Department of Orthopaedic Surgery, Hallym University College of Medicine, Chuncheon, South Korea.
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea.
Arch Osteoporos. 2018 Mar 12;13(1):24. doi: 10.1007/s11657-018-0442-8.
We evaluated the vitamin D receptor (VDR) expression in the forearm flexor muscle of women with distal radius fracture. High VDR expression was associated with low appendicular lean mass index.
We aimed to evaluate the relationship between the VDR expression in the muscle cell and the muscle mass in women with a distal radius fracture (DRF).
We prospectively recruited 45 women over 50 years of age (mean age, 66 years) with DRF and acquired biopsy of the forearm flexor muscle. The muscle cross-sectional area (CSA) and VDR expression were measured using immunohistochemistry staining. The clinical parameters including grip strength, gait speed, body mass index (BMI), bone mineral density (BMD), and serum vitamin D levels were compared between patients grouped by appendicular lean mass index and were correlated with the VDR expression.
Twelve patients (27%) showed a decreased appendicular lean mass index, less than the cut-off value of 5.4 kg/m which was suggested by the Asian Working Group for Sarcopenia. Patients with a low appendicular lean mass index had significantly lower muscle CSA (p = 0.037), but a higher VDR expression (p = 0.045) than those with higher indices. VDR expression was negatively correlated with BMI (r = - 0.417, p = 0.004) and appendicular lean mass index (r = - 0.316, p = 0.044).
DRF patients with low appendicular lean mass index presented high VDR expression and low CSA in forearm muscle cells. This suggests that the VDR expression might be upregulated in the attempt to compensate for the decreasing muscle mass. Further studies are necessary to explore the role of VDR in the progression of sarcopenia.
评估远端桡骨骨折(DRF)女性前臂屈肌中维生素 D 受体(VDR)的表达与四肢瘦肉质量指数(ALMI)的关系。
我们前瞻性招募了 45 名年龄在 50 岁以上(平均年龄 66 岁)的 DRF 女性,并采集了前臂屈肌的活检样本。使用免疫组织化学染色测量肌肉横截面积(CSA)和 VDR 表达。比较按四肢瘦肉质量指数分组的患者的临床参数,包括握力、步速、体重指数(BMI)、骨密度(BMD)和血清维生素 D 水平,并与 VDR 表达相关。
12 名患者(27%)的四肢瘦肉质量指数低于亚洲肌少症工作组建议的 5.4kg/m 的截断值。四肢瘦肉质量指数较低的患者肌肉 CSA 明显较低(p=0.037),但 VDR 表达较高(p=0.045)。VDR 表达与 BMI(r=-0.417,p=0.004)和四肢瘦肉质量指数(r=-0.316,p=0.044)呈负相关。
四肢瘦肉质量指数低的 DRF 患者前臂肌肉细胞中 VDR 表达较高,CSA 较低。这表明 VDR 表达可能上调以代偿肌肉量的减少。需要进一步研究以探讨 VDR 在肌少症进展中的作用。