Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania, USA.
Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, USA.
J Gerontol A Biol Sci Med Sci. 2022 Dec 29;77(12):2445-2452. doi: 10.1093/gerona/glac112.
Computed tomography (CT)-scan measures of muscle composition may be associated with recovery post hip fracture.
In an ancillary study to Baltimore Hip Studies Seventh cohort, older adults were evaluated at 2 and 6 months post hip fracture. CT-scan measures of muscle were acquired at 2 months. Short Physical Performance Battery (SPPB) was measured at 2 and 6 months. Generalized estimating equations were used to model the association of muscle measures and physical function, adjusting for age, sex, body mass index, and time postfracture.
Seventy-one older adults (52% males, age 79.6 ± 7.3 years) were included. At 2-months, males had greater thigh cross-sectional area (CSA, p < .0001) and less low-density muscle (p = .047), and intermuscular adipose tissue (p = .007) than females on the side of the fracture, while females performed better on the SPPB (p = .05). Muscle measures on the fractured side were associated with function at 2 months in both sexes. Participants with the lowest tertile of muscle CSA difference at 2-months, indicating greater symmetry in CSA between limbs, performed better than the other 2 tertiles at 6-months. Males performed worse in functional measures at baseline and did not recover as well as females (p = .02).
CT-scan measures of muscle CSA and fatty infiltration were associated with function at 2-months post hip fracture and with improvement in function by 6 months. Observed sex differences in these associations suggest that rehabilitation strategies may need to be adapted by sex after hip fracture.
计算机断层扫描（CT）-扫描测量的肌肉成分可能与髋部骨折后的恢复有关。
在巴尔的摩髋部研究第七队列的辅助研究中，对髋部骨折后 2 个月和 6 个月的老年人进行了评估。在 2 个月时获取 CT 扫描肌肉测量值。在 2 个月和 6 个月时测量短体物理性能电池（SPPB）。使用广义估计方程来模拟肌肉测量值与身体功能之间的关联，调整年龄、性别、体重指数和骨折后时间。
共纳入 71 名老年人（52%为男性，年龄 79.6±7.3 岁）。在 2 个月时，男性骨折侧的大腿横截面积（CSA，p<0.0001）更大，低密度肌肉（p=0.047）和肌肉间脂肪组织（p=0.007）更少，而女性的 SPPB 得分更高（p=0.05）。在两性中，骨折侧的肌肉测量值与 2 个月时的功能相关。在 2 个月时，CSA 差异最低的 tertile 参与者（表明四肢 CSA 之间的对称性更高），在 6 个月时的功能表现优于其他 2 tertile。男性在基线时的功能测量值较差，且恢复不如女性（p=0.02）。
CT 扫描肌肉 CSA 和脂肪浸润的测量值与髋部骨折后 2 个月的功能相关，并与 6 个月时的功能改善相关。这些关联中观察到的性别差异表明，髋部骨折后，可能需要根据性别调整康复策略。
