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绝经后骨质疏松症与临床肌肉减少症成分的关系。

Relationship between postmenopausal osteoporosis and the components of clinical sarcopenia.

机构信息

Bone and Cartilage Research Unit (BCRU) Mediteknia Building, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland.

出版信息

Maturitas. 2013 Jun;75(2):175-80. doi: 10.1016/j.maturitas.2013.03.016. Epub 2013 Apr 28.

Abstract

PURPOSE

The aim of the study was to determine the relationship between the components of clinical sarcopenia and osteoporosis in postmenopausal women.

METHODS

A population-based cohort of 590 Finnish postmenopausal women (mean age 67.9; range 65-72) was selected from the Osteoporosis Fracture Prevention (OSTPRE-FPS) study in 2002. Bone mineral density (BMD) and lean tissue mass were assessed by dual X-ray absorptiometry (DXA). The study sample was divided into three categories according to the WHO BMD classification: normal, osteopenia and osteoporosis. The study sample was divided into non-sarcopenic, presarcopenic, sarcopenic and non-classified groups according to quartiles of RSMI i.e. relative skeletal muscle index (appendicular muscle mass (kg)/square of height (m)), hand grip strength (kPa) and walking speed.

RESULTS

In logistic regression analysis sarcopenic women had 12.9 times higher odds of having osteoporosis (p ≤ 0.001, OR=12.9; 95% CI=3.1-53.5) in comparison to non-sarcopenic women. In comparison to women in the highest grip strength quartile, women within the lowest quartile had 11.7 times higher odds of having osteoporosis (p=0.001, OR=11.7; 2.6-53.4). Sarcopenic women had 2.7 times higher odds of having fractures than their non-sarcopenic counterparts (p=0.005, OR=2.732; 1.4-5.5). Sarcopenic women had also 2.1 times higher risk of falls during the preceding 12 months compared to non-sarcopenic women (p=0.021, OR=2.1; 1.1-3.9). Adjustment for age, body mass index (BMI), physical activity and hormone therapy (HT) did not significantly alter these results.

CONCLUSIONS

The components of clinical sarcopenia are strongly associated with osteoporosis. Grip strength is the most significant measurement to reveal the association between sarcopenia and osteoporosis, falls and fractures.

摘要

目的

本研究旨在确定绝经后妇女临床肌少症与骨质疏松症各组成部分之间的关系。

方法

2002 年,从骨质疏松症骨折预防(OSTPRE-FPS)研究中选择了一个基于人群的 590 名芬兰绝经后妇女队列(平均年龄 67.9 岁;范围 65-72 岁)。通过双能 X 线吸收法(DXA)评估骨矿物质密度(BMD)和瘦体重。根据世界卫生组织(WHO)BMD 分类,将研究样本分为正常、骨量减少和骨质疏松症三组。根据相对骨骼肌指数(四肢肌肉质量(kg)/身高(m)平方)、握力(kPa)和步行速度的 RSMI 四分位数,将研究样本分为非肌少症、肌少症前期、肌少症和未分类组。

结果

在逻辑回归分析中,与非肌少症妇女相比,肌少症妇女发生骨质疏松症的几率高 12.9 倍(p≤0.001,OR=12.9;95%CI=3.1-53.5)。与握力最高四分位组的女性相比,握力最低四分位组的女性发生骨质疏松症的几率高 11.7 倍(p=0.001,OR=11.7;2.6-53.4)。肌少症妇女发生骨折的几率比非肌少症妇女高 2.7 倍(p=0.005,OR=2.732;1.4-5.5)。与非肌少症妇女相比,肌少症妇女在过去 12 个月内发生跌倒的风险也高 2.1 倍(p=0.021,OR=2.1;1.1-3.9)。调整年龄、体重指数(BMI)、身体活动和激素治疗(HT)后,这些结果并未显著改变。

结论

临床肌少症的各组成部分与骨质疏松症密切相关。握力是揭示肌少症与骨质疏松症、跌倒和骨折之间关联的最显著测量指标。

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