Lee Dong-Won, Jin Hyun-Jung, Shin Kyeong-Cheol, Chung Jin-Hong, Lee Hyoung-Woo, Lee Kwan-Ho
Division of Pulmonology, Department of Internal Medicine, Andong Sungso Hospital, Andong.
Division of Pulmonology and Allergy.
Int J Chron Obstruct Pulmon Dis. 2017 Aug 7;12:2355-2362. doi: 10.2147/COPD.S138497. eCollection 2017.
Sarcopenia and decreased bone-mineral density (BMD) are common in elderly people, and are major comorbidities of obstructive airway disease (OAD). However, the relationship between sarcopenia and BMD in each OAD phenotype, especially asthma-COPD overlap syndrome (ACOS), is not yet clear. We aimed to evaluate differences in BMD according to the presence of sarcopenia in each OAD phenotype.
Among the research subjects in KNHANES IV and V (2008-2011), 5,562 were ≥50 years old and underwent qualified spirometry and dual-energy X-ray absorptiometry. A total of 947 subjects were included in the study: 89 had asthma, 748 COPD, and 110 ACOS.
In the COPD and ACOS phenotypes, T-scores were lower in the sarcopenia group than the nonsarcopenia group. Prevalence rates of osteopenia and osteoporosis were higher in the sarcopenia group than the nonsarcopenia group. (<0.001 and =0.017, respectively). The sarcopenia group had higher risks of developing osteopenia, osteoporosis, and low BMD than the nonsarcopenia group in the ACOS phenotype (OR 6.620, 95% CI 1.129-38.828 [=0.036], OR 9.611, 95% CI 1.133-81.544 [=0.038], and OR 6.935, 95% CI 1.194-40.272 [=0.031], respectively). However, in the asthma phenotype, the sarcopenia group showed no increased risk compared with the nonsarcopenia group.
In the ACOS phenotype, individuals with sarcopenia had a higher prevalence rate and higher risks of osteopenia and osteoporosis than those without sarcopenia among all OAD phenotypes.
肌肉减少症和骨密度(BMD)降低在老年人中很常见,并且是阻塞性气道疾病(OAD)的主要合并症。然而,在每种OAD表型中,尤其是哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)中,肌肉减少症与骨密度之间的关系尚不清楚。我们旨在评估每种OAD表型中存在肌肉减少症时骨密度的差异。
在韩国国家健康与营养检查调查(KNHANES)IV和V(2008 - 2011年)的研究对象中,5562名年龄≥50岁,接受了合格的肺量计检查和双能X线吸收测定。共有947名受试者纳入研究:89名患有哮喘,748名患有慢性阻塞性肺疾病(COPD),110名患有ACOS。
在COPD和ACOS表型中,肌肉减少症组的T值低于非肌肉减少症组。肌肉减少症组的骨质减少和骨质疏松患病率高于非肌肉减少症组。(分别为<0.001和=0.017)。在ACOS表型中,肌肉减少症组发生骨质减少、骨质疏松和低骨密度的风险高于非肌肉减少症组(OR分别为6.620,95%CI 1.129 - 38.828 [=0.036],OR 9.611,95%CI 1.133 - 81.544 [=0.038],以及OR 6.935,95%CI 1.194 - 40.272 [=0.031])。然而,在哮喘表型中,肌肉减少症组与非肌肉减少症组相比风险没有增加。
在ACOS表型中,与所有OAD表型中无肌肉减少症的个体相比,有肌肉减少症的个体骨质减少和骨质疏松的患病率更高,风险也更高。