绝经后骨质疏松症女性25(OH)D、BMP-2与肌肉量、肌肉功能关系及对肌少症影响

Relationship of 25(OH)D and BMP-2 with muscle mass and muscle function and their effects on sarcopenia in postmenopausal women with osteoporosis

目的探究绝经后骨质疏松症(POP)女性25羟维生素D[25(OH)D]、骨形态发生蛋白-2(BMP-2)与肌肉量、肌肉功能关系及对肌少症影响。方法从2020年8月至2022年8月在秦皇岛市中医医院就诊的POP女性中随机抽取85例作为研究组,另外从同期来院体检的健康绝经期女性中随机抽取30例作对照组,比较两组25(OH)D、BMP-2、肌肉量及肌肉功能水平。研究组患者入院后均接受综合规范化治疗,根据《肌少症共识》将其分为肌少症组和无肌少症组,采用单因素、多因素Logistic回归分析、Pearson相关分析明确25(OH)D、BMP-2水平与肌肉量、肌肉功能关系及对肌少症影响。结果相较对照组,研究组患者血清25(OH)D、BMP-2水平、上肢肌肉量、下肢肌肉量、全身肌肉量均偏低,SMFA评分偏高(P<0.05);经单因素、多因素Logistic回归分析,低25(OH)D、BMP-2、股骨颈骨密度(FN.BMD)、Ward’s三角区骨密度(WTB.BMD)、全髋骨密度(TH.BMD)、腰椎1-4骨密度(LS.BMD)水平、少肌肉量(上肢肌肉量、下肢肌肉量、全身肌肉量)、合并糖尿病、高SMFA评分均是影响POP发生肌少症的危险因素(P<0.05);经Pearson相关分析,血清25(OH)D、BMP-2与上肢肌肉量、下肢肌肉量、全身肌肉量均呈正相关,与SMFA评分均呈负相关(P<0.05)。结论血清25(OH)D、BMP-2在POP中呈高表达,与肌肉量、肌肉功能存在显著相关性,且是影响POP女性发生肌少症的危险因素。

Objective To explore the relationship between 25 hydroxyvitamin D[25(OH)D]and bone morphogenetic protein-2(BMP-2)with muscle mass and muscle function and their effects on sarcopenia in postmenopausal women with osteoporosis.Methods A total of 85 postmenopausal women with osteoporosis admitted to hospital from August 2020 to August 2022 were selected as the study group,and 30 healthy postmenopausal women admitted for physical examination during the same period were selected as the control group.The 25(OH)D,BMP-2,muscle mass and muscle function levels of the two groups were tested and compared.Patients in the study group were admitted to hospital and received comprehensive standardised treatment.They were divided into the sarcopenia group and the no sarcopenia group according to the Consensus on Sarcopenia.Univariate,multivariate Logistic regression and Pearson correlation analysis were used to determine the relationship between 25(OH)D and BMP-2 levels,meat mass and muscle function and their influence on sarcopenia.Results Compared with the control group,the serum 25(OH)D,BMP-2 levels,upper limb muscle mass,lower limb muscle mass and whole body muscle mass in the study group were lower,and the SMFA score was higher(P<0.05).Through univariate Logistic regression analysis,Low 25(OH)D,BMP-2,femoral neck bone mineral density(FN.BMD),Ward's trigonal bone mineral density(WTB.BMD),hip bone mineral density(TH.BMD),Lumbar 1-4 bone mineral density(LS.BMD)levels,low muscle mass(upper limb muscle mass,lower limb muscle mass,whole body muscle mass)and combined with diabetes mellitus,high SMFA score were all risk factors for sarcopenia in postmenopausal osteoporosis(P<0.05).According to Pearson correlation analysis,serum 25(OH)D and BMP-2 were positively correlated with upper limb muscle mass,lower limb muscle mass and whole body muscle mass,but negatively correlated with SMFA score(P<0.05).Conclusion Serum 25(OH)D and BMP-2 are highly expressed in postmenopausal osteoporosis,significantly correlated with muscle mass and muscle function,and are risk factors for sarcopenia in postmenopausal women with osteoporosis.