Ito Kiyonori, Ookawara Susumu, Sanayama Hidenori, Kakuda Hideo, Kanai Chieko, Iguchi Katsuo, Shindo Mitsutoshi, Tanno Keisuke, Ishibashi Shun, Kakei Masafumi, Tabei Kaoru, Morishita Yoshiyuki
Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama City, 330-8503, Saitama, Japan.
Division of General Medicine, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Sci Rep. 2025 Jan 2;15(1):544. doi: 10.1038/s41598-024-84873-4.
Patients undergoing dialysis are at risk of osteoporosis and sarcopenia because of mineral and bone disorders or malnutrition. Additionally, maintaining muscle mass is important to prevent osteoporosis. The psoas muscle mass index (PMI) was recently used to evaluate muscle mass. However, few studies have evaluated the association between the PMI and bone mineral density (BMD); therefore, we examined the association between PMI and BMD in the femoral neck (FN) of 80 patients (45 males, age, 71 (60-76) years; dialysis duration, 74 (36-140) months) undergoing hemodialysis. FN-BMD was measured using dual-energy X-ray absorptiometry, and PMI was evaluated using psoas muscle areas on computed tomography. FN-BMD and PMI were significantly higher in males than in females. In a correlation analysis, sex, BMI, serum creatinine levels, HbA1c levels, and PMI were positively correlated with FN-BMD, whereas age, history of bone fracture, difficulty in walking and bone-specific alkaline phosphatase level were negatively correlated. In the multivariate regression analysis using clinical factors significantly correlated to FN-BMD, including PMI, both sex (standardized coefficient: 0.249, p = 0.028) and PMI (standardized coefficient: 0.249, p = 0.038) were extracted. Multivariable linear regression analysis using PMI and traditional osteoporosis factors revealed that PMI was significantly and independently associated with FN-BMD (standardized coefficient: 0.308, p = 0.010). In conclusion, PMI was positively associated with FN-BMD. Attention should be paid to the possibility of decreased BMD with decreased muscle mass.
接受透析的患者由于矿物质和骨代谢紊乱或营养不良，有患骨质疏松症和肌肉减少症的风险。此外，维持肌肉量对于预防骨质疏松症很重要。最近，腰大肌质量指数（PMI）被用于评估肌肉量。然而，很少有研究评估PMI与骨密度（BMD）之间的关联；因此，我们研究了80例接受血液透析的患者（45例男性，年龄71（60 - 76）岁；透析时间74（36 - 140）个月）的PMI与股骨颈（FN）骨密度之间的关联。使用双能X线吸收法测量FN - BMD，并使用计算机断层扫描上的腰大肌面积评估PMI。男性的FN - BMD和PMI显著高于女性。在相关性分析中，性别、体重指数（BMI）、血清肌酐水平、糖化血红蛋白（HbA1c）水平和PMI与FN - BMD呈正相关，而年龄、骨折史、行走困难和骨特异性碱性磷酸酶水平与FN - BMD呈负相关。在使用与FN - BMD显著相关的临床因素（包括PMI）进行的多变量回归分析中，性别（标准化系数：0.249，p = 0.028）和PMI（标准化系数：0.249，p = 0.038）均被提取出来。使用PMI和传统骨质疏松症因素进行的多变量线性回归分析显示，PMI与FN - BMD显著且独立相关（标准化系数：0.308，p = 0.010）。总之，PMI与FN - BMD呈正相关。应注意肌肉量减少导致骨密度降低的可能性。
