World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU B.23 - Quartier Hôpital, Avenue Hippocrate, 13, 4000, Liège, Belgium.
ULiège Library, University of Liège, Liège, Belgium.
BMC Musculoskelet Disord. 2019 Sep 14;20(1):429. doi: 10.1186/s12891-019-2752-4.
Various cross-sectional studies provide an abundance of evidence that shows a relationship between bone quantity and muscle health. However, one question remains, less-often studied: is their development - or decline - associated? The aim of the research was to conduct a systematic review and meta-analysis to summarize the studies exploring the association between changes in bone mineral density (BMD) and changes in muscle parameters (registration CRD42018093813).
We searched for prospective studies, both in children and adults, by consulting electronic databases (Ovid-MEDLINE, Ovid-AMED, Scopus). Each review steps were performed by two independent reviewers. For outcomes reported by less of 3 studies, we synthetized the results narratively. In other cases, a meta-analysis was performed, giving an overall r coefficient and its 95% confidence interval (CI).
Fifteen papers were included. In connection with the change of BMD, 10 studies concerned the parallel change of lean mass, 4 were about grip strength, and 1 was about physical performance. Children were the population of interest for 5 studies, while the aging population was the focus of the other studies. The correlation between hip BMD and lean mass was significant, with an overall coefficient r = 0.37 (95% CI 0.23-0.49). High heterogeneity was observed between studies but the length of follow-up, sex and study quality did not seem to significantly influence results. The systematic review allowed some other highlights: a significant link between changes in BMD and changes in muscle strength was observed (p-value < 0.05 in the 4 studies), in addition to changes in performance (1 study, r = 0.21, p-value = 0.004).
Despite the heterogeneity between studies, we highlighted a significant association between the change of BMD and the change of various muscle parameters. Future studies should investigate preventive and therapeutic strategies that are based on a single entity: the 'muscle-bone unit'.
多项横断面研究提供了大量证据表明，骨量与肌肉健康之间存在关联。然而，有一个问题仍然较少被研究：它们的发展——或衰退——是否相关？本研究旨在进行系统回顾和荟萃分析，以总结探讨骨密度（BMD）变化与肌肉参数变化之间关系的研究。
我们通过检索电子数据库（Ovid-MEDLINE、Ovid-AMED、Scopus），搜索了儿童和成人的前瞻性研究。每个审查步骤均由两名独立审查员进行。对于报告结果少于 3 项的研究，我们进行了叙述性综合。在其他情况下，我们进行了荟萃分析，给出了总体 r 系数及其 95%置信区间（CI）。
共纳入 15 篇论文。关于 BMD 的变化，有 10 项研究涉及瘦体重的平行变化，4 项研究涉及握力，1 项研究涉及身体机能。有 5 项研究的研究对象为儿童，而其他研究则关注老年人群体。髋部 BMD 与瘦体重之间的相关性具有统计学意义，总体相关系数 r=0.37（95%CI 0.23-0.49）。尽管存在高度异质性，但研究的随访时间、性别和研究质量似乎并未显著影响结果。系统综述还发现了一些其他亮点：观察到 BMD 变化与肌肉力量变化之间存在显著关联（4 项研究中 p 值均<0.05），此外还观察到了身体机能的变化（1 项研究，r=0.21，p 值=0.004）。
尽管研究之间存在异质性，但我们强调了 BMD 变化与各种肌肉参数变化之间存在显著关联。未来的研究应探讨基于单一实体（“肌肉-骨骼单位”）的预防和治疗策略。
