小梁骨评分与四肢瘦体重有关吗？
Is trabecular bone score associated with appendicular lean mass?
作者信息
Giangregorio Lora M, Alexiuk Mackenzie Ryann, Tangri Navdeep, Hans Didier, Leslie William D
机构信息
University of Waterloo and Schlegel-UW Research Institute for Aging, Waterloo, Canada.
Chronic Disease Innovation Centre, Winnipeg, MB, Canada.
出版信息
Osteoporos Int. 2025 Sep 8. doi: 10.1007/s00198-025-07674-z.
UNLABELLED
Among individuals aged ≥ 40 years old, we found that after controlling for age, sex, FMI, and tissue thickness, an increase of 1kg/m of ALMI is associated with an increase in TBS of 0.058, which is approximately half of one population standard deviation, or 4.7% of the average value for TBS.
BACKGROUND
Trabecular bone score (TBS) has been shown to be an independent risk factor for fracture. Muscle pulling on bone is hypothesized to be a mechanical stimulus for osteogenesis. Our aim was to explore whether TBS is associated with appendicular lean mass index (ALMI, appendicular lean mass divided by height squared, units kg/m2).
METHODS
We used visit data from individuals aged 40 years and older in the Manitoba DXA Registry (February 1999-March 2016). ALMI, total body lean mass index (LMI) and total body fat mass index (FMI) were estimated from weight, sex, and percent fat from spine and hip DXA (all R > 0.85 vs total body DXA). We used linear and logistic regression analyses to examine cross-sectional associations between ALMI or LMI and TBS in analyses adjusted for age and sex, and age, sex, FMI, and abdominal tissue thickness.
RESULTS
Among 60,196 individuals (90% female), descriptive statistics as mean (SD) were: TBS 1.245 (0.122), BMI 26.4 kg/m (4.4), ALMI 6.7 kg/m (0.9), LMI 15.3 kg/m (1.7) and FMI kg/m 10.0 (3.3). ALMI was associated with TBS after adjustment for age and sex (Unstandardized β = 0.007, 95%CI 0.006 to 0.008, Adjusted R = 0.130, p < 0.001). The association and explained variation were stronger in a model including age, sex, FMI, and abdominal tissue thickness (Unstandardized β = 0.058, 95%CI 0.056 to 0.059, Adjusted R = 0.557, p < 0.001); an increase of 1kg/m of ALMI was associated with an increase in TBS of 0.058, approximately half of one population standard deviation, or 4.7% of the average value for TBS. Meeting the EWGSOP2 criterion for sarcopenia was associated with being in the lowest TBS tertile after adjustment for age, sex and FMI with odds ratio 1.46 (95% CI 1.38 to 1.55).
CONCLUSIONS
ALMI was associated with TBS after controlling for age, sex, FMI, and abdominal tissue thickness.
未标注
在年龄≥40岁的个体中，我们发现，在控制年龄、性别、脂肪质量指数（FMI）和组织厚度后，每增加1kg/m的四肢瘦体重指数（ALMI），小梁骨评分（TBS）增加0.058，约为总体标准差的一半，或TBS平均值的4.7%。
背景
小梁骨评分（TBS）已被证明是骨折的独立危险因素。肌肉对骨骼的牵拉被认为是成骨的机械刺激因素。我们的目的是探讨TBS是否与四肢瘦体重指数（ALMI，四肢瘦体重除以身高平方，单位为kg/m²）相关。
方法
我们使用了马尼托巴省双能X线吸收测定法（DXA）登记处（1999年2月至2016年3月）中40岁及以上个体的就诊数据。根据体重、性别以及脊柱和髋部DXA的脂肪百分比估算ALMI、全身瘦体重指数（LMI）和全身脂肪质量指数（FMI）（与全身DXA相比，所有相关系数R均>0.85）。我们使用线性和逻辑回归分析，在调整年龄和性别，以及年龄、性别、FMI和腹部组织厚度的分析中，检验ALMI或LMI与TBS之间的横断面关联。
结果
在60196名个体（90%为女性）中，描述性统计的均值（标准差）为：TBS 1.245（0.122），体重指数（BMI）26.4kg/m（4.4），ALMI 6.7kg/m（0.9），LMI 15.3kg/m（1.7），FMI 10.0kg/m（3.3）。调整年龄和性别后，ALMI与TBS相关（非标准化β=0.007，95%置信区间为0.006至0.008，调整后R=0.130，p<0.001）。在包含年龄、性别、FMI和腹部组织厚度的模型中，这种关联和解释的变异更强（非标准化β=0.058，95%置信区间为0.056至0.059，调整后R=0.557，p<0.001）；每增加1kg/m的ALMI，TBS增加0.058，约为总体标准差的一半，或TBS平均值的4.7%。在调整年龄、性别和FMI后，符合欧洲老年人肌肉减少症工作组（EWGSOP2）肌肉减少症标准与处于最低TBS三分位数相关，优势比为1.46（95%置信区间为1.38至1.55）。
结论
在控制年龄、性别、FMI和腹部组织厚度后，ALMI与TBS相关。
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