Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, VIC, Australia.
Department of Medicine-Western Health, The University of Melbourne, St. Albans, VIC, Australia.
Calcif Tissue Int. 2019 Oct;105(4):392-402. doi: 10.1007/s00223-019-00582-5. Epub 2019 Jul 10.
Osteosarcopenia is defined as the concomitant occurrence of osteoporosis and sarcopenia. Current lack of consensus on sarcopenia definitions, combined with the low sensitivity and specificity of screening methodologies, has resulted in varying prevalences of sarcopenia, and consequently osteosarcopenia diagnosis. Previous research indicates that mid-thigh is a potential surrogate region for the assessment of bone, muscle, and fat mass in a single, efficient and low-radiation dual x-ray absorptiometry (DXA) scan. We hypothesized that muscle and bone mass measurements in the mid-thigh region can be used to evaluate bone and muscle health and function. A retrospective study was conducted on community-dwelling older subjects (> 65 y.o., n = 260) who were at risk of falls and fractures. Mid-thigh and mid-calf bone, lean muscle, and fat masses, as well as their association with muscle function, falls, and fractures were compared against conventional measures (hip/spine bone, appendicular lean, and gynoid/android fat masses). Mid-thigh bone, lean, and fat masses showed strong correlation with conventional measures. Mid-thigh lean mass showed similar associations with grip strength, gait speed, and timed up and go (TUG) test as appendicular lean mass. Appendicular, mid-thigh and mid-calf lean masses corrected for body mass index (BMI) showed stronger associations than when corrected for height. None of the indices were associated with fractures; but fat mass was invariably associated with falls. Those with falls and fractures history had lower bone and muscle mass at mid-thigh. Mid-thigh is a potential new surrogate to study bone, muscle, and fat mass in older people, with comparable ability in predicting muscle performance and falls.
骨肌减少症定义为骨质疏松症和肌少症同时发生。目前对肌少症定义缺乏共识，再加上筛查方法的敏感性和特异性较低，导致肌少症的患病率不同，进而导致骨肌减少症的诊断不同。之前的研究表明，大腿中段是在单次高效低辐射双能 X 线吸收法 (DXA) 扫描中评估骨、肌肉和脂肪质量的潜在替代区域。我们假设大腿中段的肌肉和骨量测量可用于评估骨骼和肌肉健康及功能。对有跌倒和骨折风险的社区居住的老年受试者 (>65 岁，n=260)进行了一项回顾性研究。将大腿中段和小腿骨、瘦肌肉和脂肪质量及其与肌肉功能、跌倒和骨折的关系与常规测量方法（髋/脊柱骨、四肢瘦肌肉和女性/男性脂肪质量）进行了比较。大腿中段的骨、瘦肌肉和脂肪质量与常规测量方法具有很强的相关性。大腿中段瘦肌肉与握力、步速和计时起立行走 (TUG) 测试的相关性与四肢瘦肌肉相似。校正体重指数 (BMI) 后，四肢、大腿中段和小腿中段的瘦肌肉质量比校正身高后具有更强的相关性。没有任何指数与骨折有关；但脂肪量始终与跌倒有关。有跌倒和骨折病史的患者大腿中段的骨和肌肉质量较低。大腿中段是研究老年人骨骼、肌肉和脂肪质量的潜在新替代区域，在预测肌肉性能和跌倒方面具有相当的能力。
