[1]李新民,王玲,蒋雯,等.中老年女性腰椎椎后肌群退变与腰椎骨密度的关系研究[J].中医正骨,2018,30(02):16-20.
　LI Xinmin,WANG Ling,JIANG Wen,et al.A clinical study on the relationship between lumbar vertebrae posterior muscle group degeneration and lumbar bone mineral density in middle-aged and elderly females[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(02):16-20.
点击复制

中老年女性腰椎椎后肌群退变与腰椎骨密度的关系研究()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年02期
页码:
16-20
栏目:
临床研究
出版日期:
2018-02-20

文章信息/Info

Title:
A clinical study on the relationship between lumbar vertebrae posterior muscle group degeneration and lumbar bone mineral density in middle-aged and elderly females
作者:
李新民1; 王玲1; 蒋雯1; 娄路馨1; 陈义忠2; 江艳芬2; 于爱红1; 程晓光1
1.北京积水潭医院,北京 100035; 2.四川省大邑县人民医院,四川 大邑 611300
Author(s):
LI Xinmin1; WANG Ling1; JIANG Wen1; LOU Luxin1; CHEN Yizhong2; JIANG Yanfen2; YU Aihong1; CHENG Xiaoguang1
1.Beijing Jishuitan Hospital,Beijing 100035,China 2.The People's Hospital of Dayi county,Dayi 611300,Sichuan,China
关键词:
腰椎;  骨密度;  定量CT;  肌少症;  骨质疏松;  女性
Keywords:
Keywords lumbar vertebrae;  bone density;  quantitative computerized tomography;  sarcopenia;  osteoporosis;  femininity
摘要:
目的:研究中老年女性腰椎椎后肌群退变与腰椎骨密度的关系。方法:以一项前瞻性中国城乡流行病学研究项目招募的社区健康志愿者中的中老年女性作为研究对象,共115例。45岁≤年龄<60岁者62例(中年组),年龄≥60岁者53例(老年组)。使用定量CT分别测量其腰椎骨密度,并测量L3椎体中部层面椎后肌群的肌肉面积及脂肪面积,计算腰椎椎后肌群内的肌肉脂肪浸润程度(muscle fat infiltration,MFI)[MFI=脂肪面积/(肌肉面积+脂肪面积)×100%]。采用直线相关分析和多元线性回归分析探讨腰椎骨密度与腰椎椎后肌群退变的关系。结果:中年组的腰椎骨密度、椎后肌群肌肉面积均高于老年组[(132.74±35.74)mg·cm-3,(91.43±28.40)mg·cm-3,t=6.779,P=0.000;(40.68±6.62)cm2,(38.01±6.41)cm2,t=2.182,P=0.031],椎后肌群脂肪面积、MFI均低于老年组[(1.89±0.99)cm2,(2.34±1.45)cm2,t=-1.997,P=0.048;(4.48±2.11)%,(5.85±3.44)%,t=-2.604,P=0.010]; 2组的体质量指数比较,组间差异无统计学意义[(23.96±3.22)kg·m-2,(24.08±3.06)kg·m-2,t=-0.190,P=0.850]。中年组、老年组及总体研究对象的腰椎骨密度均与年龄呈负相关(r=-0.552,P=0.000; r=-0.599,P=0.000; r=-0.690,P=0.000)。中年组腰椎骨密度与椎后肌群脂肪面积及MFI均呈负相关(r=-0.267,P=0.037; r=-0.304,P=0.017),与椎后肌群肌肉面积不存在直线相关关系(r=0.081,P=0.581); 老年组腰椎骨密度与椎后肌群脂肪面积及MFI均呈负相关(r=-0.331,P=0.017; r=-0.371,P=0.007),与椎后肌群肌肉面积不存在直线相关关系(r=0.235,P=0.094); 总体研究对象的腰椎骨密度与椎后肌群脂肪面积及MFI均呈负相关(r=-0.191,P=0.042; r=-0.214,P=0.023),与椎后肌群肌肉面积不存在直线相关关系(r=0.132,P=0.163)。以腰椎骨密度为因变量,以年龄、体质量指数、腰椎椎后肌群肌肉面积和脂肪面积作为自变量,进行多元线性回归分析,得到的回归方程分别为,腰椎骨密度(中年组)=379.695-3.929×年龄-7.609×腰椎椎后肌群脂肪面积、腰椎骨密度(老年组)=146.419-1.190×年龄-6.350×腰椎椎后肌群脂肪面积、腰椎骨密度(总体研究对象)=269.577-2.962×年龄-5.307×腰椎椎后肌群脂肪面积。结论:中老年女性腰椎椎后肌群脂肪含量的增加可能会导致腰椎骨密度的下降,是骨质疏松的重要危险因素。
Abstract:
ABSTRACT Objective:To study the relationship between lumbar vertebrae posterior muscle group degeneration and lumbar bone mineral density(BMD)in middle-aged and elderly females.Methods:One hundred and fifteen middle-aged and elderly females were selected as the subjects from community healthy volunteers that were recruited for a prospective urban and rural epidemiologic study in China.Sixty-two females ranged in age from 45 to 60 years(middle-aged group),and 53 females were≥60 years old(elder group).Their lumbar BMD were measured by using quantitative computerized tomography(CT),and muscle area and fat area of posterior vertebral muscle group were measured at the level of middle-layer of L3 vertebrae.The degree of muscle fat infiltration(MFI)(MFI=fat area/(muscle area+fat area)×100%)of lumbar vertebrae posterior muscle group was calculated.The relationship between lumbar BMD and lumbar vertebrae posterior muscle group degeneration were analyzed by using linear correlation analysis and multiple linear regression

参考文献/References:

[1] MURRAY TÉ,WILLIAMS D,LEE MJ.Osteoporosis,obesity,and sarcopenia on abdominal CT:a review of epidemiology, diagnostic criteria,and management strategies for the reporting radiologist[J].Abdom Radiol(NY),2017,42(9):2376-2386.
[2] DREY M,SIEBER CC,BERTSCH T,et al.Osteosarcopenia is more than sarcopenia and osteopenia alone[J].Aging Clin Exp Res,2016,28(5):895-899.
[3] 金小岚,侯建明,李梅.肌少症与骨质疏松及骨折[J].中华骨质疏松和骨矿盐疾病杂志,2016,9(3):247-250.
[4] KÄSER L,MANNION AF,RHYNER A,et al.Active therapy for chronic low back pain:part 2.Effects on paraspinal muscle cross-sectional area,fiber type size,and distribution[J].Spine(Phila Pa 1976),2001,26(8):909-919.
[5] 王玲,汪伟,邓微,等.定量CT测量腹部脂肪面积及分布的重复性研究[J].中国骨质疏松杂志,2012,18(11):999-1003.
[6] 中华医学会骨质疏松和骨矿盐疾病分会.肌少症共识[J].中华骨质疏松和骨矿盐疾病杂志,2016,9(3):215-227.
[7] YOSHIMURA N,MURAKI S,OKA H,et al.Is osteoporosis a predictor for future sarcopenia or vice versa?Four-year observations between the second and third ROAD study surveys[J].Osteoporos Int,2017,28(1):189-199.
[8] PASCO JA,MOHEBBI M,HOLLOWAY KL,et al.Musculoskeletal decline and mortality:prospective data from the Geelong Osteoporosis Study[J].J Cachexia Sarcopenia Muscle,2017,8(3):482-489.
[9] BINKLEY N,KRUEGER D,BUEHRING B.What's in a Name revisited:should osteoporosis and sarcopenia be considered components of “dysmobility syndrome?”[J].Osteoporos Int,2013,24(12):2955-2959.
[10] LEE I,HA C,KANG H.Association of sarcopenia and physical activity with femur bone mineral density in elderly women[J].J Exerc Nutrition Biochem,2016,20(1):23-28.
[11] TARANTINO U,BALDI J,SCIMECA M,et al.The role of sarcopenia with and without fracture[J].2016,47(Suppl 4):3-10.
[12] LEE I,CHO J,JIN Y,et al.Body fat and physical activity modulate the association between sarcopenia and osteoporosis in elderly korean women[J].J Sports Sci Med,2016,15(3):477-482.
[13] MILLER PD,SIRIS ES,BARRETT-CONNOR E,et al.Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry:evidence from the National Osteoporosis Risk Assessment[J].J Bone Miner Res,2002,17(12):2222-2230.
[14] 李娜,唐海,张勇,等.双能X线吸收与定量CT对比评价北京地区中老年女性与年龄相关的骨丢失[J].中国医学影像技术,2015,31(10):1487-1491.
[15] LANG TF,SIGURDSSON S,KARLSDOTTIR G,et al.Age-related loss of proximal femoral strength in elderly men and women:the Age Gene/Environment Susceptibility Study—Reykjavik[J].Bone,2012,50(3):743-748.
[16] FORTIN M,VIDEMAN T,GIBBONS LE,et al.Paraspinal muscle morphology and composition:a 15-yr longitudinal magnetic resonance imaging study[J].Med Sci Sports Exerc,2014,46(5):893-901.
[17] CRAWFORD RJ,FILLI L,ELLIOTT JM,et al.Age- and Level-Dependence of fatty infiltration in lumbar paravertebral muscles of healthy volunteers[J].AJNR Am J Neuroradiol,2016,37(4):742-748.
[18] 李新民,王玲,侯雪,等.正常中老年女性椎后肌群增龄退变与体质量指数关系的研究[J].重庆医学,2017,46(22):3053-3056.
[19] VERSCHUEREN S,GIELEN E,O'NEILL TW,et al.Sarcopenia and its relationship with bone mineral density in middle-aged and elderly European men[J].Osteoporos Int,2013,24(1):87-98.
[20] CUI LH,SHIN MH,KWEON SS,et al.Relative contribution of body composition to bone mineral density at different sites in men and women of South Korea[J].J Bone Miner Metab,2007,25(3):165-171.
[21] 侯雪,王晨,张勇,等.老年女性椎后伸肌群肌肉面积及密度与腰椎定量CT骨密度的相关性研究[J].重庆医学,2016,45(30):4190-4192.
[22] LEE DY,YANG JH,KI CH,et al.Relationship between Bone Mineral Density and Spinal Muscle Area in Magnetic Resonance Imaging[J].J Bone Metab,2015,22(4):197-204.
[23] KIM JY,CHAE SU,KIM GD,et al.Changes of paraspinal muscles in postmenopausal osteoporotic spinal compression fractures:magnetic resonance imaging study[J].J Bone Metab,2013,20(2):75-81.

相似文献/References:

[1]徐帮杰,杨楠,白伟杰,等.坐位定点旋转整复法治疗腰椎间盘突出症的疗效观察[J].中医正骨,2015,27(11):17.
　XU Bangjie,YANG Nan,BAI Weijie,et al.Observation on the curative effect of fixed-point rotational reduction in sitting position in the treatment of lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):17.
[2]白春晓,贾育松,孙旗,等.中医药在腰椎间盘突出症围手术期应用的研究进展[J].中医正骨,2015,27(11):65.
[3]王少纯,周英杰.郭维淮教授运用活血益气通经汤治疗腰椎间盘突出症的经验[J].中医正骨,2015,27(11):75.
[4]邓红军.硫酸钙骨水泥椎体成形联合后路短节段椎弓根螺钉 内固定治疗创伤性胸腰椎骨折[J].中医正骨,2015,27(10):35.
[5]张莉,秦丹霞,张细姣.腹针治疗椎间盘源性腰痛[J].中医正骨,2015,27(10):38.
[6]苏洪,张雪林.患侧下肢牵引配合腰椎斜扳法治疗 极外侧型腰椎间盘突出症[J].中医正骨,2015,27(10):40.
[7]吴青坡,孙国绍,王林杰.后路椎管减压联合腰椎椎弓根钉动态稳定装置内固定 治疗单节段腰椎退行性疾病[J].中医正骨,2015,27(10):42.
[8]谢冬群,黄中梁,叶金丽.加强隔附子饼灸治疗肾阳虚型腰椎间盘突出症的 临床研究[J].中医正骨,2015,27(09):18.
　XIE Dongqun,HUANG Zhongliang,YE Jinli.Clinical study on intensive aconite root cake separated moxibustion in the treatment of kidney-yang-deficiency-type lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):18.
[9]沈海良,钱万锋,周骁栋.针刀松解联合局部封闭与口服中药治疗腰椎间盘突出症[J].中医正骨,2015,27(09):46.
[10]王仁灿,黄炎洪,潘伟江,等.45°肩踝悬吊牵引下撞击腰椎疗法治疗L5S1椎间盘突出症[J].中医正骨,2015,27(08):51.

备注/Memo

备注/Memo:
基金项目:北京市卫生系统高层次卫生技术人才培养项目(2009-2-03; 2013-3-033) 通讯作者:于爱红 E-mail:imaging2008@sina.com
更新日期/Last Update: 2018-07-02