肌肉含量指标预测社区人群骨质疏松症风险研究  

Screening on muscle mass indexes for predicting osteoporosis risk in community residents

作　　者：杨秀琳[1,2] 马斌 莫晓丹[1,2] 马力扬 海向军 YANG Xiulin;MA Bin;MO Xiaodan;MA Liyang;HAI Xiangjun(Medical Department of Northwest Minzu University, Lanzhou 730030;Key Laboratory of Environmental Ecology and Population Health in Northwest Minority Areas,Northwest Minzu University, Lanzhou 730030,China)

机构地区：[1]西北民族大学医学部,甘肃兰州730030 [2]西北民族地区环境生态与人群健康国家民委重点实验室,甘肃兰州730030

出　　处：《中国骨质疏松杂志》2022年第2期168-173,共6页Chinese Journal of Osteoporosis

基　　金：甘肃省科学技术厅技术引导创新计划项目(20CX9ZA115);甘肃省教育厅高等学校创新基金项目(2020B-072);兰州市城关区科技计划项目(2018-7-18);西北民族大学中央高校基本科研业务费资助项目(31920190207,31920170002,31920190007)。

摘　　要：目的评价肌肉含量指标与骨质疏松症(osteoporosis,OP)的关联性,筛选预测社区人群OP风险的良好肌肉含量指标。方法选取来自甘肃省四个市、县的3151名社区居民,用超声骨密度仪测量研究对象的骨强度、T值,运用生物电阻抗体成分分析仪分别测量四肢肌肉量,并计算四肢骨骼肌量(appendicular skeletal muscle mass,ASM)、四肢骨骼肌指数(appendicular skeletal muscle mass index,ASMI)、四肢骨骼肌体重比(skeletal muscle index,SMI)及四肢骨骼肌BMI比(ASM-to-BMI ratio)。应用ROC曲线及Logistic回归分析评价各肌肉量指标与OP风险的关联强度。结果男、女性ASM、ASMI、SMI、ASM-to-BMI ratio预测OP的ROC曲线下面积均有统计学意义(P<0.05),最佳切点值:ASM:男19.550 kg,女16.350 kg;ASMI:男7.5233 kg/m^(2),女6.4633 kg/m^(2);SMI:男0.3275,女0.2816;ASM-to-BMI ratio:男0.8986,女0.7088。多因素Logistic回归分析显示,男性ASM与ASMI,女性ASM、ASMI与ASM-to-BMI ratio是预测OP风险有意义的肌肉量指标;男性ASM与AMSI均(+)组与均(-)组OP检出率分别为26.60%及4.38%;女性ASM、AMSI、ASM-to-BMI ratio均(-)组与均(+)组OP检出率分别为0.88%与23.78%。结论男性ASM与ASMI,女性ASM、ASMI与ASM-to-BMI ratio是预测OP风险的良好肌肉量指标;指标联合应用能显著提高预测OP风险的效果。Objective To assess relationships of muscle mass indexes and osteoporosis,and identify muscle mass indexes for predicting risk of osteoporosis in community residents.Methods Bone strength,T value,appendicular skeletal muscle mass(ASM)on a sample of 3151 Gansu community dwellers in 4 cities/counties were tested by Ultrasonic bone mineral density meter and bioelectric impedance technique;three other muscle mass indexes include appendicular skeletal muscle mass index(ASMI),skeletal muscle index(SMI)and ASM/BMI(ASM-to-BMI ratio)were calculated.ROC curve and Logistic analysis were used to analyze the relationship of muscle mass indexes and the risk of osteoporosis.Results ASM、ASMI、SMI and ASM-to-BMI ratio were significant muscle mass index in predicting OP risk in both male and female according to the result of ROC curves analysis,the optimal cut-off values were:ASM(male 19.550 kg,female 16.350 kg),ASMI(male 7.5233 kg/m^(2),female 6.4633 kg/m^(2)),SMI(male 0.3275,female 0.2816),ASM-to-BMI ratio(male 0.8986,female 0.7088);Multivariate logistic analysis showed that ASM and ASMI were significant indexes for predicting OP risk for male whereas ASM,ASMI and ASM-to-BMI ratio were significant indexes for female;the incidence of OP in ASM(-),ASMI(-)group and ASM(+),ASMI(+)group of male were 4.38%and 26.60%respectively whereas the incidence of OP in ASM(-),ASMI(-),ASM-to-BMI ratio(-)group and ASM(+),ASMI(+),ASM-to-BMI ratio(+)group were 0.88%and 23.78%respectively of female.Conclusion ASM and ASMI in male and ASM,ASMI and ASM-to-BMI ratio in female were significant muscle mass indexes for OP risk prediction;the combination of indicators can significantly improve the effect of predicting OP risk.

关 键 词：肌肉量指标 骨质疏松症 风险 预测 

分 类 号：R681[医药卫生—骨科学]