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维持性血液透析患者中通过定量计算机断层扫描评估腰椎椎体体积骨密度与躯干肌肉密度的关系。

Relationship of lumbar vertebral volumetric bone mineral density with trunk muscle density assessed by quantitative computed tomography in maintenance hemodialysis patients.

作者信息

Yang Lijiao, Zhang Liping, Cheng Xiaoguang, Wang Ling, Wang Chao, Zhang Dongliang

机构信息

Renal Division, Beijing Jishuitan Hospital Affiliated with Capital Medical University, Beijing, China.

Department of Radiology, Beijing Jishuitan Hospital Affiliated with Capital Medical University, Beijing, China.

出版信息

Ren Fail. 2025 Dec;47(1):2534844. doi: 10.1080/0886022X.2025.2534844. Epub 2025 Jul 23.

Abstract

BACKGROUND

Sarcopenia due to abnormal muscle metabolism and osteoporosis due to abnormal bone metabolism are common complications in maintenance hemodialysis (MHD) patients. The aim of this study was to investigate the association between volumetric bone mineral density (vBMD) and trunk muscle density, as assessed by quantitative computed tomography (QCT) in MHD patients.

METHODS

A total of 108 patients were included. Patients were categorized into a nonosteopenia ( = 38) and an osteopenia group ( = 70) on the basis of vBMD. Multivariate logistic regression was employed to adjust for potential confounding factors.

RESULTS

Patients in the osteopenia group were older (65.03 ± 10.05 vs. 53.16 ± 13.52 years,  < 0.001). Trunk muscle density (24.97 ± 7.14 vs. 32.04 ± 5.79,  < 0.001) were lower in the osteopenia group than in the nonosteopenia group. Multiple linear regression revealed a positive correlation between trunk muscle density and lumbar vBMD ( = 2.362; 95% CI (1.325-3.399),  < 0.001). Logistic regression analysis revealed that patients with greater trunk muscle density had a lower risk of osteopenia (odds ratio [OR] = 0.842; 95% CI (0.713-0.995),  = 0.043). The predictive value of trunk muscle density for osteopenia in MHD patients was 0.779 ( < 0.001).

CONCLUSIONS

We found that the greater the trunk muscle density is, the greater is the vBMD of the lumbar spine in MHD patients. This may indicate that trunk muscle density serves as a protective factor against osteopenia in this population.

摘要

背景

维持性血液透析(MHD)患者中,因肌肉代谢异常导致的肌肉减少症和因骨代谢异常导致的骨质疏松症是常见并发症。本研究旨在通过定量计算机断层扫描(QCT)评估MHD患者的体积骨密度(vBMD)与躯干肌肉密度之间的关联。

方法

共纳入108例患者。根据vBMD将患者分为非骨质减少组(n = 38)和骨质减少组(n = 70)。采用多因素逻辑回归对潜在混杂因素进行校正。

结果

骨质减少组患者年龄较大(65.03±10.05岁 vs. 53.16±13.52岁,P < 0.001)。骨质减少组的躯干肌肉密度低于非骨质减少组(24.97±7.14 vs. 32.04±5.79,P < 0.001)。多元线性回归显示躯干肌肉密度与腰椎vBMD呈正相关(β = 2.362;95%CI(1.325 - 3.399),P < 0.001)。逻辑回归分析显示,躯干肌肉密度较高的患者发生骨质减少的风险较低(比值比[OR] = 0.842;95%CI(0.713 - 0.995),P = 0.043)。躯干肌肉密度对MHD患者骨质减少的预测价值为0.779(P < 0.001)。

结论

我们发现,MHD患者的躯干肌肉密度越高,腰椎的vBMD越高。这可能表明躯干肌肉密度是该人群骨质减少的保护因素。

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