Kim Segi, Jeong Simho, Kim Kyeongmi, Sung Junhee, Kim Do Kyung, Lee Soonchul
Department of Orthopaedic Surgery, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 13496, Republic of Korea.
Department of Laboratory Medicine, CHA Ilsan Medical Center, School of Medicine, CHA University, 100, Ilsan-ro, Ilsandong-gu, Goyang 10414, Republic of Korea.
Diagnostics (Basel). 2025 Jan 3;15(1):96. doi: 10.3390/diagnostics15010096.
This study aimed to investigate the relationship between the sarcopenia index (SI), which is derived from serum creatinine and cystatin C levels, and osteoporosis in chronic kidney disease (CKD). This study initially included patients who underwent dual-energy X-ray absorptiometry (DXA) and serum creatinine and cystatin C testing between 2005 and 2022. Subsequently, patients diagnosed with CKD were selected for the final analysis, totaling 102 patients. Both traditional and new SI were calculated, with each participant categorized into one of two groups (non-osteoporosis and osteoporosis) according to bone mineral density. To enhance statistical validity, the patients were further divided into low- and high-index groups based on the median value of both indices for comparative analysis. The association between SI and the risk of osteoporosis was estimated using multivariable logistic regression analysis. Participants with lower SI values had lower bone mineral density and a higher diabetes mellitus prevalence. The non-osteoporotic group exhibited significantly higher mean values for both traditional and new SI. Multivariable logistic regression analysis identified three statistically significant variables: both indices, sex, and diabetes mellitus. Both traditional and new SI yielded individual odds ratios of 0.906 with estimated areas under the curve of 0.847 for traditional SI and 0.833 for new SI. This study confirmed that both traditional and new SI are associated with osteoporosis in patients with CKD. Therefore, clinicians can raise the suspicion of osteoporosis based on traditional and new SI in patients with CKD, even when DXA results are unavailable.
本研究旨在探讨由血清肌酐和胱抑素C水平得出的肌少症指数（SI）与慢性肾脏病（CKD）患者骨质疏松症之间的关系。本研究最初纳入了2005年至2022年间接受双能X线吸收测定法（DXA）以及血清肌酐和胱抑素C检测的患者。随后，选取被诊断为CKD的患者进行最终分析，共计102例患者。计算了传统SI和新SI，并根据骨密度将每位参与者分为两组（非骨质疏松组和骨质疏松组）之一。为提高统计效力，根据两个指数的中位数将患者进一步分为低指数组和高指数组进行对比分析。使用多变量逻辑回归分析评估SI与骨质疏松症风险之间的关联。SI值较低的参与者骨密度较低，糖尿病患病率较高。非骨质疏松组的传统SI和新SI平均值均显著更高。多变量逻辑回归分析确定了三个具有统计学意义的变量：两个指数、性别和糖尿病。传统SI和新SI的个体比值比均为0.906，传统SI的曲线下面积估计值为0.847，新SI为0.833。本研究证实，传统SI和新SI均与CKD患者的骨质疏松症相关。因此，即使在没有DXA结果的情况下，临床医生也可根据传统SI和新SI提高对CKD患者骨质疏松症的怀疑。
