中老年女性骨密度与肌肉质量及躯体功能水平的相关性分析

Analysis of the Correlation of Bone Mineral Density and Muscle Mass and Physical Function Level in Middle-aged and Elderly Women

目的分析中老年女性骨密度(bone mineral density,BMD)与肌肉质量和躯体功能水平的相关性,为肌少-骨质疏松症的防治提供一定的参考。方法回顾性分析2021年10月~2023年6月南京中医药大学附属医院收治的111例年龄≥45岁女性患者的临床资料。采用双能X线吸收测定仪(dual-energy X-ray absorptiometry,DXA)检测腰椎BMD、骨骼肌质量(appendicular skeletal muscle,ASM),并计算出骨骼肌质量指数(appendicular skeletal muscle index,ASMI)作为肌肉质量的指标。通过起立-行走计时测试(timed up and go,TUG)反映躯体功能水平。按照年龄及BMD进行分组,比较各组年龄、体重指数(body mass index,BMI)、ASMI、TUG、BMD的差异,并比较各BMD组中低肌肉质量的检出率,利用Pearson法分析各指标与BMD的相关性。结果BMD随年龄的增加而下降(P<0.001),TUG随年龄的增加而增加(P<0.001)。ASMI显示,45~55岁组高于66岁以上组,差异有统计学意义(P<0.05)。各年龄段组BMI和ASMI比较,差异无统计学意义(P>0.05)。各BMD组的年龄、TUG随BMD的减少而呈上升趋势,差异有统计学意义(P<0.001),而ASMI(P<0.001)随着BMD的减少而下降。骨量正常组BMI高于骨质疏松组,差异有统计学意义(P<0.05)。各BMD组BMI比较,差异无统计学意义(P>0.05)。111例患者中,骨质疏松症者占49.6%,低肌肉质量者占72.1%。各BMD组中低肌肉质量者检出率依次为85.5%、64.3%、53.6%,差异有统计学意义(P<0.05)。BMD与年龄(r=-0.328,P=0.002)、TUG(r=-0.262,P=0.017)呈负相关,与BMI(r=0.224,P=0.042)、ASMI(r=0.291,P=0.008)呈正相关。结论肌肉质量及躯体功能水平是影响中老年女性BMD的重要因素。早期干预肌肉质量,提高躯体功能水平可延缓中老年女性骨量丢失,改善骨代谢。

Objective To analyze the correlation between bone mineral density(BMD)and muscle mass and physical function level in middle-aged and elderly women,and to provide certain reference for the prevention and treatment of osteosarcopenia.Methods The clinical data of 111 female patients aged≥45 years old who received the Affiliated Hospital of Nanjing University of Chinese Medicine from October 2021 to June 2023 were selected.Dual-energy X-ray absorptiometry(DXA)was used to detect the BMD of lumbar and appendicular muscle mass(ASM),appendicular skeletal muscle mass index(ASMI)was calculated as the index of muscle mass.The physical function level was measured by the timed up and go test(TUG).The groups were grouped according to age and BMD,and the differences in age,body mass index(BMI),ASMI,TUG and BMD among all groups were compared.The detection rate of low muscle mass in BMD groups was also compared.Pearson method was used to analyze the correlation between each index and BMD.Results BMD decreased with increasing age(P<0.001),and the TUG increased with increasing age(P<0.001).ASMI showed that 45-55 years old group was higher than over 66 years old group,and the difference was statistically significant(P<0.05).There were no significant differences in BMI and ASMI among the different age groups(P>0.05).The age and TUG of BMD groups increased with the decrease of BMD,and the differences were statistically significant(P<0.001),while ASMI(P<0.001)decreased with the decrease of BMD.The BMI of normal bone mass group was higher than that of osteoporosis group,and the difference was statistically significant(P<0.05).There was no significant difference in BMI among the different BMD groups(P>0.05).Among the 111 patients,49.6% had osteoporosis,and 72.1% had low muscle mass.The detection rates of low muscle mass in different BMD groups were 85.5%,64.3% and 53.6%,respectively,and the difference was statistically significant(P<0.05).BMD was negatively correlated with age(r=-0.328,P=0.002),TUG(r=-0.262,P=0.017),and positively correlated with BMI(r=0.224,P=0.042),ASMI(r=0.291,P=0.008).Conclusion Muscle mass and physical functional level are important factors affecting BMD in middle-aged and elderly women.Early intervention of muscle mass and improvement of physical functional level can delay bone loss and improve bone metabolism in middle-aged and elderly women.