Vogrin Sara, Bani Hassan Ebrahim, Munandar Putra Fernan, Pasco Julie A, Kotowicz Mark A, Duque Gustavo
Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program The University of Melbourne and Western Health St. Albans Victoria Australia.
Department of Medicine-Western Health The University of Melbourne St. Albans Victoria Australia.
JBMR Plus. 2023 Feb 16;7(4):e10704. doi: 10.1002/jbm4.10704. eCollection 2023 Apr.
Sarcopenia and osteoporosis are highly prevalent syndromes in older people, characterized by loss of muscle and bone tissue, and related to adverse outcomes. Previous reports indicate mid-thigh dual-energy X-ray absorptiometry (DXA) is well suited for the simultaneous assessment of bone, muscle, and fat mass in a single scan. Using cross-sectional clinical data and whole-body DXA images of 1322 community-dwelling adults from the Geelong Osteoporosis Study (57% women, median age 59 years), bone and lean mass were quantified in three unconventional regions of interest (ROIs): (i) a 2.6-cm-thick slice of mid-thigh, (ii) a 13-cm-thick slice of mid-thigh, and (iii) the whole thigh. Conventional indices of tissue mass were also calculated (appendicular lean mass [ALM] and bone mineral density [BMD] of lumbar spine, hip, and femoral neck). The performance of thigh ROIs in identifying osteoporosis, osteopenia, low lean mass and strength, past falls, and fractures was evaluated. All thigh regions (especially whole thigh) performed well in identifying osteoporosis (area under the receiver-operating characteristic [ROC] curve [AUC] > 0.8) and low lean mass (AUC >0.95), but they performed worse in the diagnosis of osteopenia (AUC 0.7-0.8). All thigh regions were equivalent to ALM in discrimination of poor handgrip strength, gait speed, past falls, and fractures. BMD in conventional regions was more strongly associated with past fractures than thigh ROIs. In addition to being faster and easier to quantify, mid-thigh tissue masses can be used for identifying osteoporosis and low lean mass. They are also equivalent to conventional ROIs in their associations with muscle performance, past falls, and fractures; however, further validation is required for the prediction of fractures. © 2022 The Authors. published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
肌肉减少症和骨质疏松症在老年人中极为常见，其特征是肌肉和骨组织流失，并与不良后果相关。先前的报告表明，大腿中部双能X线吸收法（DXA）非常适合在单次扫描中同时评估骨骼、肌肉和脂肪量。利用来自吉朗骨质疏松症研究的1322名社区居住成年人的横断面临床数据和全身DXA图像（57%为女性，中位年龄59岁），在三个非常规感兴趣区域（ROI）中对骨骼和瘦体重进行了量化：（i）大腿中部2.6厘米厚的切片，（ii）大腿中部13厘米厚的切片，以及（iii）整个大腿。还计算了组织质量的常规指标（腰椎、髋部和股骨颈的附属瘦体重[ALM]和骨矿物质密度[BMD]）。评估了大腿ROI在识别骨质疏松症、骨质减少、低瘦体重和力量、既往跌倒和骨折方面的性能。所有大腿区域（尤其是整个大腿）在识别骨质疏松症（受试者操作特征[ROC]曲线下面积[AUC]>0.8）和低瘦体重（AUC>0.95）方面表现良好，但在骨质减少的诊断中表现较差（AUC 0.7 - 0.8）。在区分握力差、步态速度、既往跌倒和骨折方面，所有大腿区域与ALM相当。常规区域的BMD与既往骨折的相关性比大腿ROI更强。除了更快、更容易量化外，大腿中部组织质量可用于识别骨质疏松症和低瘦体重。它们在与肌肉性能、既往跌倒和骨折的关联方面也与常规ROI相当；然而，骨折预测需要进一步验证。© 2022作者。由Wiley Periodicals LLC代表美国骨与矿物质研究学会出版。
