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骨质疏松性肌少症会协同增加类风湿关节炎患者跌倒的风险。

Osteosarcopenia synergistically increases the risk of falls in patients with rheumatoid arthritis.

作者信息

Tada Masahiro, Yamada Yutaro, Mandai Koji, Matsumoto Yoshinari, Hidaka Noriaki

机构信息

Department of Orthopaedic Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Japan.

Department of Orthopaedic Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.

出版信息

Osteoporos Sarcopenia. 2021 Dec;7(4):140-145. doi: 10.1016/j.afos.2021.11.002. Epub 2021 Dec 4.

DOI:10.1016/j.afos.2021.11.002
PMID:35005250
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8714468/
Abstract

OBJECTIVES

Osteosarcopenia is defined as osteoporosis with sarcopenia. The impacts of osteosarcopenia on falls and fractures in rheumatoid arthritis (RA) patients were investigated using 4 years of data from a longitudinal study (CHIKARA study).

METHODS

The patients were divided into 4 groups by their baseline status: no sarcopenia and no osteoporosis (SP-OP-); only sarcopenia (SP + OP-); only osteoporosis (SP-OP+); and both sarcopenia and osteoporosis (SP + OP+). Survival rates and Cox hazard ratios were analyzed using falls and fractures as endpoints, adjusted by age, sex, and body mass index.

RESULTS

A total of 100 RA patients (SP-OP-: 44%, SP + OP-: 17%, SP-OP+: 28%, and SP + OP+: 11%) were enrolled; 37 patients had falls, and 19 patients had fractures. The fall-free and fracture-free survival rates were significantly lower in SP + OP+ (36.4%, 54.5%) than in SP-OP- (75.0%, 86.4%). The hazard ratio of falls was significantly increased in SP + OP+, by 3.32-fold (95%CI: 1.01-10.9), whereas in SP + OP- and SP-OP+, there were no differences compared to SP-OP-.

CONCLUSIONS

The survival rates with the endpoints of falls and fractures in RA patients with osteosarcopenia were lower during 4-year follow-up. The risk of falls increased with the synergistic effect of osteoporosis and sarcopenia.

摘要

目的

骨少肌症被定义为伴有肌少症的骨质疏松症。利用一项纵向研究（CHIKARA研究）的4年数据，调查了骨少肌症对类风湿关节炎（RA）患者跌倒和骨折的影响。

方法

根据患者的基线状态将其分为4组：无肌少症且无骨质疏松症（SP-OP-）；仅有肌少症（SP + OP-）；仅有骨质疏松症（SP-OP+）；以及既有肌少症又有骨质疏松症（SP + OP+）。以跌倒和骨折为终点，对年龄、性别和体重指数进行调整后，分析生存率和Cox风险比。

结果

共纳入100例RA患者（SP-OP-：44%，SP + OP-：17%，SP-OP+：28%，SP + OP+：11%）；37例患者发生跌倒，19例患者发生骨折。SP + OP+组的无跌倒生存率和无骨折生存率（36.4%，54.5%）显著低于SP-OP-组（75.0%，86.4%）。SP + OP+组跌倒的风险比显著增加，为3.32倍（95%CI：1.01-10.9），而SP + OP-组和SP-OP+组与SP-OP-组相比无差异。

结论

在4年随访期间，患有骨少肌症的RA患者以跌倒和骨折为终点的生存率较低。骨质疏松症和肌少症的协同作用增加了跌倒风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9294/8714468/e754419cbbf3/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9294/8714468/cc825f09a6dc/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9294/8714468/1b29c4c4d9ad/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9294/8714468/dc343c05c0dc/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9294/8714468/585ae2f2ca72/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9294/8714468/e754419cbbf3/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9294/8714468/cc825f09a6dc/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9294/8714468/1b29c4c4d9ad/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9294/8714468/dc343c05c0dc/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9294/8714468/585ae2f2ca72/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9294/8714468/e754419cbbf3/gr5.jpg

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