髋部肌肉面积、老年营养风险指数与骨质疏松症老年患者骨密度及髋部骨折风险的关联研究^*

Study on the association between hip muscle area, geriatric nutritional risk index and bone mineral density and hip fracture risk in elderly patients with osteoporosis

摘要

目的 分析骨质疏松症老年患者髋部肌肉面积、老年营养风险指数变化,探究二者与骨密度及髋部骨折风险的关联研究。方法 选取2023年9月—2024年9月广州中医药大学海南医院(三亚市中医院)收治的118例骨质疏松症老年患者作为研究组,另选取同期体检的104例非骨质疏松症老年患者作为对照组。比较两组髋部肌肉面积、老年营养风险指数及不同部位骨密度,采用Pearson相关性分析骨质疏松症老年患者髋部肌肉面积、老年营养风险指数与不同部位骨密度的关系,根据骨质疏松症老年患者是否发生髋部骨折分为发生组(53例)和未发生组(65例),采用多因素logistic回归分析影响髋部骨折的因素。结果 研究组患者臀中小肌肌肉截面面积、臀大肌肌肉截面面积、老年营养风险指数及腰椎、髋部、股骨颈骨密度均低于对照组(P<0.05)。骨质疏松症老年患者臀中小肌肌肉截面面积、臀大肌肌肉截面面积、老年营养风险指数与腰椎骨密度(r=0.361,0.325,0.394)、髋部骨密度(r=0.437,0.385,0.459)、股骨颈骨密度(r=0.382,0.354,0.408)均呈正相关(P<0.05)。发生组患者白蛋白、25-羟基维生素D水平、腰椎骨密度、髋部骨密度、股骨颈骨密度、臀中小肌肌肉截面面积、臀大肌肌肉截面面积、老年营养风险指数均低于未发生组(P<0.05)。25-羟基维生素D水平、髋部骨密度、老年营养风险指数均是影响骨质疏松症老年患者髋部骨折的独立危险因素(P<0.05)。结论 髋部肌肉面积、老年营养风险指数与骨质疏松症老年患者骨密度密切相关,且25-羟基维生素D水平、髋部骨密度、老年营养风险指数均是影响骨质疏松症老年患者髋部骨折的独立危险因素,可为骨质疏松症老年患者的分层管理、风险筛查与精准干预提供重要的临床参考依据。

Abstract

Objective To analyze the changes in hip muscle area and geriatric nutritional risk index in elderly patients with osteoporosis, and to explore the association between the two and bone mineral density as well as the risk of hip fractures. Methods 118 elderly patients with osteoporosis who were admitted to Guangzhou University of Chinese Medicine-Hainan Hospital (Sanya City Hospital of Traditional Chinese Medicine) from September 2023 to September 2024 were selected as the research group, and 104 elderly patients without osteoporosis who underwent physical examinations during the same period were selected as the control group. The hip muscle area, geriatric nutritional risk index and bone mineral density of different parts in the two groups were compared. Pearson correlation was used to analyze the relationship between the hip muscle area, the elderly nutritional risk index, and bone density at different sites in elderly patients with osteoporosis. According to whether hip fractures occurred in elderly patients with osteoporosis, they were divided into the occurrence group (53 cases) and the non-occurrence group (65 cases). Multivariate logistic regression was used to analyze the factors influencing hip fractures. Results The cross-sectional areas of the gluteus medius muscle, gluteus maximus muscle, geriatric nutritional risk index, and bone mineral densities of the lumbar vertebrae, hip, and femoral neck in the patients of the research group were all lower than those in the control group (P<0.05). The cross-sectional area of the gluteus medius muscle, the cross-sectional area of the gluteus maximus muscle, and the geriatric nutritional risk index in elderly patients with osteoporosis were positively correlated with the bone mineral density of the lumbar vertebrae (r=0.361, 0.325, 0.394), hip (r=0.437, 0.385, 0.459), and femoral neck (r=0.382, 0.354, 0.408) (P<0.05). Albumin, 25-hydroxy-vitamin D, lumbar bone mineral density, hip bone mineral density, femoral neck bone mineral density, cross-sectional area of gluteus medius muscle, cross-sectional area of gluteus maximus muscle, and geriatric nutritional risk index in the occurrence group were all lower than those in the non-occurrence group (P<0.05). 25-hydroxy-vitamin D level, hip bone mineral density and geriatric nutritional risk index are all independent risk factors affecting hip fractures in elderly patients with osteoporosis (P<0.05). Conclusion Hip muscle area, geriatric nutritional risk index are closely related to bone mineral density in elderly patients with osteoporosis. Moreover, 25-hydroxy-vitamin D level, hip bone mineral density and geriatric nutritional risk index are all independent risk factors affecting hip fractures in elderly patients with osteoporosis. They can provide an important clinical reference basis for the stratified management, risk screening and precise intervention of elderly patients with osteoporosis.

关键词

骨质疏松症 / 髋部肌肉面积 / 老年营养风险指数 / 骨密度

Key words

Osteoporosis / Hip muscle area / Geriatric nutritional risk index / Bone mineral density

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基金资助

^*海南省自然科学基金(825MS192)