- 學位論文
骨質疏鬆患者之身體組成及身體功能表現
Body composition and physical performance in patients with osteoporosis
摘要
研究背景: 人口老化使骨質疏鬆症日漸嚴重，患者常見跌倒引起骨折，導致嚴重併發症甚至死亡。骨質疏鬆症患者若功能表現不佳，如肌力不足、行走及平衡能力差，可能容易造成跌倒並發生骨折。本研究目的為研究骨質疏鬆患者之身體組成及身體功能表現。 研究方法: 本研究招募門診骨質疏鬆患者，調查基本資料、病人症狀、疼痛強度與失能狀況；以雙能量X光測量儀(Dual energy X-ray Absorptiometry)測量患者身體組成；身體功能表現測量包括握力、簡式生理表現評估量表(Short Physical Performance Battery, SPPB)及計時行走測試(Timed Up and Go test, TUG)。 研究結果: 骨質疏鬆病患共有202人，平均年齡73.4 ± 8.9歲。體脂率男性為26.3 ± 8.0%，女性為38.2 ± 5.8%，超過衛福部肥胖標準(男性25%,女性30%)。骨骼肌質量指數(Skeletal Muscle Mass Index, SMI)為四肢肌肉質量除以身高平方，本研究男性SMI平均為6.86 kg/m2，小於亞洲肌少症工作小組(Asian Working Group for Sarcopenia, AWGS)男性建議標準7.0 kg/m2。女性SMI、握力及行走速度顯著比男性低(p < 0.001, 0.001, 0.008)。握力男性為30.9 ± 7.2公斤及為女性19.2 ± 4.9公斤，高於AWGS建議標準(男性26公斤,女性18公斤)。上肢及下肢肌肉比率與握力有高相關(r = 0.65, 0.64)，與SPPB得分有低相關(r = 0.23, 0.22)；而軀幹肌肉比率較高者，行走速度較快(r = 0.28)，TUG使用時間較短(r = -0.26)。 結論: 骨質疏鬆病患肌肉質量較高身體功能表現較好，脂肪對於身體功能表現有負面影響。
並列摘要
Background and purpose: Due to the increase of aged people, the issue of osteoporosis cannot be ignored. Fall of patients with osteoporosis may cause fracture leading severe complication or even death. When a person with osteoporosis, poor functional performance such as the weakness and poor balance may easily cause fall and fracture. The purpose of this study was to investigate the body composition and physical performance in patients with osteoporosis. Methods: The patients with osteoporosis were recruited from OPD. We recorded the personal information, symptoms, pain intensity and disability of the patients with osteoporosis. The body composition was measured by Dual energy X-ray Absorptiometry (DXA). The physical performances of grip strength, Short Physical Performance Battery (SPPB) and Timed Up and Go test (TUG) were evaluated. Results: Two hundred and two patients with osteoporosis (mean age: 73.4 ± 8.9 years) participated in this study. The percentage of body fat were 26.3 ± 8.0% for men and 38.2 ± 5.8% for women, exceeding the Ministry of Health's obesity standard (25% for men and 30% for women). The Skeletal Muscle Mass Index (SMI) is the muscle mass of the limbs divided by the square of height. The SMI of males was 6.86 ± 1.0 kg/m2, below the suggestion (7.0 kg/m2) of the Asian Working Group for Sarcopenia (AWGS). The SMI, grip strength, and walking speed were significantly lower in women than those in men (p < 0.001, 0.001, and 0.008, respectively). The grip strength was 30.9 ± 7.2 kg for men and 19.2 ± 4.9 kg for women, which is higher than the AWGS suggestion (26 kg for men and 18 kg for women). The upper and lower limb muscle ratios were highly correlated with grip strength (r = 0.65, 0.64); the trunk muscle ratio was correlated with walking speeds (r = 0.28) and TUG (r = -0.26). Conclusion: Most patient with osteoporosis with higher muscle mass exhibit better physical performance. Obesity may have negative effects on physical performance.