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老年人群中心血管疾病风险评分与骨质疏松性肌少症的关联:布什尔老年人健康(BEH)项目的结果

The Association of Cardiovascular Diseases Risk Scores and Osteosarcopenia Among Older Adult Populations: The Results of Bushehr Elderly Health (BEH) Program.

作者信息

Fahimfar Noushin, Parsaiyan Hanieh, Khalagi Kazem, Shafiee Gita, Sanjari Mahnaz, Mansourzadeh Mohammad Javad, Nabipour Iraj, Larijani Bagher, Khalili Davood, Ostovar Afshin

机构信息

Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Calcif Tissue Int. 2023 Apr;112(4):422-429. doi: 10.1007/s00223-022-01059-8. Epub 2023 Jan 4.

Abstract

Considering the association of cardiovascular disease (CVD) with both osteoporosis and sarcopenia, this study aimed to explore the association between a newly developed CVD risk score and osteosarcopenia in the elderly population. Participants in the second phase of the Bushehr Elderly Health (BEH) program were included. Osteosarcopenia was defined as having both osteopenia/osteoporosis and sarcopenia. The 10-year CVD risk score was estimated using the WHO lab-based model. The participants were considered as high-risk if the CVD risk was ≥ 20%. The estimated risks were compared in individuals with and without osteosarcopenia. The association of CVD risk and osteosarcopenia was investigated using a logistic regression model, adjusted by potential confounders. In all, 2392 participants (1161 men) with a mean age of 69.3 (± 6.3) years were studied and 532 [242 (45.5%) men] individuals were diagnosed with osteosarcopenia. The median (IQR) CVD risks were 0.340 (0.214) and 0.229 (0.128) in men with and without osteosarcopenia, respectively (P < 0.001); In women, the corresponding values were 0.260 (0.147) and 0.207 (0.128), respectively (P < 0.001). Adjusted by confounders, CVD risk ≥ 20% in women, increased the odds of osteosarcopenia by 72%. Body mass index showed an inverse association with osteosarcopenia in both men (0.81, 95%CI: 0.78-0.85) and women (0.66, 95%CI: 0.62-0.70). Considering the area under the ROC curve, the models showed a discriminative ability of 82% in men and 89% in women. This study displayed a significant association between WHO CVD risk score and osteosarcopenia. Due to the difficult diagnosis of osteosarcopenia, the high association of cardiovascular risk score with this disease can help identify high-risk individuals and refer them for further diagnostic procedures. Considering the high prevalence of osteosarcopenia and its complications in the older population, comprehensive strategies are needed to find high-risk populations.

摘要

鉴于心血管疾病(CVD)与骨质疏松症和肌肉减少症均有关联,本研究旨在探讨一种新开发的CVD风险评分与老年人群中骨质疏松性肌肉减少症之间的关联。研究纳入了布什尔老年健康(BEH)项目第二阶段的参与者。骨质疏松性肌肉减少症定义为同时患有骨质减少/骨质疏松症和肌肉减少症。使用世界卫生组织基于实验室的模型估算10年CVD风险评分。如果CVD风险≥20%,则参与者被视为高危人群。比较了患有和未患有骨质疏松性肌肉减少症的个体的估算风险。使用逻辑回归模型研究CVD风险与骨质疏松性肌肉减少症的关联,并对潜在混杂因素进行了调整。总共对2392名参与者(1161名男性)进行了研究,他们的平均年龄为69.3(±6.3)岁,其中532名[242名(45.5%)男性]被诊断为骨质疏松性肌肉减少症。患有骨质疏松性肌肉减少症的男性和未患有该症的男性的CVD风险中位数(IQR)分别为0.340(0.214)和0.229(0.128)(P<0.001);在女性中,相应的值分别为0.260(0.147)和0.207(0.128)(P<0.001)。在对混杂因素进行调整后,女性中CVD风险≥20%会使骨质疏松性肌肉减少症的患病几率增加72%。体重指数在男性(0.81,95%CI:0.78 - 0.85)和女性(0.66,95%CI:0.62 - 0.70)中均与骨质疏松性肌肉减少症呈负相关。考虑到ROC曲线下面积,模型在男性中的判别能力为82%,在女性中的判别能力为89%。本研究显示世界卫生组织CVD风险评分与骨质疏松性肌肉减少症之间存在显著关联。由于骨质疏松性肌肉减少症诊断困难,心血管风险评分与该疾病的高度关联有助于识别高危个体并将他们转诊进行进一步的诊断程序。鉴于老年人群中骨质疏松性肌肉减少症及其并发症的高患病率,需要综合策略来寻找高危人群。

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