绝经后女性肌少症与骨质疏松症的相关性研究

Correlation study between sarcopenia and osteoporosis in postmenopausal female

目的探讨绝经后女性肌少症与骨质疏松症(OP)的相关性。方法选取2018年1-12月浙江中医药大学附属温州中西医结合医院就诊的117名45岁以上绝经后女性志愿者。依据骨密度(BMD)分为OP组和非OP组(Non-OP组),记录患者的一般情况,采用双能X线吸收仪测量L1-4椎体及髋部的BMD、四肢骨骼肌含量(ASM)、四肢脂肪含量(AFM),并测量肌力及步速。计算四肢肌肉指数(ASMI)。采用线性相关分析统计ASM、AFM、ASMI与BMD的相关性,采用逻辑回归分析统计肌少症与OP的相关性。结果L1-4椎体BMD与ASM、ASMI、步速、肌力、体重指数呈正相关(r=0.487、0.361、0.468、0.287、0.368,均P<0.05);髋部BMD与ASM、ASMI、步速、肌力、体重指数呈正相关(r=0.377、0.345、0.370、0.276、0.380,均P<0.05);L1-4椎体及髋部的BMD与AFM无明显相关性(均P>0.05)。肌少症患者共16例(13.7%)。logistic回归分析显示,肌少症是影响骨质疏松症的危险因素(P<0.05)。结论绝经后女性BMD与肌少症密切相关,BMD与ASM、肌力、步速呈正相关,与AFM则无明显相关性,随着BMD的减少,年龄的增加,肌少症的发病率明显升高。

Objective To investigate the correlation between sarcopenia and osteoporosis(OP)in postmenopausal female.Methods A total of 117 postmenopausal female volunteers over 45 years old who attended Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University were selected from January to December 2018.According to the bone mineral density(BMD),they were divided into OP group and non-OP group(Non-OP group).The general condition of the patients were recorded.A dual-energy X-ray absorptiometer was used to measure the BMD of the L1-4 lumbar and hips,the appendicular skeletal muscle mass(ASM),and the appendicular fat mass(AFM),as well as the muscle strength and walk velocity.The appendicular skeletal muscle mass index(ASMI)was calculated.Linear correlation analysis was used to analyze the correlation between ASM,AFM,ASMI and BMD,and logistic regression analysis was used to analyze the correlation between sarcopenia and OP.Results The BMD of L1-4 lumbar was positively correlated with ASM,ASMI,walk velocity,muscle strength and body mass index(r=0.487,0.361,0.468,0.287,0.368,all P<0.05).The BMD of hip was positively correlated with ASM,ASMI,walk velocity,muscle strength and body mass index(r=0.377,0.345,0.370,0.276,0.380,all P<0.05).There were no significant correlation between the BMD of L1-4 lumbar and hip with AFM(all P>0.05).There were 16 patients with sarcopenia(13.7%).Logistic regression analysis showed that sarcopenia was a risk factor for osteoporosis(P<0.05).Conclusion BMD is closely related to sarcopenia in postmenopausal women.BMD is positively correlated with ASM,muscle strength and walk velocity but not with AFM.The incidence of sarcopenia increases significantly with the decrease of BMD and the increase of age.