Department of Rehabilitation Medicine, National Rehabilitation Center, Yonsei University College of Medicine, Seoul, Korea.
Division of Endocrinology, Department of Internal Medicine, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Endocrinol Metab (Seoul). 2023 Oct;38(5):578-587. doi: 10.3803/EnM.2023.1795. Epub 2023 Oct 10.
In individuals with spinal cord injury (SCI), bone loss progresses rapidly to the area below the level of injury, leading to an increased risk of fracture. However, there are limited data regarding SCI-relevant characteristics for bone loss and the degree of bone loss in individuals with SCI compared with that in non-SCI community-dwelling adults.
Data from men with SCI who underwent dual-energy X-ray absorptiometry at the National Rehabilitation Center (2008 to 2020) between 12 and 36 months after injury were collected and analyzed. Community-dwelling men were matched 1:1 for age, height, and weight as the control group, using data from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008 to 2011).
A comparison of the SCI and the matched control group revealed significantly lower hip region T-scores in the SCI group, whereas the lumbar spine T-score did not differ between groups. Among the 113 men with SCI, the paraplegia group exhibited significantly higher Z-scores of the hip region than the tetraplegia group. Participants with motor-incomplete SCI showed relatively preserved Z-scores of the hip region compared to those of the lumbar region. Moreover, in participants with SCI, the percentage of skeletal muscle displayed a moderate positive correlation with femoral neck Z-scores.
Men with SCI exhibited significantly lower bone mineral density of the hip region than community-dwelling men. Paraplegia rather than tetraplegia, and motor incompleteness rather than motor completeness were protective factors in the hip region. Caution for loss of skeletal muscle mass or increased adiposity is also required.
在脊髓损伤（SCI）患者中，骨量迅速流失到损伤以下区域，导致骨折风险增加。然而，关于 SCI 相关的骨丢失特征以及与非 SCI 社区居住成年人相比的 SCI 患者的骨丢失程度的数据有限。
收集并分析了 2008 年至 2020 年期间在国立康复中心（National Rehabilitation Center）接受双能 X 射线吸收法测定（DXA）的 SCI 男性患者（损伤后 12 至 36 个月）的数据。使用 2008 年至 2011 年韩国国家健康和营养检查调查（KNHANES）的数据，将社区居住的男性按照年龄、身高和体重与 SCI 患者进行 1:1 匹配作为对照组。
与对照组相比，SCI 组的髋部区域 T 评分明显较低，而腰椎 T 评分在两组之间无差异。在 113 名 SCI 男性患者中，截瘫组的髋部区域 Z 评分明显高于四肢瘫组。运动不完全 SCI 患者的髋部区域 Z 评分相对保留，而腰椎区域则较低。此外，在 SCI 患者中，骨骼肌百分比与股骨颈 Z 评分呈中度正相关。
SCI 男性的髋部区域骨矿物质密度明显低于社区居住的男性。截瘫而非四肢瘫，以及运动不完全而非运动完全，是髋部的保护因素。还需要注意骨骼肌质量的减少或脂肪过多。
