Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150# Jimo RD, Pudong New Area, Shanghai, 200120, China.
Department of orthopedic, East Hospital, Ji'an Hospital, Jinggangshan University, Jiangxi, China.
Arch Osteoporos. 2022 Mar 6;17(1):41. doi: 10.1007/s11657-022-01087-9.
Previous studies have reported that the fracture risk related to sarcopenic obesity (SO) may be influenced by the distribution of fat mass. Therefore, it is useful to explore a body component suitable for defining obesity when predicting fracture risk. This study was an attempt to explore the contribution of SO defined by visceral adiposity on the incidence of osteoporotic fracture.
We enrolled 736 Chinese patients aged > 60 years in this prospective study. Sarcopenia was defined as low skeletal muscle index (SMI) with muscle strength or low SMI with low physical performance. Obesity was categorized as follows: (1) android to gynoid ratio (A/G ratio, men > 0.82, women > 0.65) as an indicator of visceral adiposity; (2) body fat percentage (men > 27.8%; women > 34.5%); and (3) body mass index (≥ 25 kg/m). A Cox proportional hazard model was used to determine the association between SO and the risk of osteoporotic fracture.
The incidence of SO was 8.7%; 9.0% in females and 8.1% in males. Of 223 (30.2%) patients with self-reported fractures. SO classified by A/G was associated with an increased risk of osteoporotic vertebral fracture (HR: 1.71, 95% CI: 1.07-2.72). High SMI was associated with a reduced risk of osteoporotic vertebral fracture (HR: 0.82, 95% CI: 0.72-0.93), higher BMI was associated with a higher risk vertebral fracture (HR: 1.12, 95% CI: 0.94-1.63), and higher A/G ratio was associated with a higher risk of any fracture (HR: 1.28, 95% CI: 1.14-1.43) and osteoporotic vertebral fracture (HR: 1.19, 95% CI: 1.05-1.36).
Our findings suggest that SO, defined by visceral adiposity, was associated with the risk of osteoporotic vertebral fracture. Moreover, low SMI, low muscle strength and visceral adiposity were independently associated with osteoporotic fracture.
先前的研究报告表明，与肌肉减少性肥胖（SO）相关的骨折风险可能受到脂肪量分布的影响。因此，当预测骨折风险时，探索一种适合定义肥胖的身体成分是有用的。本研究试图探讨内脏脂肪堆积所定义的 SO 对骨质疏松性骨折发生率的影响。
我们在这项前瞻性研究中纳入了 736 名年龄>60 岁的中国患者。肌少症定义为低骨骼肌指数（SMI）伴肌肉力量或低 SMI 伴低身体机能。肥胖分为以下几类：（1）男性的腰臀比（A/G 比，>0.82）和女性的 A/G 比（>0.65），作为内脏脂肪的指标；（2）体脂百分比（男性>27.8%；女性>34.5%）；（3）身体质量指数（BMI）（≥25 kg/m²）。使用 Cox 比例风险模型确定 SO 与骨质疏松性骨折风险之间的关系。
SO 的发生率为 8.7%；女性为 9.0%，男性为 8.1%。在 223 名（30.2%）自述骨折的患者中，SO 按 A/G 分类与骨质疏松性椎体骨折风险增加相关（HR：1.71，95%CI：1.07-2.72）。高 SMI 与骨质疏松性椎体骨折风险降低相关（HR：0.82，95%CI：0.72-0.93），高 BMI 与椎体骨折风险增加相关（HR：1.12，95%CI：0.94-1.63），高 A/G 比与任何骨折（HR：1.28，95%CI：1.14-1.43）和骨质疏松性椎体骨折（HR：1.19，95%CI：1.05-1.36）风险增加相关。
我们的研究结果表明，内脏脂肪堆积所定义的 SO 与骨质疏松性椎体骨折风险相关。此外，低 SMI、低肌肉力量和内脏脂肪堆积与骨质疏松性骨折独立相关。
