Department of Physical Medicine and Rehabilitation, University of Health Sciences, Etlik City Hospital, Ankara, Turkiye.
Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gaziler Training and Research Hospital, Ankara, Turkiye.
Turk J Med Sci. 2023 Nov 11;54(1):324-329. doi: 10.55730/1300-0144.5794. eCollection 2024.
BACKGROUND/AIM: There are no current guidelines to help clinicians decide whether patients with adult neuromuscular disease (NMD) should be screened or treated for osteoporosis (OP). This study was undertaken to investigate the presence of OP in patients with various types of NMD and to examine the relationship between OP evaluation parameters and functional status, daily living activities, balance, and ambulation levels.
This cross-sectional study included 45 patients with NMDs. The patients were divided into 3 groups, depending on the affected component of the motor unit (neuronopathy group, neuropathy group, and myopathy group). The laboratory and demographic data were recorded from patient files. Functional level, pain, muscular strength, balance, and daily living activity scores were evaluated. The presence of OP was quantified using bone densitometry, fracture history, and biochemical parameters. Clinical findings were correlated with laboratory and dual-energy X-ray absorptiometry (DEXA) findings.
The mean hip T-score was -1.20, and the mean lumbar spine (L1-L4) T-score was -0.95 in all groups. Six patients with T-score values of -2.5 or below were detected. Vitamin D level was found to be low in all patient groups, especially in the myopathy group, but there was no significant difference (p > 0.05). There was a negative correlation between hip T-score and the frequency of falling (r = -0.604, p = 0.022), while a positive correlation was found between hip T-score and the age at which independent walking was no longer possible (r = 0.900, p = 0.037).
OP is often overlooked in NMD patients with neurological problems and a high risk of falling. These patients should be screened for bone health and fragility.
背景/目的：目前尚无指南帮助临床医生决定是否对患有成人神经肌肉疾病（NMD）的患者进行骨质疏松症（OP）筛查或治疗。本研究旨在调查各种类型的 NMD 患者中 OP 的存在情况，并检查 OP 评估参数与功能状态、日常生活活动、平衡和步行水平之间的关系。
这是一项横断面研究，纳入了 45 例 NMD 患者。根据运动单位受累成分（神经元病组、神经病组和肌病组）将患者分为 3 组。从患者档案中记录实验室和人口统计学数据。评估功能水平、疼痛、肌肉力量、平衡和日常生活活动评分。使用骨密度仪、骨折史和生化参数定量评估 OP 的存在。将临床发现与实验室和双能 X 线吸收法（DEXA）结果相关联。
所有组的平均髋部 T 评分均为-1.20，平均腰椎（L1-L4）T 评分均为-0.95。发现 6 例 T 评分值低于-2.5 的患者。所有患者组的维生素 D 水平均较低，尤其是肌病组，但差异无统计学意义（p>0.05）。髋部 T 评分与跌倒频率呈负相关（r=-0.604，p=0.022），而髋部 T 评分与无法独立行走的年龄呈正相关（r=0.900，p=0.037）。
患有神经问题和高跌倒风险的 NMD 患者常忽略 OP。这些患者应进行骨骼健康和脆性筛查。
