Huang Pengju, Ge Yufeng, Liu Yandong, Geng Jian, Zhang Wei, Liang Wei, Yu Aihong, Wu Xinbao, Wang Ling, Cheng Xiaoguang
Department of Radiology, Beijing Jishuitan Hospital, Capital Medical University, National Center for Orthopaedics, Beijing, China.
Department of Radiology, Beijing Anding Hospital, Capital Medical University,Beijing Key Laboratory of Mental Disorders, National Center for Mental Disorders & National Clinical Research Center for Mental Disorders, Beijing, China.
BMJ Open. 2024 Aug 31;14(8):e086855. doi: 10.1136/bmjopen-2024-086855.
This study aimed to investigate differences in hip muscle area and density between older women with femoral neck fractures (FNF) and trochanteric fractures (TRF).
Cross-sectional study.
The study was conducted at a university hospital. A total of 554 older women patients were enrolled, comprising 314 with FNF (mean age 77.02±7.15 years) and 240 with TRF (mean age 79.70±6.91 years), for comparative analysis.
CT scans were used to measure the area and density of the gluteus medius and minimus muscles (G.Med/MinM) and the gluteus maximus muscle (G.MaxM). Areal bone mineral density (aBMD) of the total hip (TH) and femoral neck (FNaBMD) were quantified using quantitative CT. The cohort was stratified by age (cut-off 80 years) to explore age-specific associations.
Among all subjects, the FNF group exhibited significantly higher muscle parameters compared with the TRF group (p<0.001). With adjustments made for age, body mass index (BMI) and THaBMD, all muscle parameters, except G.Med/MinM density, showed significant correlations with TRF. In the age ≥80 group, no statistically significant correlations were observed between hip muscle parameters and TRF. Conversely, in the age <80 group, adjusting for age, BMI and THaBMD revealed significant associations between decreased muscle density and area of both G.MaxM and G.Med/MinM with TRF.
Our findings suggest that in older women, particularly those under 80 years of age, gluteus muscle parameters are associated with TRFs, independently of BMD.
本研究旨在调查老年女性股骨颈骨折(FNF)和转子间骨折(TRF)患者髋部肌肉面积和密度的差异。
横断面研究。
研究在一家大学医院进行。共纳入554名老年女性患者,其中314例为股骨颈骨折患者(平均年龄77.02±7.15岁),240例为转子间骨折患者(平均年龄79.70±6.91岁),进行对比分析。
采用CT扫描测量臀中肌和臀小肌(G.Med/MinM)以及臀大肌(G.MaxM)的面积和密度。使用定量CT对全髋(TH)和股骨颈(FNaBMD)的面积骨密度进行量化。根据年龄(分界值80岁)对队列进行分层,以探讨特定年龄的关联。
在所有受试者中,股骨颈骨折组的肌肉参数显著高于转子间骨折组(p<0.001)。在对年龄、体重指数(BMI)和THaBMD进行调整后,除G.Med/MinM密度外,所有肌肉参数均与转子间骨折显著相关。在年龄≥80岁的组中,未观察到髋部肌肉参数与转子间骨折之间存在统计学显著相关性。相反,在年龄<80岁的组中,对年龄、BMI和THaBMD进行调整后发现,G.MaxM和G.Med/MinM的肌肉密度和面积降低与转子间骨折之间存在显著关联。
我们的研究结果表明,在老年女性中,尤其是80岁以下的女性,臀肌参数与转子间骨折相关,且独立于骨密度。