Lin Yu-Ching, Juan Yu-Hsiang, Chan Wing P, Yeh Kun-Yun, Wong Alice M K, Sung Chen-Ming, Lin Yu-Jr, Chang Shu-Chen, Chen Fang-Ping
Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Keelung, College of Medicine, Chang Gung University, Keelung 222, Taiwan.
Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Taoyuan, Institute for Radiological Research, Chang Gung University, Taoyuan 333, Taiwan.
J Clin Med. 2021 Mar 8;10(5):1129. doi: 10.3390/jcm10051129.
The utility of muscle health for predicting asymptomatic vertebral fracture (VF) is uncertain. We aimed to determine the effects of muscle health on bone quantity and quality in the older adults and to integrate these factors into a predictive model for VF.
We prospectively recruited participants with a body mass index <37 kg/m. The total lean mass (TLM), appendicular skeletal muscle index, presence of sarcopenia, and bone mineral density were determined by dual-energy X-ray absorptiometry, and bone quality by the trabecular bone score (TBS). VF was diagnosed based on spine radiography.
A total of 414 females and 186 males were included; 257 participants had VF. Lower TLM was significantly associated with poorer bone quantity and quality in both males and females. A low TBS (OR: 11.302, = 0.028) and sarcopenia (Odds ratio (OR): 2.820, = 0.002) were significant predictors of VF in males, but not bone quantity. Moreover, integrating TBS and sarcopenia into the predictive model improved its performance.
Although TLM was associated with bone quantity and quality in both sexes, sarcopenia and a low TBS were significant predictors of asymptomatic VF only in male participants.
肌肉健康对预测无症状椎体骨折（VF）的作用尚不确定。我们旨在确定肌肉健康对老年人骨量和骨质量的影响，并将这些因素整合到VF的预测模型中。
我们前瞻性招募了体重指数<37kg/m的参与者。通过双能X线吸收法测定总瘦体重（TLM）、四肢骨骼肌指数、肌肉减少症的存在情况以及骨密度，并通过小梁骨评分（TBS）评估骨质量。根据脊柱X线片诊断VF。
共纳入414名女性和186名男性；257名参与者发生VF。较低的TLM与男性和女性较差的骨量和骨质量均显著相关。低TBS（比值比（OR）：11.302，P = 0.028）和肌肉减少症（OR：2.820，P = 0.002）是男性VF的显著预测因素，但与骨量无关。此外，将TBS和肌肉减少症纳入预测模型可提高其性能。
虽然TLM与两性的骨量和骨质量均相关，但肌肉减少症和低TBS仅在男性参与者中是无症状VF的显著预测因素。
