Yoshihara Toshinori, Ozaki Hayao, Nakagata Takashi, Natsume Toshiharu, Kitada Tomoharu, Ishihara Yoshihiko, Sawada Shuji, Ishibashi Masayoshi, Kobayashi Hiroyuki, Machida Shuichi, Naito Hisashi
COI Project Center, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
School of Health and Sports Science, Juntendo University, 1-1 Hirakagakuendai, Inzai, Chiba, 270-1695, Japan.
BMC Musculoskelet Disord. 2019 Mar 14;20(1):104. doi: 10.1186/s12891-019-2480-9.
Locomotive syndrome (LS) is associated with weakness and loss of function in the musculoskeletal organs. We aimed to determine the association between LS components and blood parameters in middle-aged and elderly individuals.
We included 223 middle-aged and elderly individuals in this study (104 men and 119 women; age: 40-85 years). All participants were asked to fast for at least 3 h before the venous blood samples were obtained and the hemoglobin, total protein, glycated hemoglobin (HbA1c), growth hormone, albumin and lipid profile were measured. Three functional tests, the stand-up test, the two-step test, and the 25-question geriatric locomotive function scale (GLFS) were used to assess the risk of LS. Walking speed was assessed by the 10-m walking test. Maximal isometric muscle strengths of the knee extensors were examined, and the weight bearing index (knee extension strength/body weight) was calculated. To assess an independent association between blood parameters and LS, the area under the receiver operating characteristic curve analysis (area under the curve, sensitivity, and specificity) and a binary logistic regression analysis were performed with adjustment for age.
Of the 223 subjects, 119 (53.3%) fulfilled the diagnostic criteria for LS (including a two-step test score < 1.3, difficulty with one-leg standing from 40 cm in the stand-up test, and a 25-question GLFS score ≥ 7). Increased levels of HbA1c were significant risk factors for LS with an OR of 2.62 (OR = 1.43-4.80), as determined by a logistic regression analysis. Additionally, dehydroepiandrosterone-sulfate (DHEA-S) levels were significant only in the male subjects (OR = 0.992 [OR = 0.986-0.998]), at a threshold of 88 (AUC; 0.70, sensitivity; 79.6%, specificity; 49.1%). Moreover, 101 of 223 participants (41 men, 60 women) were analyzed for serum albumin levels, with a prevalence of LS at 55.4%, indicating that low levels of albumin were significant risk factors for LS (OR = 0.148 [OR = 0.023-0.954], p = 0.0445).
These results suggest that higher HbA1c and lower albumin are associated with the prevalence of LS in Japanese middle-aged and elderly individuals. Furthermore, low DHEA-S levels may be useful screening tools for LS in men.
运动机能不全综合征（LS）与肌肉骨骼器官的虚弱和功能丧失有关。我们旨在确定中年和老年个体中LS各组成部分与血液参数之间的关联。
本研究纳入了223名中年和老年个体（104名男性和119名女性；年龄：40 - 85岁）。所有参与者在采集静脉血样前至少禁食3小时，并测量血红蛋白、总蛋白、糖化血红蛋白（HbA1c）、生长激素、白蛋白和血脂谱。使用三项功能测试，即起立测试、两步测试和25题老年运动机能功能量表（GLFS）来评估LS风险。通过10米步行测试评估步行速度。检查膝伸肌的最大等长肌力，并计算负重指数（膝伸肌力量/体重）。为了评估血液参数与LS之间的独立关联，进行了受试者操作特征曲线下面积分析（曲线下面积、敏感性和特异性）以及二元逻辑回归分析，并对年龄进行了调整。
在223名受试者中，119名（53.3%）符合LS诊断标准（包括两步测试得分<1.3、起立测试中从40厘米单腿站立困难以及25题GLFS得分≥7）。逻辑回归分析确定，HbA1c水平升高是LS的显著危险因素，OR为2.62（OR = 1.43 - 4.80）。此外，硫酸脱氢表雄酮（DHEA - S）水平仅在男性受试者中具有显著性（OR = 0.992 [OR = 0.986 - 0.998]），阈值为88（曲线下面积；0.70，敏感性；79.6%，特异性；49.1%）。此外，对223名参与者中的101名（41名男性，60名女性）进行了血清白蛋白水平分析，LS患病率为55.4%，表明低白蛋白水平是LS的显著危险因素（OR = 0.148 [OR = 0.023 - 0.954]，p = 0.0445）。
这些结果表明，较高的HbA1c和较低的白蛋白与日本中年和老年个体中LS的患病率相关。此外，低DHEA - S水平可能是男性LS的有用筛查工具。
