【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3 151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7.523 3 kg/m~2,女6.463 3 kg/m~2;SMI:男0.327 5,女0.281 6;ASM-to-BMI ratio:男0.898 6,女0.708 8。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。更多还原

【Abstract】 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 7.523 3 kg/m~2,female 6.463 3 kg/m~2), SMI(male 0.327 5,female 0.281 6), ASM-to-BMI ratio(male 0.898 6,female 0.708 8); 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.更多还原