老年髋关节置换术患者的肌肉减少症及其与骨密度变化和功能结局的关联。
Sarcopenia and Its Association With Change of Bone Mineral Density and Functional Outcome in Old-Aged Hip Arthroplasty Patients.
作者信息
Kweon Suc-Hyun, Park Jin Sung, Park Byung Ha
机构信息
Department of Orthopedic Surgery, School of Medicine, WonkwangUniversityHospital, Iksan, Korea.
出版信息
Geriatr Orthop Surg Rehabil. 2022 May 16;13:21514593221092880. doi: 10.1177/21514593221092880. eCollection 2022.
This study aimed to investigate the relationship between sarcopenia and change in bone mineral density (BMD) and functional outcome in hip arthroplasty patients. Among the 221 patients who had undergone hip arthroplasty, 147 patients were enrolled. All patients were divided into 2 groups according to presence of sarcopenia. Bone mineral density (BMD) at hospitalization and 1-year after surgery and Barthel index was measured at the time of before injury, hospitalization, 3 months and 1-year after surgery. BMD at hospitalization showed .627 ± .082 (g/cm2) in Sarcopenia and .726 ± .059 (g/cm2) in Non-sarcopenia at femur (total) site ( < .001), .531 ± .085 (g/cm2) vs .629 ± .057 (g/cm2) at femur neck site (P=.002), .715 ± .084 (g/cm2) vs .807 ± .058 (g/cm2) at lumbar (L1-L4) site ( < .001). BMD at 1-year follow-up period, Sarcopenia showed .626 ± .082 (g/cm2) and Non-sarcopenia showed .725 ± .060 (g/cm2) at femur (total) site ( < .001), .530 ± .085 (g/cm2) vs .629 ± .058 (g/cm2) at femur neck site ( < .001), .715 ± .084 (g/cm2) vs .806 ± .058 (g/cm2) at lumbar (L1-L4) site ( < .001). Change of BMD showed -.01 ± .25% for Sarcopenia and -.15 ± .47% for Non-sarcopenia in femur (total) site (P=.089), -.08 ± .63% vs -.01 ± 1.01% in femur neck site ( = .058), .00 ± .09% vs -.12 ± .33% for each group in lumbar (L1-L4) site ( = .052). Barthel index score showed 79.94 ± 5.66 for Sarcopenia and 84.74 ± 5.36 for Non-sarcopenia at pre-injury status ( < .001), 33.89 ± 4.94 vs 33.87 ± 5.36 at the time of hospitalization ( = .977), 57.42 ± 7.19 vs 60.06 ± 5.39 at 3 months follow up ( = .015), 73.86 ± 5.94 vs 80.71 ± 4.81 for each group at 1-year follow up ( < .001). Our study found that the sarcopenia showed lower BMD than the non-sarcopenia, but there was no significant difference of BMD change in the follow-up period. In addition, the sarcopenia showed poor functional results at all points except at the time of hospitalization.
本研究旨在调查髋部置换术患者中肌肉减少症与骨密度（BMD）变化及功能结局之间的关系。在221例行髋部置换术的患者中，纳入了147例患者。所有患者根据是否存在肌肉减少症分为两组。测量患者受伤前、住院时、术后3个月和1年时的住院骨密度、术后1年骨密度以及Barthel指数。肌肉减少症组股骨（总体）部位住院时骨密度为0.627±0.082（g/cm²），非肌肉减少症组为0.726±0.059（g/cm²）（P<0.001）；股骨颈部位分别为0.531±0.085（g/cm²）和0.629±0.057（g/cm²）（P = 0.002）；腰椎（L1-L4）部位分别为0.715±0.084（g/cm²）和0.807±0.058（g/cm²）（P<0.001）。术后1年随访时，肌肉减少症组股骨（总体）部位骨密度为0.626±0.082（g/cm²），非肌肉减少症组为0.725±0.060（g/cm²）（P<0.001）；股骨颈部位分别为0.530±0.085（g/cm²）和0.629±0.058（g/cm²）（P<0.001）；腰椎（L1-L4）部位分别为0.715±0.084（g/cm²）和0.806±0.058（g/cm²）（P<0.001）。股骨（总体）部位骨密度变化，肌肉减少症组为-0.01±0.25%，非肌肉减少症组为-0.15±0.47%（P = 0.089）；股骨颈部位分别为-0.08±0.63%和-0.01±1.01%（P = 0.058）；腰椎（L1-L4）部位两组分别为0.00±0.09%和-0.12±0.33%（P = 0.052）。受伤前状态下，肌肉减少症组Barthel指数评分为79.94±5.66，非肌肉减少症组为84.74±5.36（P<0.001）；住院时分别为33.89±4.94和33.87±5.36（P = 0.977）；术后3个月随访时分别为57.42±7.19和60.06±5.39（P = 0.015）；术后1年随访时分别为73.86±5.94和80.71±4.81（P<0.001）。我们的研究发现，肌肉减少症患者的骨密度低于非肌肉减少症患者，但随访期间骨密度变化无显著差异。此外，除住院时外，肌肉减少症患者在所有时间点的功能结果均较差。
Zotero 插件