Lee Naomi, Radford-Smith Graham L, Forwood Mark, Wong Joseph, Taaffe Dennis R
School of Human Movement Studies, Faculty of Health Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia.
J Bone Miner Metab. 2009;27(4):456-63. doi: 10.1007/s00774-009-0059-5. Epub 2009 Mar 31.
Compromised skeletal status is a frequent finding in patients with Crohn's disease (CD), leading to increased fracture risk. Low body weight is associated with bone mineral density (BMD) in CD, although the relative importance of its components, lean and fat mass, is unclear. Muscle strength is also a predictor of BMD in nondiseased populations; however, its association with bone in CD is unknown. We examined the independent effects of body composition and muscle strength on regional and whole-body BMD in a cohort of CD patients. Sixty men and women, aged 22-72 years, with disease duration of 13 +/- 7 years, underwent scanning of the spine, hip, forearm, and whole-body BMD by dual-energy X-ray absorptiometry (DXA). Lean tissue, appendicular muscle mass (AMM), and fat mass were derived by DXA and grip strength by dynamometry. Medical history, medication usage, clinical variables, and nutritional intake were obtained by questionnaire. Prevalence of osteopenia and osteoporosis was 32 and 17%, respectively, with osteopenia more common at the hip and osteoporosis more common at the spine. In multiple regression analyses, AMM was an independent predictor of whole-body and regional BMD whereas lean mass was an independent predictor at the hip. Neither grip strength nor fat mass was independently associated with BMD. Of the components of body composition, muscle mass was strongly associated with regional and whole-body BMD. Preserving or augmenting muscle mass in this population may be a useful strategy to preserve BMD and thereby reduce fracture risk.
骨骼状态受损在克罗恩病（CD）患者中很常见，会导致骨折风险增加。低体重与CD患者的骨密度（BMD）相关，但其组成部分（瘦体重和脂肪量）的相对重要性尚不清楚。在未患病人群中，肌肉力量也是骨密度的一个预测指标；然而，其与CD患者骨骼的关联尚不清楚。我们在一组CD患者中研究了身体成分和肌肉力量对局部和全身骨密度的独立影响。60名年龄在22 - 72岁之间、病程为13±7年的男性和女性，通过双能X线吸收法（DXA）对脊柱、髋部、前臂和全身骨密度进行扫描。通过DXA得出瘦组织、附属肌肉量（AMM）和脂肪量，通过测力计得出握力。通过问卷调查获取病史、用药情况、临床变量和营养摄入量。骨质减少和骨质疏松的患病率分别为32%和17%，骨质减少在髋部更常见，骨质疏松在脊柱更常见。在多元回归分析中，AMM是全身和局部骨密度的独立预测指标，而瘦体重是髋部骨密度的独立预测指标。握力和脂肪量均与骨密度无独立关联。在身体成分的各组成部分中，肌肉量与局部和全身骨密度密切相关。在该人群中保持或增加肌肉量可能是维持骨密度从而降低骨折风险的有效策略。
