of performing chest CT scans to measure posterior fat content of vertebral muscles and lumbar 1-2 BMD.After the subjects were grouped according to age,body mass index(BMI),waist circumference,BMD,number and proportion of osteoporosis patients,and posterior vertebral muscles mean fat content were compared between the male and female groups.After the subjects were grouped according to BMI,the mean fat content of the posterior vertebral musculature was compared between the groups using ANOVA,and the Games-Howell test was used for two-way comparisons.After grouping the data according to men and women,conventional linear regression was implemented to analyze the correlation between fat content of the posterior vertebral muscles and lumbar spine BMD.Results The fat content of the posterior vertebral muscles increased with age,and the fat content of the posterior vertebral muscles in female(9.66%±3.92%)was higher than that of male(7.06%±2.91%).As BMI increased,the fat content of the posterior vertebral muscles gradually increased(F=35.051,P<0.001).BMD decreased by 2.13(95%CI:-3.07,-1.18)units in males and 1.62(95%CI:-2.55,-0.68)units in females for each unit increase in mean fat content of the posterior vertebral muscles in adults.Conclusion The fat content of posterior vertebral muscles is negatively correlated with lumbar BMD.