老年髋部骨折患者肌肉减少症与骨密度的关系

被引：56

作者：

洪维

朱晓颖

程群

朱汉民

李慧林

杜艳萍

张雪梅

薛思红

唐雯菁

机构：

[1] 复旦大学附属华东医院骨质疏松科上海市老年医学研究所骨代谢病研究室

来源：

中华骨质疏松和骨矿盐疾病杂志 | 2014年 / 7卷 / 02期

关键词：

髋部骨折; 肌肉减少症; 骨密度;

D O I：

暂无

中图分类号：

R683 [骨折、骨的损伤];

学科分类号：

100220 [骨科学];

摘要：

目的探讨老年髋部骨折患者肌肉减少症(sarcopenia)及与骨密度下降的关系。方法 113例>65岁的老年髋部骨折患者(骨折组)纳入本研究,男性67例,女性46例;同期非髋部骨折老年患者1 321例作为对照组,男性654例,女性667例。所有患者均用双能X线骨密度仪(DXA)检测全身身体组成成分(骨量、肌肉含量,脂肪含量)。肌肉减少症的诊断标准:骨骼肌重量指数(SMI)(肢体骨骼肌重量/身高平方,kg/m2)低于同人种健康成年人1个标准差为1级肌肉减少症(class 1),低于2个标准差为2级肌肉减少症(class 2)。根据以上标准将受试者分为肌量正常组:男性SMI>7.01 kg/m2,女性SMI>5.42 kg/m2;class 1组:男性SMI 6.09～7.01 kg/m2,女性SMI 4.80～5.42 kg/m2;class2组:男性SMI≤6.08 kg/m2,女性SMI≤4.79 kg/m2。分析不同组老年髋部骨折患者肌肉减少症的检出率。结果老年髋部骨折患者肌肉减少症检出率明显高于同性别类似年龄人群:骨折组男性肌肉减少症检出率(62.6%)与对照组男性肌肉减少症检出率(12.8%)比较差异有统计学意义(P<0.001),骨折组女性肌肉减少症检出率(13.0%)与非骨折组女性肌肉减少症检出率(4.1%)比较差异有统计学意义(P<0.001);老年女性髋部骨折患者中肌量正常者24例(52.1%),Class 1级者16例(34.7%),Class 2级者6例(13.0%);骨骼肌重量指数与股骨颈骨密度和全身骨密度呈正相关。老年男性髋部骨折患者中肌量正常者9例(13.4%),Class 1级者16例(23.8%),Class 2级者42例(62.6%),骨骼肌重量指数与BMI呈正相关,与年龄呈负相关。结论老年髋部骨折患者肌肉减少症检出率明显高于同龄非骨折者,男性肌少症检出率高于女性。老年女性髋部骨折患者的骨骼肌重量指数与股骨颈和全身骨密度呈正相关,老年男性髋部骨折患者骨骼肌重量指数则与骨密度无明显相关性。应关注骨折患者肌肉减少症的防治。

引用

页码：106 / 112

页数：7

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