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肌少症性骨关节炎:老年医学中的一个新实体?

Sarcopenic osteoarthritis: a new entity in geriatric medicine?

作者信息

Veronese Nicola, Punzi Leonardo, Sieber Cornel, Bauer Jurgen, Reginster Jean-Yves, Maggi Stefania

机构信息

National Research Council, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128, Padua, Italy.

Rheumatology Unit, Department of Medicine (DIMED), University of Padova, Padua, Italy.

出版信息

Eur Geriatr Med. 2018 Apr;9(2):141-148. doi: 10.1007/s41999-018-0034-6. Epub 2018 Feb 12.

Abstract

PURPOSE

Osteoarthritis, a disease characterized by cartilage degradation, abnormal subchondral bone remodeling and some grade of inflammation, and sarcopenia, a condition of low muscle mass associated with reduced strength and function, are prevalent disorders in older adults. In this review, we examine what is known about the relationship between osteoarthritis and sarcopenia, with particular focus on the older population. We also discuss how osteoarthritis and sarcopenia may interact and affect each other in clinical progression and the potential benefits from developing treatments that address such muscular-skeletal interaction.

METHODS

We searched in Pubmed and Scopus through a combination of search and MESH terms, for osteoarthritis and sarcopenia.

RESULTS

Even if more literature is needed, there is increasing evidence that decline in lower limb muscle strength is associated with knee or hip osteoarthritis in a pathological network of pain, altered joint stability, maladapted postures and defective neuromuscular communication. At the cellular levels, chondrocytes and myoblasts share common pathways, and the close anatomical location of both cell types also suggest the possibility of paracrine communication.

CONCLUSIONS

Sarcopenia and osteoarthritis are significantly intercorrelated and in the near future should be considered as an only entity, as we have recently proposed for sarcopenia and osteoporosis. The treatment of both sarcopenia and osteoarthritis is based on physical exercise and nutritional interventions with the aim of improving cartilage, bone and muscle health. Future studies are needed, particularly to know the exact prevalence of sarcopenia in people with osteoarthritis, its peculiar consequences and the most appropriate treatments.

摘要

目的

骨关节炎是一种以软骨降解、软骨下骨异常重塑和一定程度炎症为特征的疾病,而肌肉减少症是一种肌肉量低且伴有力量和功能下降的病症,这两种疾病在老年人中都很常见。在本综述中,我们研究了关于骨关节炎与肌肉减少症之间关系的已知情况,特别关注老年人群。我们还讨论了骨关节炎和肌肉减少症在临床进展中可能如何相互作用和影响,以及开发针对这种肌肉骨骼相互作用的治疗方法可能带来的潜在益处。

方法

我们通过搜索词和医学主题词(MESH)的组合在PubMed和Scopus中搜索骨关节炎和肌肉减少症。

结果

即使还需要更多文献,但越来越多的证据表明,在疼痛、关节稳定性改变、姿势适应不良和神经肌肉沟通缺陷的病理网络中,下肢肌肉力量下降与膝关节或髋关节骨关节炎有关。在细胞水平上,软骨细胞和成肌细胞共享共同途径,而且这两种细胞类型紧密的解剖位置也提示了旁分泌通讯的可能性。

结论

肌肉减少症和骨关节炎显著相互关联,在不久的将来应被视为一个整体,就像我们最近对肌肉减少症和骨质疏松症所提议的那样。肌肉减少症和骨关节炎的治疗都基于体育锻炼和营养干预,目的是改善软骨、骨骼和肌肉健康。未来需要进行研究,特别是要了解骨关节炎患者中肌肉减少症的确切患病率、其特殊后果以及最合适的治疗方法。

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