Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK.
J Cachexia Sarcopenia Muscle. 2022 Feb;13(1):220-229. doi: 10.1002/jcsm.12870. Epub 2021 Dec 6.
Ageing is commonly associated with sarcopenia (SP) and osteoporosis (OP), both of which are associated with disability, impaired quality of life, and mortality. The aims of this study were to explore the relationships between SP, OP, frailty, and multimorbidity in community-dwelling older adults participating in the Hertfordshire Cohort Study (HCS) and to determine whether coexistence of OP and SP was associated with a significantly heavier health burden.
At baseline, 405 participants self-reported their comorbidities. Cut-offs for low grip strength and appendicular lean mass index were used according to the EWSGOP2 criteria to define SP. OP was diagnosed when T-scores of < -2.5 were present at the femoral neck or the participant reported use of the anti-OP medications including hormone replacement therapy (HRT), raloxifene, or bisphosphonates. Frailty was defined using the standard Fried definition.
One hundred ninety-nine men and 206 women were included in the study. Baseline median (interquartile range) age of participants was 75.5 (73.4-77.9) years. Twenty-six (8%) and 66 (21.4%) of the participants had SP and OP, respectively. Eighty-three (20.5%) reported three or more comorbidities. The prevalence of pre-frailty and frailty in the study sample was 57.5% and 8.1%, respectively. Having SP only was strongly associated with frailty [odds ratio (OR) 8.28, 95% confidence interval (CI) 1.27, 54.03; P = 0.027] while the association between having OP alone and frailty was weaker (OR 2.57, 95% CI 0.61, 10.78; P = 0.196). The likelihood of being frail was substantially higher in the presence of coexisting SP and OP (OR 26.15, 95% CI 3.13, 218.76; P = 0.003). SP alone and OP alone were both associated with having three or more comorbidities (OR 4.71, 95% CI 1.50, 14.76; P = 0.008 and OR 2.86, 95% CI 1.32, 6.22; P = 0.008, respectively) although the coexistence of SP and OP was not significantly associated with multimorbidity (OR 3.45, 95% CI 0.59, 20.26; P = 0.171).
Individuals living with frailty were often osteosarcopenic. Multimorbidity was common in individuals with either SP or OP. Early identification of SP and OP not only allows implementation of treatment strategies but also presents an opportunity to mitigate frailty risk.
衰老通常与肌肉减少症（SP）和骨质疏松症（OP）相关，两者都与残疾、生活质量下降和死亡率有关。本研究的目的是探讨参与赫特福德郡队列研究（HCS）的社区居住老年人中 SP、OP、衰弱和多种合并症之间的关系，并确定 OP 和 SP 同时存在是否与更严重的健康负担有关。
在基线时，405 名参与者自我报告了他们的合并症。根据 EWSGOP2 标准，使用低握力和四肢瘦体重指数的截断值来定义 SP。当股骨颈 T 评分< -2.5 或参与者报告使用包括激素替代疗法（HRT）、雷洛昔芬或双膦酸盐在内的抗 OP 药物时，诊断为 OP。使用标准的 Fried 定义来定义衰弱。
本研究纳入了 199 名男性和 206 名女性。参与者的基线中位（四分位间距）年龄为 75.5（73.4-77.9）岁。26（8%）和 66（21.4%）名参与者分别患有 SP 和 OP。83（20.5%）名参与者报告了三种或更多种合并症。研究样本中预衰弱和衰弱的患病率分别为 57.5%和 8.1%。仅有 SP 与衰弱密切相关[优势比（OR）8.28，95%置信区间（CI）1.27，54.03；P = 0.027]，而单独存在 OP 与衰弱的相关性较弱（OR 2.57，95%CI 0.61，10.78；P = 0.196）。同时存在 SP 和 OP 时，衰弱的可能性显著增加（OR 26.15，95%CI 3.13，218.76；P = 0.003）。单独的 SP 和 OP 均与三种或更多种合并症相关（OR 4.71，95%CI 1.50，14.76；P = 0.008 和 OR 2.86，95%CI 1.32，6.22；P = 0.008，分别），尽管 SP 和 OP 同时存在与多种合并症无显著相关性（OR 3.45，95%CI 0.59，20.26；P = 0.171）。
患有衰弱症的个体通常患有肌肉减少症-骨质疏松症。无论 SP 或 OP 存在与否，多种合并症都很常见。早期识别 SP 和 OP 不仅可以实施治疗策略，还有机会降低衰弱风险。
