Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
Institute of Spinal Diseases, Jinggangshan University, Jiangxi, China.
J Bone Miner Metab. 2024 May;42(3):372-381. doi: 10.1007/s00774-024-01514-6. Epub 2024 May 25.
The effect of nutritional status on osteosarcopenia (OS) and major osteoporotic fracture (MOF) among the elderly is still unclear. So we aimed to compare the efficacy of the Mini-Nutrition Assessment-Short Form (MNA-sf), the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status (CONUT) for predicting OS and MOF among the elderly.
A total of 409 participants were enrolled in this prospective study. Blood biochemical indexes, nutritional status, and bone- and muscle-related examinations were assessed at initial visit to the outpatient. Participants were divided into 4 groups: (1) control; (2) osteopenia/osteoporosis; (3) sarcopenia; (4) osteosarcopenia, and then followed for 5 years, recording the occurrence time of MOF.
The frequency values of osteopenia/osteoporosis, sarcopenia, and OS, at baseline, were respectively 13.4, 16.1, and 12% among the study samples. Correlation analysis showed that nutritional status scores were associated with body mass index, handgrip strength, albumin, bone mineral density, and physical functions. According to multivariate models, poor nutritional status was significantly associated with a higher risk of OS and MOF (P < 0.05). Survival analysis showed that the MOF rate in malnutrition group was significantly higher than normal nutrition group (P < 0.05). The receiver operator characteristic curve shows that the value of MNA-sf to diagnose OS and MOF is greater (P < 0.05).
The poor nutritional status was associated with a higher risk of both OS and MOF. MNA-sf showed a superior diagnostic power for OS and MOF among the elderly. Early nutrition assessments and interventions may be key strategies to prevent OS and fractures.
营养状况对老年人骨肌减少症（OS）和主要骨质疏松性骨折（MOF）的影响仍不清楚。因此，我们旨在比较迷你营养评估-短表（MNA-sf）、老年营养风险指数（GNRI）和控制营养状况（CONUT）预测老年人 OS 和 MOF 的疗效。
本前瞻性研究共纳入 409 名参与者。在门诊初诊时评估血液生化指标、营养状况和骨肌相关检查。将参与者分为 4 组：（1）对照组；（2）骨质疏松/骨量减少；（3）肌少症；（4）骨肌减少症，然后随访 5 年，记录 MOF 的发生时间。
研究样本在基线时骨质疏松/骨量减少、肌少症和 OS 的频率值分别为 13.4%、16.1%和 12%。相关性分析表明，营养状况评分与体重指数、握力、白蛋白、骨密度和身体功能有关。根据多变量模型，营养不良与 OS 和 MOF 的风险增加显著相关（P<0.05）。生存分析显示，营养不良组的 MOF 发生率明显高于营养正常组（P<0.05）。受试者工作特征曲线显示，MNA-sf 对诊断 OS 和 MOF 的价值更大（P<0.05）。
营养不良与 OS 和 MOF 的风险增加相关。MNA-sf 对老年人 OS 和 MOF 的诊断能力更强。早期营养评估和干预可能是预防 OS 和骨折的关键策略。
