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绝经后女性瘦体重的长期变化及骨质疏松症药物治疗的效果:一项为期10年的纵向研究。

Long-term changes in lean mass in postmenopausal women and the effects of osteoporosis pharmacotherapy: A 10-year longitudinal study.

作者信息

Miyakoshi Naohisa, Hongo Michio, Shimada Yoichi

机构信息

Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.

出版信息

Osteoporos Sarcopenia. 2021 Mar;7(1):30-35. doi: 10.1016/j.afos.2021.02.002. Epub 2021 Mar 9.

Abstract

OBJECTIVES

Although sarcopenia is diagnosed using appendicular lean mass (ALM), only a few long-term studies on changes in both ALM and bone mineral density (BMD) have been reported. The purposes of this study are to evaluate the changes in the parameters of lean mass and bone mass over a 10-year interval and to estimate the effects of osteoporosis pharmacotherapy on muscle.

METHODS

A total of 175 postmenopausal women were evaluated at baseline and after 10 years for BMD, ALM, fat mass, height, and weight. Subjects were further divided into an osteoporosis treatment group (n = 60) and a control group (n = 67) according to whether they had received pharmacotherapy for > 5 years. This was followed by propensity score matching for age, height, weight, and body mass index (BMI), and estimated parameters were compared between groups.

RESULTS

Height, weight, ALM, and fat mass decreased significantly over 10 years (P < 0.05). However, lean mass index (LMI), derived as the ALM divided by the height squared, increased significantly (P < 0.001). BMD increased significantly with osteoporosis treatment (P < 0.05), while no significant differences were observed between the osteoporosis treatment and control groups in the changes to ALM or fat mass.

CONCLUSIONS

ALM was decreased, while LMI was significantly increased. This contradictory result seems to be affected by age-related height loss. Thus, the effect of height loss needs to be considered when sarcopenia is evaluated longitudinally using LMI.

摘要

目的

尽管肌少症是通过四肢瘦体重(ALM)来诊断的,但关于ALM和骨矿物质密度(BMD)变化的长期研究报告较少。本研究的目的是评估10年间瘦体重和骨量参数的变化,并估计骨质疏松症药物治疗对肌肉的影响。

方法

共有175名绝经后女性在基线时和10年后接受了BMD、ALM、脂肪量、身高和体重的评估。根据受试者是否接受了超过5年的药物治疗,将其进一步分为骨质疏松症治疗组(n = 60)和对照组(n = 67)。随后对年龄、身高、体重和体重指数(BMI)进行倾向得分匹配,并比较两组之间的估计参数。

结果

身高、体重、ALM和脂肪量在10年间显著下降(P < 0.05)。然而,以ALM除以身高平方得出的瘦体重指数(LMI)显著增加(P < 0.001)。骨质疏松症治疗后BMD显著增加(P < 0.05),而骨质疏松症治疗组和对照组在ALM或脂肪量变化方面未观察到显著差异。

结论

ALM下降,而LMI显著增加。这一矛盾结果似乎受年龄相关的身高降低影响。因此,在使用LMI纵向评估肌少症时,需要考虑身高降低的影响。

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