Kim Hun-Tae, Kim Hyun-Je, Ahn Hee-Yun, Hong Young-Hoon
Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Korean J Intern Med. 2016 May;31(3):585-93. doi: 10.3904/kjim.2015.156. Epub 2016 Mar 15.
BACKGROUND/AIMS: This study was conducted in order to analyze the effects of sarcopenia on age-related osteoarthritis (OA) of the knee in a Korean population.
All the Korean subjects who visited the Yeungnam University Medical Center Health Promotion Center between 2008 and 2012 in order to undergo a routine medical examination were enrolled. A total of 5,723 young, healthy people (2,959 males, 2,764 females) enrolled as normal subjects and 23,473 subjects (13,006 males and 10,467 females) were included for evaluation of the effects of sarcopenia on OA. There were 266 subjects who followed-up bioelectrical impedance analysis at a 4-year interval. Of 327 subjects enrolled in this study, knees with anteroposterior X-rays were assessed according to the Kellgren-Lawrence (K/L) grade.
Skeletal muscle mass index (SMI) and basal metabolic rate (BMR) showed a steady decrease with the advance of age (p < 0.01), but SMI showed strong positive correlation with BMR (r = 0.72, β = 30.96, p < 0.01). During the 4-year interval, BMR showed a significant decrease with aging (p < 0.01), consistently with the decrease of SMI. Knees with normal SMI were prone to be designated as K/L grade 0 or 1; however, subjects with sarcopenia showed a trend toward the higher K/L grade, classified as knee radiological osteoarthritis (ROA) (p < 0.01).
The results of this study may indicate that sarcopenia as age-related loss of skeletal muscle mass is interactively correlated with the presence and severity of age-related OA.
背景/目的:本研究旨在分析韩国人群中肌肉减少症对年龄相关性膝关节骨关节炎(OA)的影响。
纳入2008年至2012年间到岭南大学医学中心健康促进中心进行常规体检的所有韩国受试者。共有5723名年轻健康人(男性2959名,女性2764名)作为正常受试者入组,另有23473名受试者(男性13006名,女性10467名)纳入肌肉减少症对OA影响的评估。有266名受试者每4年进行一次生物电阻抗分析随访。在本研究纳入的327名受试者中,根据Kellgren-Lawrence(K/L)分级对有前后位X线片的膝关节进行评估。
骨骼肌质量指数(SMI)和基础代谢率(BMR)随年龄增长呈稳步下降(p<0.01),但SMI与BMR呈强正相关(r = 0.72,β = 30.96,p<0.01)。在4年期间,BMR随年龄增长显著下降(p<0.01),与SMI的下降一致。SMI正常的膝关节倾向于被定为K/L 0级或1级;然而,肌肉减少症患者显示出K/L分级较高的趋势,被归类为膝关节放射学骨关节炎(ROA)(p<0.01)。
本研究结果可能表明,作为与年龄相关的骨骼肌质量丢失的肌肉减少症与年龄相关性OA的存在和严重程度存在交互相关性。