Hida Tetsuro, Shimokata Hiroshi, Sakai Yoshihito, Ito Sadayuki, Matsui Yasumoto, Takemura Marie, Kasai Takehiro, Ishiguro Naoki, Harada Atsushi
Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology, Obu, Japan.
Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 35, Tsuruma, Showa-ku, Nagoya, 466-8550, Japan.
Eur Spine J. 2016 Nov;25(11):3424-3431. doi: 10.1007/s00586-015-3805-5. Epub 2015 Feb 18.
Sarcopenia-related falls and fractures among women with osteoporosis are becoming an emerging problem because of rapid aging worldwide. We aimed to investigate the association between sarcopenia, given by the muscle mass of the arms and legs, and osteoporotic vertebral fracture (OVF) among female patients.
This cross-sectional study examined 216 women with fresh OVF (OVF group) diagnosed by magnetic resonance imaging and 1,608 women from an outpatient clinic who did not have a OVF [non-fracture (NF) group]. We performed whole-body dual-energy X-ray absorptiometry to analyze body composition, including skeletal muscle mass index (SMI; lean mass/height) and bone mineral density (BMD). We used stepwise logistic regression analysis to determine the risk factors associated with OVF.
After controlling for age, the OVF group showed lower appendicular SMI (5.62 vs. 5.97 kg/m, P < 0.001), lower arm SMI (1.36 vs. 1.42 kg/m, P = 0.004), lower leg SMI (4.27 vs. 4.55 kg/m, P < 0.001), and higher prevalence of sarcopenia (42.3 vs. 25.9 %, P < 0.001), compared with the NF group. Reduced leg muscle mass and presence of sarcopenia were independent risk factors for acute OVF in multivariate analysis (odds ratio = 1.4, P = 0.002; odds ratio = 1.96, P < 0.001, respectively).
We found higher prevalence of sarcopenia and lower leg muscle mass among patients with acute OVF compared with patients who did not have an OVF. These results suggest that sarcopenia may be a risk factor for OVF.
由于全球人口快速老龄化，骨质疏松症女性患者中与肌肉减少症相关的跌倒和骨折正成为一个新出现的问题。我们旨在研究女性患者中由手臂和腿部肌肉量所定义的肌肉减少症与骨质疏松性椎体骨折（OVF）之间的关联。
这项横断面研究检查了216例经磁共振成像诊断为新鲜OVF的女性（OVF组）以及1608例来自门诊且无OVF的女性（非骨折[NF]组）。我们进行了全身双能X线吸收测定以分析身体成分，包括骨骼肌质量指数（SMI；瘦体重/身高）和骨密度（BMD）。我们使用逐步逻辑回归分析来确定与OVF相关的危险因素。
在控制年龄后，与NF组相比，OVF组的四肢SMI较低（5.62对5.97kg/m，P<0.001），手臂SMI较低（1.36对1.42kg/m，P=0.004），小腿SMI较低（4.27对4.55kg/m，P<0.001），肌肉减少症患病率较高（42.3%对25.9%，P<0.001）。在多变量分析中，小腿肌肉量减少和肌肉减少症的存在是急性OVF的独立危险因素（优势比分别为1.4，P=0.002；优势比为1.96，P<0.001）。
我们发现与无OVF的患者相比，急性OVF患者中肌肉减少症患病率更高且小腿肌肉量更低。这些结果表明肌肉减少症可能是OVF的一个危险因素。
