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中国肌少症患者的骨密度和小梁骨评分。

Bone mineral density and trabecular bone score in Chinese subjects with sarcopenia.

机构信息

Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.

Division of Intensive Care Unit, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China.

出版信息

Aging Clin Exp Res. 2019 Nov;31(11):1549-1556. doi: 10.1007/s40520-019-01266-8. Epub 2019 Jul 17.

Abstract

BACKGROUND

As the general population is aging worldwide, the incidence of sarcopenia and osteoporosis is also rapidly increasing. Studies have found the link between sarcopenia and osteoporosis, but the relationship between sarcopenia and osteoporosis, especially bone microarchitecture, remains unclear.

AIMS

To investigate the relationship between components of sarcopenia (muscle mass, handgrip strength, and gait speed) and components of osteoporosis [bone mass measured by bone mineral density (BMD) and bone microarchitecture measured by trabecular bone score (TBS)] in Chinese subjects.

METHODS

318 Chinese men and 203 Chinese women were included in our study. Muscle mass and BMD were measured by dual-energy X-ray absorptiometry (DXA). TBS iNsight software was used for TBS. Jamar hydraulic hand dynamometer was used to assess muscle strength, and gait speed was used to assess physical performance.

RESULTS

We found that the relative appendicular skeletal muscle mass (RASM) in both genders and handgrip strength in women correlated positively with TBS, RASM in men and handgrip strength in women correlated positively with BMDs. In the multiple linear regression model, RASM was positively associated with TBS in both genders, but no significant association was observed between RASM and BMDs. Interestingly, handgrip strength showed positive association with all evaluated BMDs and TBS in women, but not in men. Women with sarcopenia had lower TBS and BMDs at all evaluated sites. Men with sarcopenia had lower BMDs only at femur neck and total hip.

CONCLUSIONS

The reduction of muscle mass and strength was significantly associated with decreased bone mass and deteriorated bone microarchitecture. More importantly, low muscle mass is an independent risk factor for bone microarchitecture in Chinese subjects.

摘要

背景

随着全球人口老龄化,肌少症和骨质疏松症的发病率也迅速增加。研究发现肌少症和骨质疏松症之间存在关联,但肌少症和骨质疏松症之间的关系,尤其是骨微观结构,仍不清楚。

目的

探讨中国人群中肌少症(肌肉质量、握力和步速)各成分与骨质疏松症(骨密度(BMD)测定的骨量和骨小梁评分(TBS)测定的骨微观结构)各成分之间的关系。

方法

本研究纳入 318 名中国男性和 203 名中国女性。通过双能 X 射线吸收法(DXA)测量肌肉质量和 BMD。使用 TBS iNsight 软件进行 TBS 评估。使用 Jamar 液压握力计评估肌肉力量,使用步速评估身体机能。

结果

我们发现,两性的相对四肢骨骼肌质量(RASM)和女性的握力与 TBS 呈正相关,男性的 RASM 和女性的握力与 BMDs 呈正相关。在多元线性回归模型中,RASM 与两性的 TBS 呈正相关,但与 BMDs 无显著相关性。有趣的是,握力与女性所有评估的 BMD 和 TBS 呈正相关,但与男性无关。患有肌少症的女性 TBS 和所有评估部位的 BMD 均较低。患有肌少症的男性仅在股骨颈和全髋部的 BMD 较低。

结论

肌肉质量和力量的减少与骨量减少和骨微观结构恶化显著相关。更重要的是,低肌肉质量是中国人群骨微观结构的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80dc/6825032/7f54563a2c5b/40520_2019_1266_Fig1_HTML.jpg

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