Study On The Correlation Between Bone Metabolic Markers,Bone Mineral Density And Sarcopenia

Objective: To investigate the correlation between bone metabolic markers,bone mineral density and sarcopenia.Methods: We enrolled 331 elderly patients aged over 60 who were treated in the Department of Orthopedics,Xiangya Hospital,Central South University from November 2020 to December 2021.Bone mineral density and skeletal muscle mass of limbs were measured by dual energy X-ray absorptiometry.Participants were divided into sarcopenia group(75 people)and non-sarcopenia group(256 people)according to the criteria of the Asian Working Group on Sarcopenia(2019).The differences in clinical data,bone metabolism markers and bone mineral density between the two groups were compared by t test.Binary logistic regression was used to analyze the relationship between sarcopenia and age,BMI,T value of femoral neck bone mineral density,β-CTX,N-MID,and the presence or absence of hypertension and diabetes,and then Pearson correlation analysis was performed to understand bone metabolism Correlation of markers and bone mineral density with various diagnostic indicators of sarcopenia(muscle strength,muscle mass,and muscle function).At the same time,multiple linear regression analysis was used to explore the influence of bone metabolism markers and bone mineral density on various diagnostic indicators of sarcopenia.In addition,according to the severity of sarcopenia,the participants were divided into sarcopenia group and severe sarcopenia group,and the differences of related indicators in each group were analyzed.Result:(1)The prevalence of sarcopenia was 22.66%(75/331),which was higher in women than in men,of which 42(56%)were diagnosed with severe sarcopenia.Age,β-CTX,N-MID in sarcopenia group were higher than those in non-sarcopenia group,BMI and T value of bone mineral density were lower than those in non-sarcopenia group.The differences were statistically significant(P<0.05).(2)Binary logistic regression analysis showed that:(1)Increased bone mineral density at the femoral neck was a protective factor for sarcopenia(OR=0.715,95%CI: 0.519-0.986);(2)Increased β-CTX was a risk factor for sarcopenia(OR =1.061,95%CI: 1.001-1.120).(3)Pearson correlation analysis showed that all the diagnostic indicators of sarcopenia were significantly positively correlated with femoral neck BMD,and significantly negatively correlated with β-CTX and N-MID.(4)Multiple linear regression analysis model found that:(1)BMI and femoral neck BMD had a significant positive effect on muscle strength and muscle mass;(2)femoral neck BMD had a significant positive effect on muscle function;(3)β-CTX had a significant positive effect on muscle strength,muscle mass Mass and muscle function had significant negative effects.The differences were statistically significant(P<0.05).(5)The bone mineral density T value in the severe sarcopenia group was lower than that in the sarcopenia group,while the bone metabolism markers β-CTX,N-MID and TPINP in the severe sarcopenia group were higher than those in the sarcopenia group.The differences were statistically significant.(P<0.05).Conclusion: BMD and β-CTX are closely related to the onset of sarcopenia.Increased bone mineral density of the femoral neck is a protective factor for sarcopenia,and increased β-CTX is a risk factor for sarcopenia.In the clinical diagnosis and treatment of sarcopenia,it is necessary to pay attention to the detection of bone mineral density and bone metabolism marker levels,which is helpful for the early screening and diagnosis of sarcopenia.