Kim Kyoung Min, Lee Eun Young, Lim Soo, Jang Hak-Chul, Kim Chang-Oh
Division of Endocrinology, Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, South Korea.
Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Osteoporos Sarcopenia. 2017 Mar;3(1):32-36. doi: 10.1016/j.afos.2016.11.001. Epub 2016 Dec 7.
The aim of this study was to investigate associations between skeletal muscle mass and bone mineral density according to gender and skeletal sites.
Using the data from Korean National Health and Nutrition Examination Survey (KNHANES IV) 2009, a total of 711 males and 847 females over 65 years of age were evaluated. Bone mineral density (BMD) and body composition were assessed using dual-energy X-ray absorptiometry.
Relative appendicular skeletal muscle (RASM) was positively related with the femur BMD with a stronger relationship in males (r = 0.207, p < 0.001) than in females (r = 0.095, p < 0.05). However, lumbar spine BMDs in both males and females did not show any significant associations with the RASM value. In the logistic regression for osteoporosis expressed as a decrease of risk per increase of RASM by 1 standard deviation (SD) of the same sex healthy reference group, the age- and BMI-adjusted odds ratio (OR) for osteoporosis was 0.42 (95% CI 0.12-0.76) in the femur neck and 0.24 (95% CI 0.07-0.76) in the total hip for males. Among females, the age- and BMI-adjusted OR for osteoporosis was 0.65 (95% CI 0.33-1.00), which showed importance only in the total hip.
Higher RASM was significantly associated with lower risk for osteoporosis and the areas at the femur neck and total hip appeared to more likely be affected positively by muscle. Moreover, because males showed faster muscle loss with aging than females, the bones of males may be more prone to favorable effects of muscle.
本研究旨在根据性别和骨骼部位调查骨骼肌质量与骨密度之间的关联。
利用2009年韩国国家健康与营养检查调查(KNHANES IV)的数据,对711名65岁以上男性和847名65岁以上女性进行了评估。使用双能X线吸收法评估骨密度(BMD)和身体成分。
相对附属骨骼肌(RASM)与股骨骨密度呈正相关,男性(r = 0.207,p < 0.001)的相关性比女性(r = 0.095,p < 0.05)更强。然而,男性和女性的腰椎骨密度与RASM值均未显示出任何显著关联。在以同性健康参考组RASM每增加1个标准差(SD)风险降低表示骨质疏松症的逻辑回归中,男性股骨颈骨质疏松症的年龄和体重指数调整优势比(OR)为0.42(95%CI 0.12 - 0.76),全髋为0.24(95%CI 0.07 - 0.76)。在女性中,骨质疏松症的年龄和体重指数调整OR为0.65(95%CI 0.33 - 1.00),仅在全髋显示出重要性。
较高的RASM与较低的骨质疏松症风险显著相关,股骨颈和全髋部位似乎更有可能受到肌肉的积极影响。此外,由于男性随着年龄增长肌肉流失比女性更快,男性的骨骼可能更容易受到肌肉的有利影响。