The Sixth Affiliated Hospital of Kunming Medical University, Kunming, Yuxi, China.
Yunnan Key Laboratory of Digital Orthopedics, The First People's Hospital of Yunnan Province, Kunming, China.
Osteoporos Int. 2021 Nov;32(11):2173-2183. doi: 10.1007/s00198-021-05963-x. Epub 2021 Apr 20.
Osteosarcopenia is defined as the concomitant occurrence of sarcopenia and osteoporosis/osteopenia. This study aimed to clarify whether osteosarcopenia implies a greater risk of fractures, mortality, and falls and to draw attention to osteosarcopenia.
Osteosarcopenia, which is characterized by the co-existence of osteoporosis/osteopenia and sarcopenia, is one of the most challenging geriatric syndromes. However, the association between osteosarcopenia and the risk of falls, fractures, disability, and mortality is controversial.
We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials, from their inception to March 18, 2021, for cohort studies on the relationship between osteosarcopenia and fractures, falls, and mortality. Two reviewers independently extracted data and assessed study quality. A pooled analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) using fixed or random-effects models.
Eight cohort studies including 19,836 participants showed that osteosarcopenia significantly increased the risk of fracture (OR 2.46, 95% CI 1.83-3.30, P = 0.006, I = 63.0%), three cohort studies involving 2601 participants indicated that osteosarcopenia significantly increased the risk of mortality (OR 1.66, 95% CI 1.23-2.26, P = 0.214, I = 35.2%), and three cohort studies involving 3144 participants indicated that osteosarcopenia significantly increased the risk of falls (OR 1.62, 95% CI 1.28-2.04, P = 0.219, I = 34.1%). No publication bias existed among the studies regarding the association between osteosarcopenia and fractures. The findings were robust according to the subgroup and sensitivity analyses.
This pooled analysis demonstrated that osteosarcopenia significantly increased the risk of fractures, falls, and mortality, thus highlighting its relevance in daily life. Therefore, we suggest that elderly persons should be aware of the risks associated with osteosarcopenia.
明确骨肌减少症是否意味着骨折、死亡和跌倒风险增加，并引起对骨肌减少症的关注。
检索 PubMed、Embase 和 Cochrane 中央对照试验注册库，时间截至 2021 年 3 月 18 日，收集关于骨肌减少症与骨折、跌倒和死亡率关系的队列研究。两位作者独立提取数据和评估研究质量。采用固定或随机效应模型计算比值比（OR）及其 95%置信区间（CI）。
纳入 8 项队列研究（19836 名参与者），结果显示骨肌减少症显著增加骨折风险（OR 2.46，95%CI 1.833.30，P = 0.006，I² = 63.0%）；纳入 3 项队列研究（2601 名参与者），结果显示骨肌减少症显著增加死亡风险（OR 1.66，95%CI 1.232.26，P = 0.214，I² = 35.2%）；纳入 3 项队列研究（3144 名参与者），结果显示骨肌减少症显著增加跌倒风险（OR 1.62，95%CI 1.28~2.04，P = 0.219，I² = 34.1%）。骨肌减少症与骨折风险的研究间不存在发表偏倚。根据亚组和敏感性分析，结果稳健。
该汇总分析表明，骨肌减少症显著增加骨折、跌倒和死亡风险，强调了其在日常生活中的相关性。因此，我们建议老年人应了解与骨肌减少症相关的风险。
