中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (5): 1073-1080.doi: 10.12307/2026.039

• 骨组织构建 bone tissue construction •    下一篇

绝经后骨质疏松症：肌肉质量、握力、四肢骨骼肌质量指数的预测价值

杨志杰1，赵  瑞1，杨昊霖1，李小韵1，李扬博1，黄佳纯2，林燕平2，万  雷2，黄宏兴2   

  1. 1广州中医药大学第三临床医学院，广东省广州市   510006；2广州中医药大学第三附属医院，广东省广州市   510378
  • 收稿日期:2024-11-11 接受日期:2025-01-09 出版日期:2026-02-18 发布日期:2025-06-20
  • 通讯作者: 黄宏兴，主任中医师，教授，博士生导师，广州中医药大学第三附属医院，广东省广州市 510378
  • 作者简介:杨志杰，男，1998年生，安徽省合肥市人，汉族，2024年广州中医药大学毕业，硕士，医师，主要从事中医药防治骨伤科疾病研究。
  • 基金资助:
    国家自然科学基金项目(82274551)，项目负责人：黄宏兴；广东省基础与应用基础研究基金项目(2023B1515230001)，项目负责人：黄宏兴；黄宏兴广东省名中医传承工作室[粤中医办函(2018)5号]，项目负责人：黄宏兴；国家中医药管理局监测统计中心深化医改中医药政策研究自选课题(YGZXKT2024347)，项目负责人：黄佳纯；骨质疏松和骨矿盐疾病中青年医生优才培养计划暨白求恩·石药骨质疏松科研基金项目(GX2021C02)，项目负责人：黄佳纯

Postmenopausal osteoporosis: predictive values of muscle mass, grip strength, and appendicular skeletal muscle index

Yang Zhijie1, Zhao Rui1, Yang Haolin1, Li Xiaoyun1, Li Yangbo1, Huang Jiachun2, Lin Yanping2, Wan Lei2, Huang Hongxing2   

  1. 1The Third Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China; 2The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510378, Guangdong Province, China
  • Received:2024-11-11 Accepted:2025-01-09 Online:2026-02-18 Published:2025-06-20
  • Contact: Huang Hongxing, Chief physician, Professor, Doctoral supervisor, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510378, Guangdong Province, China
  • About author:Yang Zhijie, MS, Physician, The Third Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
  • Supported by:
    National Natural Science Foundation of China, No. 82274551 (to HHX); Fundamental and Applied Basic Research Fund of Guangdong Province, No. 2023B1515230001 (to HHX); Huang Hongxing Guangdong Famous Traditional Chinese Medicine Practitioner Inheritance Workshop, No. (2018)5 (to HHX); Self-selected Topic of Chinese Medicine Policy Research for Deepening Medical Reform at the Monitoring and Statistics Center of the State Administration of Traditional Chinese Medicine, No. YGZXKT2024347 (to HJC); Osteoporosis and Bone Mineral Salt Disease Young and Middle-aged Physician Excellent Talent Cultivation Program and Bethune-Shiyao Osteoporosis Scientific Research Fund Project, No. GX2021C02 (to HJC) 

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摘要：




文题释义：
四肢骨骼肌质量指数：通常用于评估人体骨骼肌质量，是身体肌肉质量的良好指标，也是骨质疏松症的重要风险指标。
受试者工作特征曲线：是一种用于评估分类模型性能的工具，通过展示模型在不同分类阈值下真阳性率和假阳性率之间的关系，帮助人们理解模型的分类能力。

背景：绝经后女性骨质疏松症的发病率较高，但目前对于肌肉质量、握力以及这些因素如何影响骨质疏松症的研究尚不充分，它们之间的确切联系尚未明确。
目的：探讨绝经后女性骨质疏松症患者的肌肉质量、握力、四肢骨骼肌质量指数与骨密度之间的相关性，并评估这些指标在预测和诊断绝经后骨质疏松症方面的潜在价值。
方法：于2023年2月至2024年1月在广州中医药大学第三附属医院门诊根据纳排标准收集83例绝经后女性作为研究对象，收集一般资料，检测骨密度并记录T值、各部位肌肉质量、握力，计算体质量指数和四肢骨骼肌质量指数。按T值及骨折史将患者分为非骨质疏松组(n=17)和绝经后骨质疏松症组(n=66)，进行相应的统计学分析。
结果与结论：①非骨质疏松组的体质量、体质量指数、腰椎整体骨密度、肌肉质量及四肢骨骼肌质量指数均高于绝经后骨质疏松症组(P < 0.05)；②肌肉质量与腰椎整体骨密度及各个椎体骨密度之间均呈正相关(P < 0.05)；③多元逐步线性回归分析表明，体质量和握力与肌肉质量呈线性正相关；身高和肌肉质量与握力呈线性正相关，体质量与握力呈线性负相关；体质量指数与骨密度呈线性正相关，年龄与骨密度呈线性负相关；④受试者工作特征曲线分析显示，肌肉质量(曲线下面积、灵敏度、特异性、临界值分别为 0.744，76.50%，74.20%和36.50 kg，
P=0.002)和四肢骨骼肌质量指数(曲线下面积、灵敏度、特异性、临界值分别为0.739，82.40%，62.10%和5.81 kg/m2，且P=0.002)对绝经后骨质疏松症均具有良好的预测价值。结果显示：肌肉质量及四肢骨骼肌质量指数下降有助于绝经后骨质疏松症发生风险的预测，当绝经后女性肌肉质量< 36.50 kg或四肢骨骼肌质量指数< 5.81 kg/m2时，就要重视骨质疏松发生的可能，以预防绝经后骨质疏松症的发生。
https://orcid.org/0009-0003-9406-9948 (杨志杰) 

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 绝经后骨质疏松症, 肌肉质量, 握力, 四肢骨骼肌质量指数, 骨密度, 工程化组织构建

Abstract: BACKGROUND: The prevalence of osteoporosis is high in postmenopausal women, but muscle mass, grip strength, and how these factors affect osteoporosis are understudied, and the exact link between them has not been clarified.
OBJECTIVE: To investigate the correlation between muscle mass, grip strength, appendicular skeletal muscle index and bone mineral density in postmenopausal women with osteoporosis and to assess the potential values of these indices in predicting and diagnosing postmenopausal osteoporosis.
METHODS: Eighty-three postmenopausal women were collected from the outpatient clinic of the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from February 2023 to January 2024. General data were collected. Bone mineral density was detected. T-value, muscle mass of each part, grip strength were recorded. The body mass index and appendicular skeletal muscle index were calculated. The patients were categorized into non-osteoporosis group (n=17) and postmenopausal osteoporosis group (n=66) according to T value and fracture history, and were statistically analyzed accordingly.
RESULTS AND CONCLUSION: (1) The body mass, body mass index, bone mineral density of the overall lumbar spine, muscle mass and appendicular skeletal muscle index were higher in the non-osteoporosis group than the osteoporosis group (P < 0.05). (2) Muscle mass was positively correlated with bone mineral density of the overall lumbar spine and individual vertebrae (P < 0.05). (3) Multiple stepwise linear regression analysis showed that body mass and grip strength were linearly and positively correlated with muscle mass; body height and muscle mass were linearly and positively correlated with grip strength, and body mass was linearly and negatively correlated with grip strength. Body mass index was linearly and positively correlated with bone mineral density, and age was linearly and negatively correlated with bone mineral density. (4) Analysis by receiver operating characteristic curve showed that: muscle mass (the area under the curve, sensitivity, specificity and critical value of muscle mass were 0.744, 76.50%, 74.20% and 36.50 kg, respectively, with P=0.002) and appendicular skeletal muscle index (the area under the curve, sensitivity, specificity and critical value of appendicular skeletal muscle index were 0.739, 82.40%, 62.10% and 5.81 kg/m2, respectively, and P=0.002) had good predictive value for postmenopausal osteoporosis. To conclude, a reduction in muscle mass and appendicular skeletal muscle index can help to predict the risk of postmenopausal osteoporosis, and the possibility of osteoporosis should be taken into account in postmenopausal women when muscle mass is < 36.50 kg or appendicular skeletal muscle index is < 5.81 kg/m2, in order to prevent the occurrence of postmenopausal osteoporosis.

Key words: postmenopausal osteoporosis, muscle mass, grip strength, appendicular skeletal muscle index, bone mineral density, engineered tissue construction

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