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老年人的骨脆弱、肌肉减少症和心脏钙化:一项初步研究。

Bone fragility, sarcopenia and cardiac calcifications in an elderly population: a preliminary study.

机构信息

Department of Medicine, Surgery and Neuroscience, University of Siena, Policlinico Le Scotte, Viale Bracci 2, 53100, Siena, Italy.

Internal Medicine, San Giovanni di Dio Hospital, Florence, Italy.

出版信息

Aging Clin Exp Res. 2023 May;35(5):1097-1105. doi: 10.1007/s40520-023-02393-z. Epub 2023 Mar 29.

Abstract

BACKGROUND

Cardiovascular disease, osteoporosis and sarcopenia are very common age-related conditions. This study aimed at investigating the relationships of cardiac calcifications, as assessed by using GCCS with BMD, fragility fractures and sarcopenia in elderly subjects.

METHODS

In a cohort of 106 subjects (age 70.4 ± 5.8 yrs) we measured lumbar (BMD-LS), femoral BMD (femoral neck: BMD-FN, total femur: BMD-TH) and body composition (BMD-WB) with Dual-energy X-ray Absorptiometry (DXA) method. We also evaluated the presence of sarcopenia on the basis of the EWGSOP Consensus. All subjects, simultaneously, underwent to a transthoracic color doppler echocardiography exam to assess the presence of cardiac calcifications. The degree of non coronaric cardiac calcifications was evaluated using the Global Cardiac Calcium Score (GCCS).

RESULTS

The degree of cardiac calcification assessed by GCCS was significantly higher in osteoporotic patients (p < 0.001). Furthermore, an inverse correlation emerged between BMD and GCCS, statistical significance was found at lumbar spine and femoral sub-regions in female population (p < 0.01). Moreover by dividing population according to the presence of fragility fractures, we observed that GCCS values were significantly higher in subjects with fractures in respect of non-fractured ones (p < 0.05). Multiple regression models showed that BMD-LS and BMD-FT were independently associated with cardiac calcification. GCCS values were significantly associated with BMI and ASMM in women (p < 0.01 and p < 0.05, respectively) and with handgrip strength in men (p < 0.05).

CONCLUSIONS

Our data confirm the presence of a relationship between cardiac calcifications and decreased BMD values. It's also the first study that relates sarcopenia and valvular calcifications.

摘要

背景

心血管疾病、骨质疏松症和肌肉减少症是与年龄相关的常见病症。本研究旨在探讨使用 GCCS 评估的心脏钙化与老年人的骨密度、脆性骨折和肌肉减少症之间的关系。

方法

在 106 名受试者(年龄 70.4±5.8 岁)的队列中,我们使用双能 X 射线吸收法测量了腰椎(骨密度-LS)、股骨骨密度(股骨颈:BMD-FN,总股骨:BMD-TH)和身体成分(骨密度-WB)。我们还根据 EWGSOP 共识评估了肌肉减少症的存在。所有受试者同时接受经胸彩色多普勒超声心动图检查,以评估心脏钙化的存在。使用全球心脏钙评分(GCCS)评估非冠状心脏钙化的程度。

结果

使用 GCCS 评估的心脏钙化程度在骨质疏松症患者中明显更高(p<0.001)。此外,BMD 与 GCCS 之间呈负相关,在女性人群中腰椎和股骨亚区均有统计学意义(p<0.01)。此外,根据脆性骨折的存在将人群进行分组后,我们发现骨折组的 GCCS 值明显高于非骨折组(p<0.05)。多元回归模型显示,BMD-LS 和 BMD-FT 与心脏钙化独立相关。GCCS 值与女性的 BMI 和 ASMM 显著相关(p<0.01 和 p<0.05),与男性的握力显著相关(p<0.05)。

结论

我们的数据证实了心脏钙化与骨密度值降低之间存在关系。这也是首次将肌肉减少症与瓣膜钙化相关联的研究。

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