老年住院患者肌少症与骨质疏松症的关系研究  

Correlation study between sarcopenia and osteoporosis in elderly inpatients

作　　者：丁红英 南亚昀[1] 李媛媛 陈燕燕 刘亚贤 李翔 DING Hongying;NAN Yayun;LI Yuanyuan;CHEN Yanyan;LIU Yaxian;LI Xiang(Geriatrics Center,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan,Ningxia 750000,China)

机构地区：[1]宁夏回族自治区人民医院老年医学中心,宁夏银川750000

出　　处：《医药前沿》2025年第13期21-25,29,共6页Journal of Frontiers of Medicine

基　　金：宁夏回族自治区人民医院培育振兴科研项目(202105)。

摘　　要：目的探讨老年住院患者肌少症与骨质疏松症的关系。方法纳入2022年1—12月宁夏回族自治区人民医院老年医学中心300例年龄≥60岁患者。测量身高、体重、小腿围、四肢骨骼肌质量(ASM)、握力、6 m步行速率、第2~4腰椎(L_(2~4))、左股骨颈、左全髋T值和骨密度,计算四肢骨骼肌质量指数(ASMI)、体重指数(BMI)。将受试者分为肌少症组(42例)和非肌少症组(258例);骨质疏松症组(75例)和非骨质疏松症组(225例)。Logistic回归分析骨质疏松症、肌少症的影响因素。借助受试者工作特征(ROC)曲线预判BMI对老年住院患者发生肌少症的价值。结果Logistic回归分析结果显示,肌少症为骨质疏松症的危险因素[β=1.142,OR=3.133,95%CI(1.090,9.004),P=0.034],ASMI[β=−0.960,OR=0.383,95%CI(0.175,0.837),P=0.016]、BMI[β=−0.248,OR=0.081,95%CI(0.665,0.915),P=0.002]为骨质疏松症的保护因素。骨质疏松症对是否患肌少症影响无统计学意义(P>0.05),BMI[β=−0.416,OR=0.660,95%CI(0.513,0.849),P=0.001]、左髋部T值[β=−2.820,OR=0.060,95%CI(0.009,0.407),P=0.004]为肌少症的保护因素。女性、男性骨质疏松症患病率分别为30.4%(58/191)和15.6%(17/109),差异有统计学意义(P<0.05)。ROC曲线分析结果显示,BMI预测老年住院患者肌少症发生的曲线下面积为0.851[95%CI(0.795,0.907)],最佳截断值为21.10 kg/m2,敏感度为76.2%,特异度为81.0%。结论老年住院患者肌少症为骨质疏松症的危险因素。Objective To investigate the correlation between sarcopenia and osteoporosis in elderly inpatients.Methods A total of 300 patients aged equal or more than 60 years old,who had admitted to Geriatrics Center in People's Hospital of Ningxia Hui Autonomous Region from January to December 2022,were enrolled.Height,body weight,calf circumference,appendicular skeletal muscle mass(ASM),grip strength,6-meter walking speed,T-values and bone mineral density at L_(2-4) lumbar spine,left femoral neck,and left total hip were measured.Appendicular skeletal muscle mass index(ASMI)and body mass index(BMI)were calculated.Subjects were divided into sarcopenia group(n=42)and non-sarcopenia group(n=258),as well as osteoporosis group(n=75)and non-osteoporosis group(n=225).Logistic regression was used to analyze influencing factors of osteoporosis and sarcopenia.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of BMI for sarcopenia in elderly inpatients.Results Logistic regression analysis showed that sarcopenia was a risk factor of osteoporosis[β=1.142,OR=3.133,95%CI(1.090,9.004),P=0.034],while ASMI[β=−0.960,OR=0.383,95%CI(0.175,0.837),P=0.016]and BMI[β=−0.248,OR=0.081,95%CI(0.665,0.915),P=0.002]were protective factors of osteoporosis.Osteoporosis showed no statistically significant effect on sarcopenia(P>0.05).T-values of BMI[β=−0.416,OR=0.660,95%CI(0.513,0.849),P=0.001]and left hip T-score[β=−2.820,OR=0.060,95%CI(0.009,0.407),P=0.004]were protective factors of sarcopenia.The prevalence rates of osteoporosis in females and males were 30.4%(58/191)and 15.6%(17/109)respectively,and the difference was statistically significant(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of BMI in predicting the pathogenesy of sarcopenia in elderly inpatients was 0.851[95%CI(0.795,0.907)],with an optimal cut-off value of 21.10 kg/m2,the sensitivity of 76.2%,and the specificity of 81.0%.Conclusions Sarcopenia is a risk factor of osteoporosis in elderly inpatients.

关 键 词：肌少症 骨质疏松症 老年住院患者 影响因素 体重指数 

分 类 号：R592[医药卫生—老年医学]