The Icelandic Gerontological Research Institute, Tungata 5, 101, Reykjavik, Iceland.
Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.
Osteoporos Int. 2021 Feb;32(2):243-250. doi: 10.1007/s00198-020-05567-x. Epub 2020 Aug 18.
Poor physical function and body composition my partly predict the risk of falls leading to fracture regardless of bone mineral density.
To examine the relationship between body composition, physical function, and other markers of health with hip fractures in older community-dwelling Icelandic adults.
A prospective cohort of 4782 older adults from the AGES-Reykjavik study. Baseline recruitment took place between 2002 and 2006, and information on hip fractures occurring through 2012 was extracted from clinical records. Using multivariate regression analyses, baseline measures of bone health, physical function, and body composition were compared between those who later experienced hip fractures and to those who did not. Associations with the risk of fractures were quantified using Cox regression.
Mean age was 76.3 years at baseline. After adjustment for age, regression showed that male hip fracture cases compared with non-cases had (mean (95% confidence interval)) significantly lower thigh muscle cross-sectional area - 5.6 cm (- 10.2, - 1.1), poorer leg strength - 28 N (- 49, - 7), and decreased physical function as measured by longer timed up and go test 1.1 s (0.5, 1.7). After adjustment for age, female cases had, compared with non-cases, lower body mass index - 1.5 kg/m2 (- 2.1, - 0.9), less lean mass - 1.6 kg (- 2.5, - 0.8), thigh muscle cross-sectional area - 4.4 cm (- 6.5, - 2.3), and worse leg strength - 16 N (- 25, - 6). These differences largely persisted after further adjustment for bone mineral density (BMD), suggesting that body composition may contribute to the risk of fracture independent of bone health. When examining the association between these same factors and hip fractures using Cox regression, the same conclusions were reached.
After accounting for age and BMD, older adults who later experienced a hip fracture had poorer baseline measures of physical function and/or body composition, which may at least partly contribute to the risk of falls leading to fracture.
身体功能和身体成分差可能会部分预测导致骨折的跌倒风险，而与骨密度无关。
检查身体成分、身体功能和其他健康标志物与冰岛老年社区居民髋部骨折的关系。
来自 AGES-Reykjavik 研究的一项前瞻性队列研究，共有 4782 名老年人。基线招募于 2002 年至 2006 年之间进行，通过临床记录提取了 2012 年之前发生的髋部骨折信息。使用多变量回归分析比较了之后发生髋部骨折的人和未发生髋部骨折的人的基线骨健康、身体功能和身体成分测量值。使用 Cox 回归分析来量化骨折风险的关联。
基线时平均年龄为 76.3 岁。在调整年龄后，回归显示男性髋部骨折病例与非病例相比，大腿肌肉横截面积显著较低（平均值（95%置信区间））-5.6cm（-10.2，-1.1），腿部力量较弱-28N（-49，-7），以及计时起立行走测试时间延长 1.1 秒（0.5，1.7），表明身体功能下降。在调整年龄后，女性病例与非病例相比，体重指数较低（BMI）-1.5kg/m2（-2.1，-0.9），瘦体重（lean mass）较少-1.6kg（-2.5，-0.8），大腿肌肉横截面积较小-4.4cm（-6.5，-2.3），腿部力量较弱-16N（-25，-6）。在进一步调整骨密度（BMD）后，这些差异基本保持不变，表明身体成分可能独立于骨骼健康对骨折风险产生影响。当使用 Cox 回归分析检查这些相同因素与髋部骨折之间的关联时，也得出了相同的结论。
在考虑年龄和 BMD 后，后来经历髋部骨折的老年人的身体功能和/或身体成分的基线测量值较差，这可能至少部分导致了导致骨折的跌倒风险。
