Eguchi Yawara, Toyoguchi Toru, Inage Kazuhide, Fujimoto Kazuki, Orita Sumihisa, Yamauchi Kazuyo, Suzuki Miyako, Kanamoto Hirohito, Abe Koki, Norimoto Masaki, Umimura Tomotaka, Koda Masao, Furuya Takeo, Aoki Yasuchika, Takahashi Kazuhisa, Ohtori Seiji
Department of Orthopaedic Surgery, Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido, Chiba, 284-0003, Japan.
Department of Orthopaedic Surgery, Chiba Qiball Clinic, 4-5-1, Chuo-ku, Chiba, 260-0013, Japan.
Eur Spine J. 2018 Mar;27(3):597-606. doi: 10.1007/s00586-017-5370-6. Epub 2017 Nov 10.
PURPOSE: Advanced glycation end products (AGEs) have been implicated in the pathogenesis of sarcopenia. The objective of the study was to investigate the prevalence of sarcopenia in degenerative lumbar scoliosis (DLS), and the relationship between biochemical markers including major AGEs, pentosidine, and DLS in older women. METHODS: Our study participants were 20 elderly women with idiopathic DLS (mean age 76.4 years, range 56-88). Nineteen age- and sex-matched volunteers (mean age 74.0 years, range 62-86) served as controls. Spinal and femoral BMD of all participants was measured using dual-energy X-ray absorptiometry. We used a bioelectrical impedance analyzer to analyze body composition, including appendicular skeletal muscle mass index [SMI; appendicular lean mass (kg)/(height (m)]. SMI < 5.75 was considered diagnostic for sarcopenia. Coronal and sagittal spinal alignments were measured. The following biochemical markers were measured: serum and urinary pentosidine, serum homocysteine, 1,25(OA)D, and 25(OH)D. The level of each variable was compared between DLS and controls. The relationship between biochemical markers including pentosidine and DLS was examined. RESULTS: Sarcopenia was observed at a high prevalence in participants with DLS: 50% compared with 15.8% of healthy controls. Height, weight, femoral BMI, appendicular lean mass, total lean mass, and SMI all had significantly lower values in the DLS group. Serum pentosidine was significantly higher for the DLS group compared with controls. Correlations with serum pentosidine revealed a significant positive correlation between lumbar scoliosis, pelvic tilt, and pelvic incidence-lumbar lordosis mismatch, and a significantly negative correlation between thoracic kyphosis (P < 0.05). CONCLUSIONS: We found that sarcopenia was involved in DLS, and high serum pentosidine levels are associated with severity of coronal and sagittal malalignment in older women, suggesting that high levels of AGEs are a potential biomarker for the progression of lumbar scoliosis and kyphotic deformity. Further studies are needed to clarify the pathogenesis of DLS.
目的：晚期糖基化终末产物（AGEs）与肌肉减少症的发病机制有关。本研究的目的是调查老年女性退行性腰椎侧凸（DLS）中肌肉减少症的患病率，以及包括主要AGEs、戊糖苷在内的生化标志物与DLS之间的关系。 方法：我们的研究参与者为20名患有特发性DLS的老年女性（平均年龄76.4岁，范围56 - 88岁）。19名年龄和性别匹配的志愿者（平均年龄74.0岁，范围62 - 86岁）作为对照。使用双能X线吸收法测量所有参与者的脊柱和股骨骨密度。我们使用生物电阻抗分析仪分析身体成分，包括四肢骨骼肌质量指数[SMI；四肢瘦体重（kg）/（身高（m）]。SMI < 5.75被认为是肌肉减少症的诊断标准。测量冠状面和矢状面脊柱排列。测量以下生化标志物：血清和尿戊糖苷、血清同型半胱氨酸、1,25(OH)D和25(OH)D。比较DLS组和对照组之间各变量的水平。研究包括戊糖苷在内的生化标志物与DLS之间的关系。 结果：在DLS参与者中观察到肌肉减少症的高患病率：50%，而健康对照组为15.8%。DLS组的身高、体重、股骨BMI、四肢瘦体重、总瘦体重和SMI均显著较低。与对照组相比，DLS组的血清戊糖苷显著更高。与血清戊糖苷的相关性显示，腰椎侧凸、骨盆倾斜和骨盆入射角 - 腰椎前凸失配之间存在显著正相关，而胸椎后凸之间存在显著负相关（P < 0.05）。 结论：我们发现肌肉减少症与DLS有关，高血清戊糖苷水平与老年女性冠状面和矢状面畸形的严重程度相关，表明高水平的AGEs是腰椎侧凸和后凸畸形进展的潜在生物标志物。需要进一步研究以阐明DLS的发病机制。
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