Hita-Contreras Fidel, Martínez-Amat Antonio, Cruz-Díaz David, Pérez-López Faustino R
Department of Health Sciences, Faculty of Health Sciences, University of Jaén, E-23071 Jaén, Spain.
University of Zaragoza, Faculty of Medicine and Lozano Blesa University Hospital, E-50009 Zaragoza, Spain.
Maturitas. 2015 Feb;80(2):126-32. doi: 10.1016/j.maturitas.2014.11.009. Epub 2014 Nov 25.
Sarcopenia, obesity, and osteoporosis are three interrelated entities which may share common pathophysiological factors. In the last decades, overall survival has drastically increased. Postmenopausal women, due to their estrogen depletion, are at higher risk of developing any of these three conditions or the three, which is termed osteosarcopenic obesity. One of the most common health problems among these patients is the elevated risk of falls and fractures. Falls and fall-related injuries are one of the major causes of mortality and morbidity in older adults, and have a significant impact on social, economical and health-related costs. Several extrinsic and intrinsic risk factors have been described that play a role in the etiology of falls. A therapeutic approach to osteosarcopenic obesity aimed at the prevention of falls must include several factors, and act on those risk elements which can be effectively modified. An adequate weight-loss diet and a good nutritional intake, with an appropriate amount of vitamin D and the right protein/carbohydrates ratio, may contribute to the prevention of falls. The recommendation of physical exercise, both traditional (resistance or aerobic training) and more recent varieties (Tai Chi, Pilates, body vibration), can improve balance and positively contribute to fall prevention, whether by itself or in combination with other therapeutic strategies. Finally, a pharmacological approach, especially one focused on hormone therapy, has shown to have a positive effect on postmenopausal women's balance, leading to a decreased risk of falls.
肌肉减少症、肥胖症和骨质疏松症是三个相互关联的实体，它们可能共享共同的病理生理因素。在过去几十年中，总体生存率大幅提高。绝经后女性由于雌激素缺乏，患这三种疾病中的任何一种或同时患这三种疾病（即骨质疏松性肥胖症）的风险更高。这些患者中最常见的健康问题之一是跌倒和骨折风险升高。跌倒及与跌倒相关的损伤是老年人死亡和发病的主要原因之一，对社会、经济和健康相关成本有重大影响。已经描述了几种外在和内在风险因素，它们在跌倒的病因中起作用。针对骨质疏松性肥胖症预防跌倒的治疗方法必须包括几个因素，并作用于那些可以有效改变的风险因素。适当的减肥饮食和良好的营养摄入，包括适量的维生素D和正确的蛋白质/碳水化合物比例，可能有助于预防跌倒。推荐进行体育锻炼，包括传统的（抗阻或有氧运动训练）和最新的类型（太极拳、普拉提、全身振动），无论单独进行还是与其他治疗策略结合使用，都可以改善平衡并对预防跌倒产生积极作用。最后，药物治疗方法，尤其是专注于激素治疗的方法，已显示对绝经后女性的平衡有积极影响，从而降低跌倒风险。
