Department of Clinical Nutrition, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China.
Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China.
Clin Interv Aging. 2020 Jun 12;15:889-895. doi: 10.2147/CIA.S250629. eCollection 2020.
The study aimed to investigate the potential association of trunk skeletal muscle mass (tSM) and phase angle measured by bioelectrical impedance analysis (BIA) with the chance of femoral neck fractures in very elderly people.
This case-control study enrolled 78 femoral neck fracture patients aged over 75 years (29 males) and 1:2 matched healthy controls. All participants were subjected to BIA examination by specialists. tSM, the corrected values by height squared of tSM (tSMI) and phase angle were compared between fracture patients and controls. Multivariate logistic regression was performed to explore the strength of association of femoral neck fracture with tSM, tSMI, and phase angle.
tSM (kg) of fracture patients was significantly lower than those of controls in all participants (women: 13.49±0.42 vs 15.44±0.39, <0.05; men: 15.30±0.71 vs 17.54±0.78, <0.05). In the sarcopenic subgroup, fracture patients also got a lower tSM than controls (women: 12.58±0.21 vs 13.62±0.16, <0.05; men:14.41±0.29 vs 16.07±0.21, <0.05). The comparison of tSMI between the two groups was similar to that of tSM. Phase angle (°) at 50 kHz in fracture patients was significantly lower than that of controls in women and men (women: 3.70±0.32 vs 4.61±0.21, <0.05; men: 3.50±0.20 vs 3.84±0.22, <0.05). Multivariate logistic regression analysis demonstrated higher fracture chance with significantly associated decreased tSM [women: OR (95% CI): 0.78(0.67-0.91); men: 0.74(0.64-0.86)] and tSMI [women: OR (95% CI): 0.72(0.61-0.85); men: 0.69 (0.59-0.81)]. In addition, per 1° increase of phase angle in the trunk could decrease the fracture risk by 14% for women [OR (95% CI): 0.86 0.79-0.94)] and 29% for men [OR (95% CI): 0.71 (0.64-0.79)].
This study indicates a decrease in tSM, tSMI, and phase angle measured by BIA is significantly related to the increased chance of femoral neck fracture in people aged over 75 years. Strengthening the mass and strength of trunk skeletal muscles may help reduce the risk of femoral neck fracture in elderly patients.
本研究旨在探讨通过生物电阻抗分析（BIA）测量的躯干骨骼肌质量（tSM）和相位角与超高龄人群股骨颈骨折发生几率的潜在关联。
本病例对照研究纳入了 78 名年龄超过 75 岁的股骨颈骨折患者（29 名男性）和按 1:2 比例匹配的健康对照。所有参与者均由专家进行 BIA 检查。比较骨折患者和对照组之间的 tSM、tSM 按身高平方校正值（tSMI）和相位角。采用多变量逻辑回归分析探讨股骨颈骨折与 tSM、tSMI 和相位角之间的关联强度。
所有参与者中，骨折患者的 tSM（kg）均明显低于对照组（女性：13.49±0.42 与 15.44±0.39，<0.05；男性：15.30±0.71 与 17.54±0.78，<0.05）。在肌少症亚组中，骨折患者的 tSM 也低于对照组（女性：12.58±0.21 与 13.62±0.16，<0.05；男性：14.41±0.29 与 16.07±0.21，<0.05）。两组间 tSMI 的比较与 tSM 相似。女性和男性中，骨折患者的相位角（°）在 50 kHz 时明显低于对照组（女性：3.70±0.32 与 4.61±0.21，<0.05；男性：3.50±0.20 与 3.84±0.22，<0.05）。多变量逻辑回归分析表明，tSM 显著降低与更高的骨折几率相关[女性：OR（95%CI）：0.78（0.67-0.91）；男性：0.74（0.64-0.86）]和 tSMI[女性：OR（95%CI）：0.72（0.61-0.85）；男性：0.69（0.59-0.81）]。此外，躯干相位角每增加 1°，女性的骨折风险降低 14%[OR（95%CI）：0.86（0.79-0.94）]，男性降低 29%[OR（95%CI）：0.71（0.64-0.79）]。
本研究表明，通过 BIA 测量的 tSM、tSMI 和相位角降低与 75 岁以上人群股骨颈骨折发生几率增加显著相关。增强躯干骨骼肌的质量和强度可能有助于降低老年患者股骨颈骨折的风险。
