社区中老年男性骨密度、肌力与代谢指标的相关性

Correlation between bone mineral density,muscle strength,and metabolic indexes of middle-aged and elderly men in the community

目的分析社区中老年男性骨密度、肌力与代谢指标的相关性,探讨男性骨量减少的危险因素。方法2014年12月20日至29日对沈阳小儿王社区居民进行流行病学抽样调查,共纳入40岁及以上男性152例。所有受试者均进行问卷调查、体格检查、生化和骨密度检测及肌肉功能评估。结果受试者中骨量减少73例(48.03%)。与正常骨量组比较,骨量减少组体质量指数(BMI)、腰围、握力明显降低,站起步行试验时间明显增加(均P<0.05)。对152例受试者相关指标分析结果显示,握力与腰椎、股骨颈及髋关节的骨密度均正相关(均P<0.05);尿酸与股骨颈骨密度正相关(P<0.05);而空腹血糖、餐后2 h血糖与握力负相关(均P<0.05),空腹血糖与股骨颈骨密度负相关(P<0.05)。BMI与腰椎、股骨颈及髋关节骨密度正相关(P<0.05),而与站立试验时间负相关(P<0.05)。多元回归分析结果显示,BMI、握力、年龄、空腹血糖是社区中老年男性骨量减少的影响因素(均P<0.05)。结论社区中老年男性的骨量减少比例较高,高BMI、握力大是中老年男性骨量减少的保护因素,而年龄大、空腹血糖高是中老年男性骨量减少的危险因素。

Objective To analyze the correlation between bone mineral density(BMD),muscle strength,and metabolic indexes in middle-aged and elderly men in the community and to explore the risk factors for bone loss in men.Methods From December 20 to 29,2014,an epidemiological sampling survey was conducted among the residents of the Xiaoerwang Community,Shenyang.A total of 152 men aged≥40 years were included in the study.All participants underwent physical examinations,biochemical and BMD tests,and muscle function assessments and responded to questionnaires.Results Bone mass decreased in 73 participants(48.03%).Compared with the normal bone mass group,body mass index(BMI),waist circumference,and grip strength were significantly decreased in the reduced bone mass group,and timed get-up-and-go test significantly increased(all P<0.05).The results showed that grip strength was positively correlated with BMD of the lumbar spine,femoral neck,and hip joint(all P<0.05).Uric acid level was positively correlated with BMD of the femoral neck(P<0.05).Fasting and 2 h postprandial blood glucose levels were negatively correlated with grip strength(P<0.05),and fasting blood glucose level negatively correlated with BMD of the femoral neck(P<0.05).BMI was positively correlated with BMD of the lumbar spine,femoral neck,and hip joint(P<0.05),but negatively correlated with the chair rising test time(P<0.05).Multiple regression analysis showed that BMI,grip strength,age,and fasting blood glucose level were the influencing factors of bone loss in middle-aged and elderly men in the community(all P<0.05).Conclusion High BMI and grip strength are protective factors for decreased bone mass in middle-aged and elderly men,whereas older age and high fasting blood glucose level are risk factors for decreased bone mass in middle-aged and elderly men.