Correlation Studies Between Osteoporosis,Sarcopenia And Sex Hormone In Postmenopausal Women

Objective:Bone density,skeletal muscle mass,hand strength,muscle function and sex hormone levels were measured in postmenopausal women To investigate the correlation between sarcopenia,bone density and sex hormone in postmenopausal women,and the risk of sarcopenia in postmenopausal osteoporosis patients of different age groups and the relationship between TCM syndrome type and sex hormone index of sarcopenia,It provides a basis for early prevention and treatment of sarcopenia.Methods:All 178 postmenopausal female volunteers aged 40-70 years old in Zhejiang University of Chinese Medicine Affiliated Wenzhou Integrated traditional Chinese and Western Medicine Hospital from May 2019 to December 2019 were selected.According to the bone mineral density(BMD)of the volunteers were divided into osteoporosis group(OP-group)and non-osteoporosis group(Non-OP group).Measuring the L1-4BMD,Hip-BMD,appendicular skeletal muscle mass(ASM),appendicular fat mass(AFM),hand strength(HS),Gait speed(GS),Sex hormones(estrogen E2,follicle stimulating hormone FSH,luteinizing hormone LH)index of volunteers,Calculation of Appendicular skeletal muscle mass(ASMI)=ASM/height squared,kg/m~2).The correlation between ASM,AFM,ASMI,HS,GS and BMD were analyzed by linear correlation analysis,and the correlation between sex hormone index and BMD,sarcopenia(ASMI,HS,GS)were also analyzed by linear correlation analysis.Estimate the risk of Sarcopenia in osteoporosis of different ages were analyzed by logical regression analysis.According to the syndrome of TCM theory,compare the relationship between different syndromes and sex hormone indexes in sarcopenia was analyzed through one-way analysis of variance.Results:(1)A total of 178 postmenopausal female volunteers were included in this study,of which 46(25.8%)were osteoporosis and 24(13.5%)were sarcopenia.Using linear correlation analysis all of the postmenopausal female,L1-4 BMD were positively correlated with ASM,ASMI,GS,HS(r=0.436,r=0.361,r=0.328,r=0.381,r=0.437;P<0.05),and Hip BMD were also positively correlated with ASM,ASMI,GS,HS(r=0.312,r=0.359,r=0.365,r=0.383,r=0.399;P<0.05).The difference was statistically significant.But there was no significant correlation between bone mineral density and AFM(P>0.05).(2)Spearman-correlation analysis showed that E2 had positive correlation with L1-4BMD,Hip-BMD,ASMI,HS(r=0.336,r=0.397,r=0.266,r=0.036),FSH had negative correlation with L1-4 BMD,Hip-BMD,ASMI(r=-0.405,r=-280,r=-0.235),LH also had negative correlation with L1-4 BMD,Hip-BMD,ASMI(r=-0.315,r=-279,r=-0.258),The difference had statistically significant(P<0.05).FSH,LH had no significant correlation with HS,GS,E2 had no significant correlation with GS.The difference was not statistically significant(P>0.05).(3)Among postmenopausal OP patients,Sarcopenia had 14 cases(30.4%).The results of Logistic regression analysis showed that the original odds ratio of the OP group and the Non-OP group was 4.378(OR=4.378,95%CI:1.844～10.381,P=0.001).After adjusting for age and BMI,The ratio of the two groups was 2.368(OR=2.368,95%CI:0.873～6.430,P=0.003).According to the age stratified analysis,there were 6cases(6.5%)of Sarcopenia among the postmenopausal women≤60 years old.The ratio of ratio between the OP group and the Non-OP group was 4.653(OR=4.653,95%CI:0.747-18.987,P=0.037).Among the aged 61-70 years,there were 18 cases(20.9%)of sarcopenia,The ratio between the two group was 3.231(OR=3.231,95%CI:1.081～9.660,P=0.026).(4)In postmenopausal women of sarcopenia,spleen and kidney Yang deficiency is the main syndrome differentiation(15cases,60%),Comparison of E2 level between different syndrome types showed that spleen-kidney Yang deficiency type(7.400±1.751pmol/L)<liver-kidney Yin deficiency type(15.431±7.151pmol/L)<other types(35.667±17.262pmol/L).Comparison of FSH level and menopause years,spleen and kidney Yang deficiency>liver and kidney Yin deficiency>other types(F=7.330,P=0.004;F=3.759,P=0.039),The difference was statistically significant.But there was no statistically significant difference in LH level between groups(F=2.258,P=0.128)Conclusion:Bone mineral density is closely related to sarcopenia and sex hormone level in postmenopausal women,while BMD is positively correlated with ASM,HS,GS,but not with fat.The incidence of sarcopenia is significantly increased with the change of sex hormone level,the decrease of BMD,and the increase of age in postmenopausal women.Osteoporosis is one of the cause of sarcopenia risk factors,clinical should focus on the OP for less muscle disease in patients with musculoskeletal system and the effect of postmenopausal muscle disease in patients with less is given priority to with spleen and kidney Yang deficiency,there is a close relationship between the characteristics of syndrome types and sex hormones,pay attention to the change of sex hormone levels in postmenopausal women,early use of traditional Chinese medicine can cure illness,and the advantage of not disease prevention first.