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肌肉减少症和平衡不良对女性类风湿关节炎椎体骨质疏松性骨折的影响。

Effect of sarcopenia and poor balance on vertebral spinal osteoporotic fracture in female rheumatoid arthritis.

机构信息

Department of Rheumatology and Nephrology, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, 230000, China.

Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.

出版信息

Sci Rep. 2022 Jun 8;12(1):9477. doi: 10.1038/s41598-022-13339-2.

Abstract

This study investigated the effect of poor balance and sarcopenia on vertebral spinal osteoporotic fracture (VOPF) in female rheumatoid arthritic (RA) patients. A total of 195 female RA and 126 normal subjects were enrolled, and the correlations between sarcopenia, poor balance and VOPF were analyzed. Furthermore, we explored the relationships between sarcopenia or poor balance with disease related indexes of female RA. Binary logistic regression analyses were performed to identify potential risk factors for VOPF in female RA. We found that female RA had an increased risk of sarcopenia, poor balance (Berg balance scale, BBS ≤ 40) and VOPF than controls (P < 0.0001). Female RA with VOPF were more likely to have poor balance and sarcopenia than those without VOPF (P < 0.0001-0.05). Meanwhile, female RA with sarcopenia and poor balance often had higher disease activity, more serious joint damage and worse joint function (P < 0.05) compared with those without sarcopenia and poor balance. Binary logistic regression analysis (LR backwald) revealed that age (OR = 1.112, 95% CI 1.065-1.160, P < 0.0001), OP (OR = 10.137, 95% CI 4.224-24.330, P < 0.0001) and GCs usage (OR = 3.532, 95% CI 1.427-8.741, P = 0.006) were risk factors, while SMI (OR = 0.386, 95% CI 0.243-0.614, P < 0.0001) and BBS (OR = 0.952, 95% CI 0.929-0.976, P < 0.0001) were protective factors for VOPF in female RA. Hence, sarcopenia and poor balance are associated with a higher risk for VOPF and are closely related to disease activity and joint structure damage of female RA.

摘要

本研究旨在探讨平衡不良和肌肉减少症对女性类风湿关节炎(RA)患者椎体骨质疏松性骨折(VOPF)的影响。共纳入 195 例女性 RA 患者和 126 例正常对照者,分析肌肉减少症、平衡不良与 VOPF 的相关性。此外,还探讨了女性 RA 患者中肌肉减少症或平衡不良与疾病相关指标的关系。采用二项逻辑回归分析确定女性 RA 患者 VOPF 的潜在危险因素。我们发现,与对照组相比,女性 RA 患者发生肌肉减少症、平衡不良(Berg 平衡量表评分≤40)和 VOPF 的风险增加(P<0.0001)。与无 VOPF 者相比,发生 VOPF 的女性 RA 患者更易出现平衡不良和肌肉减少症(P<0.0001-0.05)。同时,与无肌肉减少症和平衡不良的女性 RA 患者相比,有肌肉减少症和平衡不良的女性 RA 患者往往具有更高的疾病活动度、更严重的关节损伤和更差的关节功能(P<0.05)。二项逻辑回归分析(LR backwald)显示,年龄(OR=1.112,95%CI 1.065-1.160,P<0.0001)、OP(OR=10.137,95%CI 4.224-24.330,P<0.0001)和 GCs 应用(OR=3.532,95%CI 1.427-8.741,P=0.006)是危险因素,而 SMI(OR=0.386,95%CI 0.243-0.614,P<0.0001)和 BBS(OR=0.952,95%CI 0.929-0.976,P<0.0001)是保护性因素。因此,肌肉减少症和平衡不良与 VOPF 的风险增加相关,与女性 RA 的疾病活动度和关节结构损伤密切相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7553/9177606/05d939d09151/41598_2022_13339_Fig1_HTML.jpg

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