Department of Endocrinology, Peking University International Hospital, Beijing, China.
Front Endocrinol (Lausanne). 2023 Apr 19;14:1163029. doi: 10.3389/fendo.2023.1163029. eCollection 2023.
This study aimed to investigate the effect of sarcopenia, osteoporosis, and osteosarcopenia on spine fracture in patients with prediabetes.
We collected and analyzed the data from the U.S. National Health and Nutrition Examination Surveys during the period from 2009 to 2018. Bone mineral density and the skeletal muscle mass index (SMI) were measured with dual-energy X-ray absorptiometry (DXA). The diagnosis of spine fracture was based on DXA and history.
People with prediabetes were more likely to develop sarcopenia than normal glucose tolerance subjects (OR 1.33, 95% CI 1.07-1.66), while there was no significant increase of osteoporosis in prediabetes (OR 0.91, 95% CI 0.78-1.05). The SMI was independently associated with osteoporosis in prediabetes adults (OR 0.65, 95% CI 0.50-0.85). Both sarcopenia and osteoporosis were positively associated with spine fracture in prediabetes (OR 4.44, 95% CI 1.76-11.21, and OR 2.90, 95% CI 1.85-4.56, respectively). The risk of spine fracture was substantially higher in the presence of osteosarcopenia (OR 6.63; 95% CI, 1.34-32.94) than in the presence of sarcopenia or osteoporosis alone in prediabetes.
In adults with prediabetes, both sarcopenia and osteoporosis are risk factors for spine fracture, and the combination of sarcopenia and osteoporosis further increases the prevalence of spine fracture.
本研究旨在探讨肌少症、骨质疏松症和肌骨减少症对糖尿病前期患者脊柱骨折的影响。
我们收集并分析了 2009 年至 2018 年期间美国国家健康和营养调查的数据。采用双能 X 线吸收法（DXA）测量骨密度和骨骼肌质量指数（SMI）。脊柱骨折的诊断依据 DXA 和病史。
与正常糖耐量受试者相比，糖尿病前期患者更易发生肌少症（OR 1.33，95%CI 1.07-1.66），而糖尿病前期患者的骨质疏松症并无显著增加（OR 0.91，95%CI 0.78-1.05）。SMI 与糖尿病前期成人的骨质疏松症独立相关（OR 0.65，95%CI 0.50-0.85）。肌少症和骨质疏松症均与糖尿病前期的脊柱骨折呈正相关（OR 4.44，95%CI 1.76-11.21 和 OR 2.90，95%CI 1.85-4.56）。与单纯肌少症或骨质疏松症相比，糖尿病前期同时存在肌骨减少症时脊柱骨折的风险显著更高（OR 6.63；95%CI，1.34-32.94）。
在糖尿病前期成人中，肌少症和骨质疏松症均为脊柱骨折的危险因素，肌少症和骨质疏松症同时存在进一步增加了脊柱骨折的发生率。
