RA患者肌肉含量与骨量变化的相关性分析

目的分析类风湿关节炎(rheumatoid arthritis,RA)患者的肌肉含量与其骨量变化特点的相关性,以及影响RA患者肌肉含量减少的相关因素。方法选取66名(男∶女=8∶25) RA患者为研究对象,平均年龄为60. 4岁。采用双能X线骨密度仪(dual energy X-ray absorptiometry,DXA)及法国MEDI-LINK超声骨密度仪对研究对象进行二维骨密度(bone mineral density,BMD)、3D体积骨密度(皮质骨、骨小梁及总体积骨密度)及肌肉含量的测定,根据T值将研究对象分为骨量正常组(41名)和骨量流失组(25名),并收集患者的一般资料和临床数据,包括性别、年龄、骨折史、吸烟史、糖尿病史、肾病史、甲状腺病史以及RA疾病活动度DSA28评分。结果与RA骨量正常组患者相比,RA骨量流失组患者的全身各部位的肌肉含量均明显降低(P0. 05); RA患者肌肉含量的减少与其BMD及总的体积骨密度的减低具有明显相关性(r=0. 342,P=0. 005及B=35022. 918,P0. 001);而RA患者的总体肌肉含量与激素的使用及RA疾病活动度(DSA28)无明显相关性。结论 RA合并骨量流失患者的肌肉含量明显减少,肌肉含量的改变与骨密度存在一定的相关性。

Correlation analysis between muscle content and bone mass changes in RA patients

Objective To analyze the correlation between muscle content and the changes of bone mass in patients with rheumatoid arthritis (RA), and the related factors affecting the muscle content of RA patients. Methods Sixty-six (male: female = 8:25) RA patients were enrolled in the study, with an average age of 60.35 years. Dual-energy X-ray absorptiometry (DXA) and French MEDI-LINK ultrasound bone densitometry were used to measure the bone mineral density (BMD), 3D volumetric bone mineral density (cortical bone, trabecular bone, and total volume bone density), and muscle content. The patients were divided into normal bone mass group (n=41) and bone mass loss group (n=25) according to T values. General data and clinical data were also collected, including gender, age, fracture history, smoking history, history of diabetes, history of kidney disease, history of thyroid disease, and DSA28 score of RA disease activity. Results Compared with normal RA bone mass group, the muscle content of all parts in patients with RA bone loss group reduced significantly (P<0.05). The decrease in muscle mass was associated with a decrease in BMD (r=0.342, P=0.005) and total volume bone density (r=35022.918, P = 0.000). There was no significant correlation between total muscle mass and the use of hormones and RA disease activity in RA patients. Conclusion Muscle content reduces significantly in RA patients with bone loss. There is a certain correlation between the change of muscle mass and bone mineral density.