Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea.
Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.
Sci Rep. 2022 Apr 4;12(1):2231. doi: 10.1038/s41598-021-02640-1.
Osteoporosis and sarcopenia are substantially interrelated with shared cardiovascular risk factors. However, the relationship between osteosarcopenia and coronary artery disease is largely unexplored. We aimed to investigate the association between osteosarcopenia and coronary artery calcification (CAC) scores in asymptomatic adults. A total of 5969 asymptomatic adults without cardiovascular disease who underwent a health examination including estimation of CAC scores by cardiac tomography were analyzed. Osteoporosis was defined as low bone mineral density T-score ≤ - 2.5 standard deviation, and sarcopenia as appendicular skeletal muscle mass < 5.7 kg/m for women and < 7.0 kg/m for men, and osteosarcopenia as the copresence of both osteoporosis and sarcopenia. Participants were divided into four groups according to the presence of osteoporosis and/or sarcopenia as control, sarcopenia alone, osteoporosis alone, and osteosarcopenia. Prevalence of CAC was 22.0% in control, 23.6% in sarcopenia alone, 38.5% in osteoporosis alone, and 48.3% in osteosarcopenia group, with the osteosarcopenia group showing the highest (p < 0.0001). After adjustments for possible confounders, mean of log (CAC score + 1) in osteosarcopenia group was higher than other three groups (Bonferroni p < 0.0001). Using multivariate-adjusted analysis, subjects with osteosarcopenia had the highest risk for having CAC > 0 (odds ratio [OR] 2.868; 95% confidence interval [CI] 1.717-4.790). Furthermore, subjects with osteosarcopenia had a significant risk of moderate-to-extensive CAC (CAC score ≥ 100) (OR 2.709; 95% CI 1.128-6.505). We demonstrated that osteosarcopenia was independently associated with a higher prevalence of subclinical coronary atherosclerosis. Our results suggest osteosarcopenia as a predisposing factor for coronary heart disease.
骨质疏松症和肌肉减少症与心血管危险因素有密切关系。然而，关于骨质疏松症与肌肉减少症和冠状动脉疾病之间的关系，目前还知之甚少。我们旨在研究无症状成年人中骨质疏松症与冠状动脉钙化（CAC）评分之间的关系。
共分析了 5969 名无症状成年人，他们接受了健康检查，包括通过心脏 CT 估计 CAC 评分。骨质疏松症定义为骨矿物质密度 T 评分≤-2.5 个标准差，女性四肢骨骼肌质量<5.7kg/m，男性<7.0kg/m，骨质疏松症与肌肉减少症并存。
根据是否存在骨质疏松症和/或肌肉减少症将参与者分为四组：对照组、单独肌肉减少症组、单独骨质疏松症组和骨质疏松症与肌肉减少症并存组。对照组 CAC 患病率为 22.0%，单独肌肉减少症组为 23.6%，单独骨质疏松症组为 38.5%，骨质疏松症与肌肉减少症并存组为 48.3%，后者患病率最高（p<0.0001）。
在调整了可能的混杂因素后，骨质疏松症与肌肉减少症并存组的 log（CAC 评分+1）平均值高于其他三组（Bonferroni p<0.0001）。
使用多变量调整分析，骨质疏松症与肌肉减少症并存的患者 CAC>0 的风险最高（比值比[OR]2.868；95%置信区间[CI]1.717-4.790）。此外，骨质疏松症与肌肉减少症并存的患者有发生中重度 CAC（CAC 评分≥100）的显著风险（OR 2.709；95%CI 1.128-6.505）。
我们的研究结果表明，骨质疏松症与肌肉减少症并存与亚临床冠状动脉粥样硬化的患病率增加独立相关。我们的结果提示骨质疏松症与肌肉减少症并存可能是冠心病的一个易患因素。
