绝经后超重及肥胖女性四肢肌肉/脂肪比与骨质疏松性椎体骨折的相关性:一项横断面研究  

Correlation between limb muscle/fat ratio and osteoporotic vertebral fracture in postmenopausal overweight and obese women:a cross-sectional study

作　　者：汪青[1] 黄昊强 洪嵘[1] 陈勇[1] 陈吉[1] 林华[2] WANG Qing;HUANG Hao-qiang;HONG Rong;CHEN Yong;CHEN Ji;LIN Hua(Department of Orthopedics,Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine,Kunshan 215300,Zhejiang,China;Department of Orthopedics,The Affiliated Drum Tower Hospital of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京中医药大学昆山附属医院骨科,江苏昆山215300 [2]南京大学医学院附属鼓楼医院骨科,南京210008

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2022年第5期463-468,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：苏州市民生科技项目(SYS2020065);南京中医药大学昆山附属医院金杏优才项目(03rczc-25)。

摘　　要：目的研究绝经后超重及肥胖女性四肢肌肉与脂肪比值与骨质疏松性椎体骨折(osteoporotic vertebral fractures,OVF)的相关性,为骨质疏松性骨折的防治提供新的策略。方法共纳入704例绝经后超重及肥胖女性,其中OVF 107例,骨质疏松症214例,骨量减少220例及骨量正常163例。评估临床因素,测量骨密度、四肢肌量及脂肪量。采用多元Logistic回归分析四肢肌肉量与脂肪量的比值与骨密度及OVF间的相关性。结果与无OVF相比,OVF女性的四肢肌肉/脂肪比值较低(1.59±0.35 vs.1.87±0.45,P<0.001)。调整年龄、体质量指数(body mass index,BMI)、骨密度及白蛋白等因素后,四肢肌肉/脂肪比最高的四分位患者最低的四分位患者OVF发病率分别为8.41%和50.47%(95%CI:0.055~0.281,P<0.001)。基于四肢肌肉/脂肪比,OVF患病率随四分位的增高呈显著下降趋势。另外,四肢肌肉/脂肪比与骨密度显著相关。结论在绝经后超重及肥胖女性中,四肢肌肉与脂肪比值与骨密度及骨质疏松性椎体体骨折的发生可能有关联。绝经后超重及肥胖女性应注意加强锻炼,增肌减脂,以利于减少骨量丢失及降低骨折风险。Objective To study the correlation between the limb muscle/fat ratio and osteoporotic vertebral fracture(OVF)in postmenopausal overweight and obese women,in order to provide a new strategy for the prevention and treatment of osteoporotic fracture.Methods A total of 704 postmenopausal overweight and obese women were included,including 107 cases of OVF,214 cases of osteoporosis,220 cases of osteopenia,and 163 cases of normal bone mass.Clinical factors were evaluated and bone mineral density,limb muscle mass,and fat mass were measured.Multiple Logistic regression was used to analyze the correlation between the limb muscle/fat ratio,bone mineral density and OVF.Results Compared with women without OVF,the limb muscle/fat ratio of OVF women was lower(1.59±0.35 vs.1.87±0.45,P<0.001).After adjusting for age,bone mass index(BMI),bone mineral density,and serum albumin,the OVF prevalence was 8.41%and 50.47%in the patients with the highest quartile and the lowest quartile of limb muscle/fat ratio,respectively(95%CI:0.056-0.280,P<0.001).Based on the limb muscle/fat ratio,the prevalence of OVF decreased significantly in the four quartiles.In addition,limb muscle/fat ratio was significantly correlated with bone mineral density.Conclusion In postmenopausal over weight and obese women,the limb muscle/fat ratio may be associated with bone mineral density and the occurrence of osteoporotic vertebral fractures.Postmenopausal overweight and obese women should pay attention to resistance exercise,increasing muscle and reducing fat,which is conducive to reducing bone loss and fracture risk.

关 键 词：肌肉/脂肪比值 骨质疏松 骨质疏松性椎体骨折 绝经后女性 超重及肥胖 

分 类 号：R681[医药卫生—骨科学]