不同骨密度老年人群的体成分、肌力及心脏功能特点

目的 分析不同骨密度老年人群的体成分、肌力和心脏功能特点。方法 选择2019年1月至2021年12月在内蒙古自治区人民医院健康管理中心行骨密度检查年龄为65~80岁的500名受试者作为研究对象。采用人体成分分析仪检测并记录受试者骨骼肌指数、体脂肪率、脂肪控制、肌肉控制、右臂肌肉量、肌力；采用超声诊断仪检查并记录受试者心脏功能（EF、EDV、ESV、FS、HR、e/a）。结果 在500例研究对象中，骨量异常人数较多，占77 %，其中骨质疏松者93人（18.6 %），骨量减少者292人（58.4 %），骨量正常者115人（23%）。在男性中，骨质疏松者21人（8.4 %），骨量减少者153人（61.2 %），骨量正常者76人（30.4 %）；在女性中，骨质疏松者72人（28.8 %），骨量减少者139人（55.6 %），骨量正常者39人（15.6 %）；女性患骨质疏松的比例高于男性。女性的体脂肪率（37.20±4.13）高于男性（28.15±5.38）；女性骨骼肌指数（8.20±0.58）低于男性（9.23±0.55）（P＜0.05）。500例研究对象中需进行肌肉控制（增肌）的比例为55.6 % (278人),需进行脂肪控制（减脂）的比例为100 %（500人）。男性、女性分别按照骨密度分为骨质疏松组、骨量减少组及骨质正常组，三组体质量指数（body mass index, BMI)、T值、 Z值、骨骼肌指数、肌肉控制、右臂肌肉量、右手握力、左手握力比较，差异有统计学意义（P＜0.05）；年龄、体脂肪率、脂肪控制比较，差异无统计学意义（P＞0.05）。组间两两比较男性组BMI、T值、 Z值、骨骼肌指数、肌肉控制、右臂肌肉量、右手握力、左手握力组间比较差异有统计学意义（P＜0.05）；女性组T值、 Z值、骨骼肌指数、肌肉控制、右臂肌肉量、右手握力、左手握力组间比较差异有统计学意义（P＜0.05）。Pearson 相关分析显示，T值与骨骼肌指数、BMI、右臂肌肉量及右手握力呈正相关；相较BMI，T值与骨骼肌指数、右臂肌肉量相关性更高；与肌肉控制（增肌）呈负相关（r值= – 0.326，P=0.000）；与体脂肪率及脂肪控制无相关性。心脏功能EDV（F=0.042,P=0.958）、ESV（F=0.008,P=0.992）、EF值（F=0.060,P=0.942）、FS值（F=0. 057,P=0.945）、HR（F=0. 032,P=0.969）组间比较差异无统计学意义（P＞0.05）；e/a（F=3.768,P=0.034）比较差异有统计学意义（P＜0.05）。结论 老年人群骨量异常比率较高，随着骨密度减低，骨骼肌指数及肌力也会下降，且骨质疏松患者易出现心脏舒张功能减低。利用生物电阻抗测定人体成分可以分析骨质疏松患者人体成分变化，能够更细化地了解其肌肉和脂肪的含量，为进一步预防、治疗骨质疏松及优化老年人人体成分提供依据。

Characteristics of body composition, muscle strength and cardiac function in elderly people with different bone mineral densities

Objective To analyze the characteristics of body composition, muscle strength and cardiac function in elderly people with different bone densities. Methods This study was conducted from January 2019 to December 2021, A total of 500 subjects who underwent bone mineral density examination in the Health Management Center of our Hospital. The skeletal muscle index, body fat percentage, fat control muscle, muscle mass and muscle strength of right arm were measured and recorded. Cardiac function was recorded by ultrasound (EF, EDV, ESV, FS, HR ,e/a). Results Among the 500 subjects, the number of people with abnormal bone mass was 77%, including 93 people with osteoporosis (18.6%), 292 people with decreased bone mass (58.4%) and 115 people with normal bone mass (23%). In the male group, 21(8.4 %) were osteoporosis, 153(61.2 %) were bone loss, and 76(30.4 %) were normal bone mass. In the female group, 72(28.8 %) were osteoporosis, 139(55.6 %) were bone mass loss, and 39(15.6 %) were normal bone mass. The body fat percentage of female (37.20±4.13) was higher than that of male (28.15± 5.38). the skeletal muscle index of females (8.20 ±0.58) was lower than that of males (9.23± 0.55) ( P<0.05). Among the 500 subjects, the ratio of muscle control was 278(55.6 %), and the ratio of fat control was 500(100 %). BMI, T value, Z value, skeletal muscle index, muscle control, right arm muscle mass and grip strength were compared among the three groups, and the differences were statistically significant (P<0.05). There were no significant differences in age, body fat percentage and fat control (P>0.05). There were significant differences in BMI, T value, Z value, skeletal muscle index, muscle control, right arm muscle mass, right hand grip strength and left hand grip strength between the male group (P<0.05). There were significant differences in T value, Z value, skeletal muscle index, muscle control, right arm muscle mass, right hand grip strength and left hand grip strength between the female group (P<0.05). Pearson correlation analysis showed that T value was positively correlated with skeletal muscle index, BMI, right arm muscle mass and right hand grip strength. Compared with BMI,T value had a higher correlation with skeletal muscle index. It was negatively correlated with muscle control (muscle gain) (r = 0.326, P=0.000). There was no correlation between T value and body fat percentage. In the three groups, EDV (F=0.042, P=0.958), ESV(F=0.008, P=0.992), EF (F=0.060, P=0.942), FS (F=0.057, P=0.945), HR(F=0.032, P=0.969) had no significant difference (P>0.05). E/A (F=3.768, P=0.034) was significantly different (P<0.05). Conclusions The rate of abnormal bone mass is higher in the elderly population. As bone mineral density decreases in the elderly, skeletal muscle index and muscle strength also decrease. Patients with osteoporosis may have decreased diastolic function. Using a body composition analyzer to analyze changes in the body composition of osteoporosis patients, we can learn about their muscle and fat content. The results provide a basis for further prevention and treatment of osteoporosis and optimization of body composition in the elderly.