| Background:Osteoporosis is an age-related chronic disease of the skeletal system,with postmenopausal women and older men being the most prevalent groups,characterized by a decrease in Bone Mineral Density(BMD),destruction of bone microstructure and an increased risk of fragility fractures.Osteoporosis can be divided into primary osteoporosis,secondary osteoporosis and idiopathic osteoporosis,of which,primary osteoporosis can be categorized into postmenopausal osteoporosis(type I)and senile osteoporosis(type II).Bone Turnover Markers(BTMs)are products present in blood or urine during the metabolism of bone tissue,mostly the metabolites of osteoblasts and osteoclasts,and are important diagnostic aids for osteoporosis.Sarcopenia is a geriatric syndrome of decreased muscle mass,decreased muscle strength,and/or decreased somatic function associated with increased age.The diagnostic criteria for sarcopenia are:1.decrease in muscle mass(skeletal muscle content<7.0 kg/m2 in men and<5.4 kg/m2 in women,as determined by dual-energy X-ray method);2.decrease in muscle strength(grip strength<28 kg in men and<18 kg in women);3.decrease in muscle function(gait speed<1.0 m/s in the 6-meter walk test or 5 chair stand-up tests greater than or equal to 12 seconds or simple body function assessment method<9 points).The diagnosis of sarcopenia can be made by meeting 1 plus 2 or 3.In clinical studies,the Skeletal Muscle Index(SMI)is commonly measured by CT or MRI to evaluate the muscle mass of patients.The main independent risk factor for sarcopenia is ageing.Other risk factors including chronic underlying diseases such as diabetes,hypertension and malignancies may also have an impact on the development of sarcopenia.With the progress of aging,the prevalence of osteoporosis and sarcopenia is increasing,and the incidence of fragility fractures such as osteoporosis vertebral compression fracture(OVCF)and femoral neck fracture caused by the interaction between them is also increasing significantly,leading to many complications,which seriously affect the quality of life of the elderly,reduce life expectancy and cause a significant increase in social burden.The paravertebral muscles of the lumbar spine mainly include the erector spinae(ES),multifidus(MF),psoas major(PS),and quadratus lumborum(QL),which play an important role in maintaining the stability of the lumbar spine.Patients with sarcopenia have decreased lumbar paravertebral muscle mass and function,resulting in decreased lumbar spine stability,which may lead to increased incidence of lumbar spine disease and increased hospitalization days.Objectives:The aim of this study was to investigate the correlation between osteoporosis and SMI in postmenopausal women and to delve into the correlation between BTMs and SMI,SMI and days of hospitalization after lumbar fusion,and SMI and other indexes of patients such as age,hemoglobin and albumin.Methods:Postmenopausal female patients admitted to Qilu Hospital of Shandong university from January 2020 to December 2021 who underwent BMD tests,BTMs tests and lumbar spine CT examinations,and their L3SMI was analyzed using lumbar spine CT images,and the correlation between L3SMI and their BMD,BTMs,admission blood test indexes,and relevant data in the cases such as age,time of menopause,and whether they smoked and drank alcohol were counted and analyzed.The main bone metabolism indicators include total 25hydroxyvitamin D(Vit-D),β-collagen degradation products(β-CTx),N-terminal osteocalcin(N-MIDOS),total propeptides of type Ⅰ procollagen,N-terminal(T-PINP)and parathyroid hormone(PTH).Results:A total of 141 postmenopausal female patients were included in this study,and statistical analysis showed significant differences in L3SMI between osteoporotic and nonosteoporotic patients,and between patients with and without fracture in osteoporotic patients(p<0.01);patients’ L3SMI was positively correlated with serum N-terminal osteocalcin,body weight,and serum albumin levels(p<0.05)and negatively correlated with age(p<0.05).Conclusions:In the daily anti-osteoporosis treatment,we can help to increase the muscle mass of patients,thus achieving the effect of aiding the treatment of postmenopausal osteoporosisand preventing osteoporotic fractures. |
