Orces Carlos H
Internal Medicine/Rheumatology, Laredo Medical Center, Laredo, USA.
Cureus. 2021 Sep 16;13(9):e18019. doi: 10.7759/cureus.18019. eCollection 2021 Sep.
Background Previous research conducted among institutionalized older adults has reported increased bone turnover markers (BTMs) in those subjects with mobility limitation. However, the association between walking speed and bone metabolism has not been well described in community-dwelling older adults. Methods The National Health and Nutrition Examination Survey 1999-2000 and 2001-2002 cycles were used to determine the association between the 20-feet walking speed test and bone alkaline phosphatase (BAP) and the cross-linked N-telopeptides of type I bone collagen (NTx). Sex-specific general linear models adjusted for potential confounders were assembled to examine the independent association between the time to complete the walking speed test grouped into quartiles and the logarithmic transformations of BAP and NTx levels. Results Of 2,521 older adults, 25.8% were defined as having mobility limitation. In both genders, BTM levels progressively increased as the time to complete the walking test also increase. Indeed, women and men who completed the walking speed test in the worst time quartile had on average 6% and 2.8% higher NTx levels than their counterparts who completed the test in the best time quartile, respectively. Likewise, BAP levels also progressively increased across walking speed time quartiles, but to a lesser degree. Notably, NTx levels were 4.7% and 2.6% higher in women and men with mobility limitation than those without, respectively. In contrast, BAP levels did not significantly differ in older adults regardless of their mobility limitation status. Conclusions Community-dwelling older adults with slower walking speeds and mobility limitation consistently had evidence of increased bone resorption. Thus, the present findings indicate that older adults with mobility limitation should be considered at risk of osteoporosis.
背景 先前针对机构养老老年人开展的研究报告称，行动受限的老年人骨转换标志物（BTMs）升高。然而，在社区居住的老年人中，步行速度与骨代谢之间的关联尚未得到充分描述。方法 利用1999 - 2000年和2001 - 2002年周期的美国国家健康与营养检查调查，确定20英尺步行速度测试与骨碱性磷酸酶（BAP）以及I型骨胶原交联N-端肽（NTx）之间的关联。构建针对潜在混杂因素进行调整的性别特异性一般线性模型，以检验将完成步行速度测试的时间分为四分位数后与BAP和NTx水平的对数转换之间的独立关联。结果 在2521名老年人中，25.8%被定义为行动受限。在男性和女性中，随着完成步行测试时间的增加，BTM水平均逐渐升高。实际上，在最差时间四分位数完成步行速度测试的女性和男性，其NTx水平分别比在最佳时间四分位数完成测试的同龄人平均高6%和2.8%。同样，BAP水平也随着步行速度时间四分位数的增加而逐渐升高，但幅度较小。值得注意的是，行动受限的女性和男性的NTx水平分别比无行动受限者高4.7%和2.6%。相比之下，无论行动受限状况如何，老年人的BAP水平均无显著差异。结论 社区居住的步行速度较慢且行动受限的老年人始终有骨吸收增加的证据。因此，本研究结果表明，行动受限的老年人应被视为骨质疏松症的高危人群。
