Osteoporosis Research Center, Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Opera San Camillo Foundation, Turin, Italy -
Osteoporosis Research Center, Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Opera San Camillo Foundation, Turin, Italy.
Eur J Phys Rehabil Med. 2020 Apr;56(2):184-190. doi: 10.23736/S1973-9087.20.05991-2. Epub 2020 Feb 12.
The concurrent presence of sarcopenia and osteoporosis may enhance fracture risk.
The aim of this study was to evaluate the association between sarcopenia, osteoporosis, or the concurrent presence of both the conditions (osteosarcopenia) and the burden (number and severity) of vertebral fractures in women with hip fracture.
Cross-sectional study.
Division of Physical and Rehabilitation Medicine.
We studied 350 women with subacute hip fracture.
Lateral radiographs of the spine were taken 18.2±4.5 days after fracture occurrence and the Spine Deformity Index (SDI) was calculated. Body composition was assessed by dual-energy X-ray absorptiometry. Low muscle mass was identified with appendicular lean mass <15.02 kg and low bone mineral density with a femoral T-Score <-2.5.
The presence of sarcopenia (P=0.033) and osteoporosis (P=0.032) was associated with the SDI scores independently of each other and independently of age, percentage of body fat and hip-fracture type. The 350 women were categorized into 3 groups according to the absence of both osteoporosis and sarcopenia (N.=25), presence of either osteoporosis or sarcopenia (N.=95) or presence of osteosarcopenia (N.=230). We found a significant difference in SDI scores across the 3 groups: χ2 (2, N.=350) = 15.29; P<0.001. The categorization of the 350 women into the 3 groups was associated with the SDI scores (P=0.001) independently of age, percentage of body fat and hip-fracture type.
Both osteoporosis and sarcopenia were independently associated with the burden of prevalent vertebral fractures in women with hip fracture. The concurrent presence of sarcopenia and osteoporosis was associated with a higher SDI Score than the presence of only one of the 2 conditions.
Subjects with both low bone mass and low muscle mass should be considered at particularly high risk for vertebral fractures. Interventions targeting both the components of the muscle-bone unit, including exercise, nutrition, and possibly new medications, should be investigated to optimize fracture prevention.
肌肉减少症和骨质疏松症的同时存在可能会增加骨折风险。
本研究旨在评估髋部骨折女性中肌肉减少症、骨质疏松症或两者同时存在（骨质减少症）以及椎体骨折的负担（数量和严重程度）之间的关系。
横断面研究。
物理康复医学科。
我们研究了 350 名亚急性髋部骨折女性。
骨折发生后 18.2±4.5 天拍摄脊柱侧位 X 线片，并计算脊柱畸形指数（SDI）。通过双能 X 射线吸收法评估身体成分。四肢瘦肉量<15.02kg 被定义为低肌肉量，股骨 T 评分<-2.5 被定义为低骨密度。
肌肉减少症（P=0.033）和骨质疏松症（P=0.032）的存在与 SDI 评分独立相关，与年龄、体脂百分比和髋部骨折类型无关。根据是否同时存在骨质疏松症和肌肉减少症将 350 名女性分为 3 组：均无骨质疏松症和肌肉减少症（N.=25）、存在骨质疏松症或肌肉减少症之一（N.=95）或存在骨质减少症（N.=230）。我们发现 3 组间 SDI 评分存在显著差异：χ2（2，N.=350）=15.29；P<0.001。将 350 名女性分为 3 组与 SDI 评分相关（P=0.001），与年龄、体脂百分比和髋部骨折类型无关。
骨质疏松症和肌肉减少症均与髋部骨折女性椎体骨折的负担独立相关。肌肉减少症和骨质疏松症同时存在与仅存在其中一种情况相比，SDI 评分更高。
低骨量和低肌肉量的患者应被视为椎体骨折的高风险人群。应研究针对肌肉骨骼单位的两种成分的干预措施，包括运动、营养，可能还有新的药物，以优化骨折预防。
