腰肌指数、腰椎椎体骨髓脂肪分数与骨密度关系及对骨质疏松的诊断效能  

The Relationship Between Psoas Muscle Index, Lumbar Vertebral Bone Marrow Fat Fraction and Bone Mineral Density and the Diagnostic Efficacy of Osteoporosis

作　　者：苟静 岳建彪[1] 易松[1] 魏翾娣 张文举[2] Gou Jing;Yue Jianbiao;Yi Song;Wei Xuandi;Zhang Wenju(Department of General Internal Medicine,Sichuan Orthopaedic Hospital,Chengdu610000,China;Department of Foot and Ankle,Sichuan Orthopaedic Hospital,Chengdu610000,China)

机构地区：[1]四川省骨科医院综合内科,四川成都610000 [2]四川省骨科医院足踝2科,四川成都610000

出　　处：《实用骨科杂志》2023年第1期27-31,共5页Journal of Practical Orthopaedics

基　　金：四川省干部保健科研课题(川干研2019-605)。

摘　　要：目的探讨腰肌指数(psoas muscle index,PMI)、腰椎椎体骨髓脂肪分数(fat fraction,FF)与骨密度(bone mineral density,BMD)间的关系及对骨质疏松(osteoporosis,OP)的诊断效能。方法选取四川省骨科医院2018年3月至2021年5月BMD筛查的200例检查者作为研究对象,根据BMD分为骨量正常组(T值≥-1.0,n=105)、骨量减少组(-2.5<T值<-1.0,n=57)、OP组(T值≤-2.5,n=38)。对比三组一般资料及BMD、PMI、腰椎椎体骨髓FF,分析PMI、腰椎椎体骨髓FF与BMD间关系,建立OP的Logistic回归模型,评估PMI、腰椎椎体骨髓FF对OP的诊断效能。结果OP组BMD、PMI低于骨量减少组、骨量正常组,FF高于骨量减少组、骨量正常组(P<0.05);骨量减少组的BMD、PMI低于骨量正常组,FF高于骨量正常组(P<0.05);PMI与BMD呈正相关,腰椎椎体骨髓FF与BMD呈负相关(P<0.05);年龄、身体质量指数(body mass index,BMI)、PMI、腰椎椎体骨髓FF是骨量减少的影响因素,年龄、PMI、腰椎椎体骨髓FF是OP的影响因素(P<0.05);腰椎椎体骨髓FF联合诊断OP的受试者工作特征(receiver operating characteristic,ROC)曲线下的面积(area under curve,AUC)为0.853,大于单一指标诊断值(P<0.05)。结论PMI、腰椎椎体骨髓FF是BMD的独立影响因素,二者联合在OP诊断中具有较高效能。Objective To explore the relationship between lumbar psoas muscle index(PMI),lumbar vertebral bone marrow fat fraction(FF)and bone mineral density(BMD)and the diagnostic efficacy of osteoporosis(OP).Methods 200 cases of BMD exam in our hospital from March 2018 to May 2021 were selected as the research objects.According to BMD,they were divided into normal bone mass group(T value≥-1.0,n=105)and bone mass reduction group(-2.5<T value<-1.0,n=57),OP group(T value≤-2.5,n=38).General information and BMD,PMI,lumbar vertebral bone marrow FF were compared in 3 groups.The relationship between PMI,lumbar vertebral bone marrow FF and BMD were analyzed.OP’s Logistic regression model was established.The diagnostic efficacy of PMI and lumbar vertebral bone marrow FF for OP was evaluated.Results The BMD and PMI of the OP group were lower than those of the osteopenia group and the normal bone mass group,and the FF was higher than that of the osteopenia group and the normal bone mass group(P<0.05).The BMD and PMI of the osteopenia group were lower than those of the normal bone mass group,and the FF was higher than that of the normal bone mass group(P<0.05).PMI was positively correlated with BMD,and lumbar vertebral bone marrow FF was negatively correlated with BMD(P<0.05).Age,body mass index,PMI,lumbar vertebral bone marrow FF were the influencing factors of bone loss,and age,PMI,lumbar vertebral bone marrow FF were the influencing factors of OP(P<0.05).The AUC of the combined diagnosis of OP with lumbar vertebral bone marrow FF was 0.853,and it was greater than the single index diagnostic value(P<0.05).Conclusion PMI and lumbar vertebral bone marrow FF are independent influencing factors of BMD,and the combination of the two has a high efficiency in the diagnosis of OP.

关 键 词：腰肌指数 腰椎椎体骨髓脂肪分数 骨密度 骨质疏松 诊断效能 

分 类 号：R580[医药卫生—内分泌]