文章摘要
林通,韩衍龙,米尔阿里木·木尔提扎,等.肌肉减少症和骨质疏松症对绝经后髋部骨折病人发生椎体压缩性骨折的影响.骨科,2021,12(6): 505-508.
肌肉减少症和骨质疏松症对绝经后髋部骨折病人发生椎体压缩性骨折的影响
Effects of Sarcocytopenia and Osteoporosis on Vertebral Compression Fractures in Postmenopausal Hip Fracture Patients
投稿时间:2021-05-11  
DOI:10.3969/j.issn.1674-8573.2021.06.004
中文关键词: 髋部骨折  骨质疏松症  肌肉减少症  脊椎骨折
英文关键词: Hip fracture  Osteoporosis  Sarcopenia  Spinal fracture
基金项目:新疆维吾尔自治区自然科学基金项目(2017D01C127)
作者单位E-mail
林通 新疆维吾尔自治区人民医院骨科中心关节老年病区乌鲁木齐 830000  
韩衍龙 新疆维吾尔自治区人民医院骨科中心关节老年病区乌鲁木齐 830000  
米尔阿里木·木尔提扎 新疆维吾尔自治区人民医院骨科中心关节老年病区乌鲁木齐 830000  
王利 新疆维吾尔自治区人民医院骨科中心关节老年病区乌鲁木齐 830000 1102715462@qq.com 
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中文摘要:
      目的 探讨肌肉减少症和骨质疏松症是否会增加绝经后髋部骨折病人椎体发生压缩性骨折的风险。方法 2016年1月至2019年12月,在我科接受治疗的绝经后髋部骨折并完善脊柱侧位片的女性病人共135例,年龄为74.00(69.00,79.00)岁。采用双能量X射线骨密度仪(dual-energy X-ray absorptiometry,DXA)评估人体肌肉量和骨密度值,以四肢肌肉的质量(appendicular lean mass,ALM)<15.02 kg视为患有肌肉减少症,以骨密度T值<-2.5 SD视为患有骨质疏松症。根据脊柱侧位X线片计算脊柱畸形指数(spine deformity index,SDI)。根据DXA检测结果进行分组,既无骨质疏松症又无肌肉减少症(A组,9例),仅患有骨质疏松症或仅患有肌肉减少症(B组,36例),同时患有肌少减少症和骨质疏松症(C组,90例)。比较组间SDI评分的差异性。结果 三组间SDI得分的差异有统计学意义(H=35.012,P<0.001),进一步两两比较结果显示,C组与A组、B组之间的差异均存在统计学意义(P均<0.05),而B组与A组之间的差异无统计学意义(P>0.05),肌肉减少症[OR=3.238,95% CI(1.352,7.755),P=0.008]和骨质疏松症[OR=4.860,95% CI(1.782,13.258),P=0.002]是椎体发生压缩性骨折的危险因素。结论 在绝经后髋部骨折老年女性中,骨质疏松症和肌肉减少症均会增加椎体发生压缩性骨折的风险,故预防肌肉减少症与改善骨密度对预防骨质疏松性骨折同等重要。
英文摘要:
      Objective To explore whether sarcopenia and osteoporosis increase the risk of vertebral compression fractures in patients with hip fractures after menopause. Methods From January 2016 to December 2019, a total of 135 postmenopausal hip fractures with lateral spine radiographs treated in our department were enrolled into this study, aged 74.00 (69.00, 79.00) years. Dual-energy X-ray absorptiometry (DXA) was used to evaluate human muscle mass and bone density. The appendicular lean mass (ALM) <15.02 kg is regarded as suffering from sarcopenia; the bone density T value <-2.5 SD is regarded as suffering from osteoporosis. The Spine Deformity Index (SDI) was calculated based on the lateral X-ray film of the spine. According to the DXA test results, the patients were divided into 3 groups: neither osteoporosis nor sarcopenia (group A, 9 cases), osteoporosis or sarcopenia only (group B, 36 cases), combined sarcopenia and osteoporosis (group C, 90 cases). The differences in SDI scores between groups were compared. Results There were significant differences in the SDI scores among the 3 groups (H=35.012, P<0.001). Further pairwise comparison showed that there was significant difference between group C and group A, group B (all P<0.05), but there was no significant difference between group B and group A (P>0.05). Sarcopenia [OR=3.238, 95% CI (1.352, 7.755), P=0.008] and osteoporosis [OR=4.860, 95% CI (1.782, 13.258), P=0.002] were risk factors for vertebral compression fractures. Conclusion In elderly women with hip fractures after menopause, both osteoporosis and sarcopenia increase the risk of vertebral compression fractures. Therefore, the prevention of sarcopenia is as important as the improvement of bone density in the prevention of osteoporotic fractures.
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