老年女性腰椎骨密度与年龄及椎旁体质成分相关性分析

目的探讨不同腰椎椎体骨密度(bone mineral density,BMD)与年龄及同层面椎旁腰大肌、竖脊肌、腹部脂肪、血管钙化情况的关系。方法收集体检中心行腰椎检查的老年女性90名,采用定量CT(quantitative CT,QCT)及后处理软件测量L2-L4椎体骨密度及三椎体同层面椎旁体质成分。统计学处理应用配对t检验、Pearson相关分析和多元逐步回归分析等。结果①3组椎体BMD均与年龄均呈负相关(P0.05),L2BMD、L3BMD均与双侧腰大肌、竖脊肌密度成正相关(r=0.233~0.301,P均0.05)。而L4BMD显示与双侧竖脊肌密度及腹部脂肪面积有良好的相关性,均呈正相关。②多元逐步回归分析显示除年龄外,肌肉是影响BMD的重要因素。年龄是唯一全部进入3组腰椎BMD回归方程,并呈负相关,是影响腰椎BMD的重要因素。结论老年女性的腰椎骨密度与椎旁腰大肌、竖脊肌密度,腹部脂肪面积及年龄密切相关,除年龄外椎旁肌肉密度对骨密度影响最大。QCT扫描更加直观、精确显示椎骨与椎旁体质成分情况,可作为测量诊断骨质疏松、体质成分的新手段。

Correlation analysis among the bone mineral density of the lumbar vertebrae, age, and the paraspinal body composition in elderly women

Objective To explore the relationship among the bone mineral density (BMD) of the lumbar vertebrae, age, and the same slice of paravertebral psoas muscle, the erector spinae, the abdominal fat, and the vascular calcification. Methods Ninety elderly women, who received the quantitative CT (QCT) of the lumbar vertebrae in healthy examination center, were selected. BMD of L2-L4 and the paravertebral body composition of the same slice of L2-L4 were detected using post-processing software. Statistical analysis was performed using paired t test, Pearson correlation analysis, and multiple regression analysis. Results The negative correlation between BMD and age was observed in 3 groups (P<0.05). BMD of L2 and L3 was positively correlated with the density of the bilateral psoas and the erector spinae (r=0.233-0.301, P <0.05). BMD of L4 was positively correlated with the bilateral erector spinal density and the abdominal fat area. Multiple stepwise regression analysis revealed that, besides age, muscle was an important factor affecting BMD. Age was the only factor entered into the three lumbar BMD regression equations, and had a negative correlation with BMD of the lumbar vertebrae. Conclusion BMD of the lumbar vertebrae in elderly women is closely correlated with the paravertebral psoas muscle, the erector spinae muscle density, the abdominal fat area, and the age. Besides age, the paravertebral muscle density has the greatest influence to BMD. QCT scanning is a more intuitive and accurate method to display the spine and the paraspinal body composition, which can be used for the diagnosis of osteoporosis and the detection of body composition.