不同绝经阶段肌力水平与骨密度和骨代谢指标之间的相关性

Correlation between muscle strength levels with bone mineral density and bone metabolism indices at different menopausal stages

目的探究北京地区绝经后女性肌力水平与骨密度(BMD)和骨代谢指标之间的相关性。方法回顾2017年9月至2018年5月北京市接受现场问卷调查且行BMD检查的绝经后女性作为研究对象,根据绝经年限,将其分为绝经早期组、绝经中期组、绝经晚期组、绝经暮期组。观察四组握力、5次坐立试验(FTSST)与BMD、骨代谢指标的变化,并分析其相关性。结果共纳入绝经后女性815例。在不同绝经阶段,肌力随绝经年限增长而下降(P<0.05),四组间的不同骨代谢指标差异均无统计学意义,股骨颈及腰椎的BMD随绝经年限增长而下降(P<0.05)。最大握力与股骨颈及腰椎的BMD均呈正相关(R=0.158,P<0.05;R=0.130,P<0.05)。肌力水平与骨代谢指标无相关性。结论不同骨代谢指标与绝经期女性肌力水平均无关。最大握力与BMD呈正相关,可作为女性骨质疏松症(OP)的辅助筛查手段;FTSST提示绝经期女性下肢肌力随年龄增长而下降,可作为预测绝经期女性跌倒危险的指标之一。

Objective To investigate the correlation between muscle strength level and bone mineral density and bone metabolism indexes in postmenopausal women in Beijing.Methods Postmenopausal women who were investigated by on-site questionnaires and followed by bone mineral density examination in Beijing from September 2017 to May 2018 were recruited as study subjects.They were divided into early menopausal group,middle menopausal group,late menopausal group,and twilight menopausal group according to the years of menopause.Changes in grip strength,5 times sit-to-stand test(FTSST)with bone mineral density(BMD)and bone metabolism indexes were observed in the four groups and their correlations were analyzed.Results A total of 815 cases of postmenopausal women were included.At different menopausal stages,muscle strength was all found to decrease with the increase of menopausal years(P<0.05),there was non-significance of different bone metabolism indexes among the four groups(P>0.05);Femoral neck and lumbar spine BMD decreased with the increase of menopausal years(P<0.05).Maximum grip strength was positively correlated with both femoral neck and lumbar spine BMD(R=0.158,P<0.05;R=0.130,P<0.05).There was no correlation between muscle strength and bone metabolism indexes(P<0.05).Conclusions Different bone metabolism indexes are not associated with muscle strength in menopausal women.Maximum grip strength is positively correlated with bone mineral density,which can be used as an auxiliary screening tool for osteoporosis(OP)in women.The FTSST suggests that the lower limb muscle strength of menopausal women decreases with age,which can be used as one of the indicators for predicting the risk of falls in menopausal women.