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伊朗老年人骨健康生物标志物与肌骨减少症的相关性:布什尔老年人健康(BEH)计划。

Association between biomarkers of bone health and osteosarcopenia among Iranian older people: The Bushehr Elderly Health (BEH) program.

机构信息

Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Department of Internal Medicine, Faculty of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

BMC Geriatr. 2021 Nov 19;21(1):654. doi: 10.1186/s12877-021-02608-w.

Abstract

BACKGROUND

Osteosarcopenia is referred to as co-incidence of osteoporosis/osteopenia and sarcopenia which is defined as a geriatric syndrome with a significant prevalence that increases morbidity and mortality. There are some relevant factors that can show an increased risk of incidence of osteosarcopenia.

AIM

We aimed to consider the association of bone turnover markers such as Osteocalcin (OC), C-terminal cross-linked telopeptide (CTX), Tartrate Resistant acid Phosphatase (TRAP), Bone Alkaline Phosphatase (BALP) and also other factors like vitamin D, calcium, phosphorous, and ALP with osteosarcopenia in elderly.

METHODS

We carried out a cross-sectional study on a random sample including 400 elder participants of Bushehr Elderly Health (BEH) study, in Iran. Osteopenia/ osteoporosis was defined as a T-score ≤ -1.0 standard deviation below the mean values of a young healthy adult. We defined sarcopenia as low muscle strength (handgrip strength<26 kg for men and <18 kg for women) with reduced skeletal muscle mass [Skeletal muscle index (SMI) < 7.0 kg/m for male and <5.4 kg/m for female]. Osteosarcopenia was considered as the presence of both osteopenia/osteoporosis and sarcopenia. We estimated the age-standardized prevalence of osteosarcopenia for men and women, separately. We used multivariable logistic regression to address the factors associated with osteosarcopenia.

RESULTS

The results showed that there was a statistically significant difference in OC), CTX, TRAP were between the osteosarcopenia (-) and osteosarcopenia (+) groups. No statistically significant difference was observed in BALP, vitamin D, calcium, phosphorous, and ALP between the compared groups. In the multivariable logistic regression model, OC and CTX were associated with increased likelihood of osteosarcopenia [adjusted OR= 1.023(1.002-1.045 for OC, 4.363(1.389-15.474 for CTX)]. Furthermore, TRAP increases the odds of osteosarcopenia in crude model [OR= 1.333 (1.070- 1.660)].

CONCLUSIONS

We observed the association between bone turnover markers particularly OC, CTX and osteosarcopenia. Given the rapid growth of the aging population, we should focus on geriatric diseases such as musculoskeletal disorders. Bone turnover markers maybe improve the early diagnosis, screening and assess the response to therapies in people with osteosarcopenia.

摘要

背景

骨质疏松-肌少症是骨质疏松症/骨量减少和肌少症同时存在的一种情况,它被定义为一种具有较高发病率的老年综合征,会增加发病率和死亡率。有一些相关因素可以显示出发生骨质疏松-肌少症的风险增加。

目的

我们旨在考虑骨转换标志物(如骨钙素(OC)、C 端交联肽(CTX)、抗酒石酸酸性磷酸酶(TRAP)、骨碱性磷酸酶(BALP))以及其他因素(如维生素 D、钙、磷和 ALP)与老年人群中骨质疏松-肌少症的关系。

方法

我们对伊朗布什尔老年健康(BEH)研究的 400 名随机样本进行了横断面研究。骨量减少/骨质疏松症定义为 T 评分≤-1.0 个标准差低于年轻健康成年人的平均值。我们将肌少症定义为肌肉力量低(男性握力<26 公斤,女性<18 公斤)伴骨骼肌质量减少[男性骨骼肌指数(SMI)<7.0 公斤/平方米,女性<5.4 公斤/平方米]。骨质疏松-肌少症被认为是同时存在骨量减少/骨质疏松症和肌少症。我们分别估计了男性和女性骨质疏松-肌少症的年龄标准化患病率。我们使用多变量逻辑回归来确定与骨质疏松-肌少症相关的因素。

结果

结果表明,OC)、CTX、TRAP 在骨质疏松-肌少症(-)和骨质疏松-肌少症(+)组之间存在统计学显著差异。BALP、维生素 D、钙、磷和 ALP 在比较组之间无统计学显著差异。在多变量逻辑回归模型中,OC 和 CTX 与骨质疏松-肌少症的发生几率增加相关[调整后的 OR=1.023(1.002-1.045 对于 OC,4.363(1.389-15.474 对于 CTX)]。此外,TRAP 在粗模型中增加了骨质疏松-肌少症的几率[OR=1.333(1.070-1.660)]。

结论

我们观察到骨转换标志物特别是 OC、CTX 与骨质疏松-肌少症之间存在关联。鉴于人口老龄化的迅速增长,我们应该关注骨骼肌肉疾病等老年疾病。骨转换标志物可能有助于早期诊断、筛查和评估骨质疏松-肌少症患者的治疗反应。

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