Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.
Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China.
Medicine (Baltimore). 2024 Jun 14;103(24):e38396. doi: 10.1097/MD.0000000000038396.
We aimed to investigate whether sarcopenia and its components are associated with osteoporosis in community-dwelling older Chinese adults with different obesity levels. This cross-sectional study included 1938 participants (42.1% male) with a mean age of 72.1 ± 5.9 years. The categorization of individuals into various weight categories was based on the Working Group on Obesity in China's criteria, utilizing the body mass index (BMI) as follows: underweight, BMI < 18.5 kg/m2; normal weight, 18.5 ≤ BMI < 24 kg/m2; overweight, 24 ≤ BMI < 28 kg/m2; and obesity, BMI ≥ 28 kg/m2. In this research, the osteoporosis definition put forth by the World Health Organization (bone mineral density T-score less than or equal to -2.5 as assessed by Dual-energy X-ray absorptiometry (DXA)). Sarcopenia was defined according to the diagnostic criteria of the Asian Working Group for Sarcopenia. The prevalence of osteoporosis was highest in the underweight group and gradually decreased with increasing BMI (Underweight: 55.81% vs Normal weight: 45.33% vs Overweight: 33.69% vs Obesity: 22.39). Sarcopenia was associated with elevated odds of osteoporosis in normal-weight subjects independent of potential covariates (OR = 1.70, 95% CI = 1.22-2.35, P = .002). In normal-weight participants, a higher appendicular skeletal muscle mass index (ASMI) was associated with a reduced risk of osteoporosis (OR = 0.56, 95% CI = 0.42-0.74, P < .001). In this study, we found that the prevalence of osteoporosis was highest in the underweight group and gradually decreased with increasing BMI. Sarcopenia, body fat percentage, and ASMI were associated with elevated odds of osteoporosis in normal-weight subjects independent of potential covariates, and higher percent body fat (PBF) was associated with an increased risk of osteoporosis in overweight people, and no such association was found in other weight groups. Different amounts of adipose tissue and muscle mass may alter bone biology. Further longitudinal follow-up studies are required to more accurately assess the risk of osteoporosis and sarcopenia in different weight populations. This cross-sectional study found that the prevalence of osteoporosis was highest in the underweight group and gradually decreased with increasing BMI. Sarcopenia was associated with elevated odds of osteoporosis in normal-weight subjects independent of potential covariates.
我们旨在研究不同肥胖水平的社区居住的老年中国成年人中，肌肉减少症及其成分是否与骨质疏松症相关。这项横断面研究纳入了 1938 名参与者（42.1%为男性），平均年龄为 72.1±5.9 岁。个体分类为不同体重类别是基于中国肥胖工作组的标准，使用体重指数（BMI）如下：体重不足，BMI<18.5kg/m2；正常体重，18.5≤BMI<24kg/m2；超重，24≤BMI<28kg/m2；肥胖，BMI≥28kg/m2。在这项研究中，骨质疏松症的定义是由世界卫生组织（通过双能 X 射线吸收法（DXA）评估的骨矿物质密度 T 评分≤-2.5）提出的。肌肉减少症根据亚洲肌肉减少症工作组的诊断标准定义。骨质疏松症的患病率在体重不足组最高，随着 BMI 的增加而逐渐降低（体重不足：55.81%比正常体重：45.33%比超重：33.69%比肥胖：22.39%）。肌肉减少症与正常体重受试者中骨质疏松症的发生风险增加独立相关，不受潜在混杂因素的影响（OR=1.70，95%CI=1.22-2.35，P=0.002）。在正常体重参与者中，较高的四肢骨骼肌质量指数（ASMI）与骨质疏松症风险降低相关（OR=0.56，95%CI=0.42-0.74，P<0.001）。在这项研究中，我们发现骨质疏松症的患病率在体重不足组最高，随着 BMI 的增加而逐渐降低。肌肉减少症、体脂肪百分比和 ASMI 与正常体重受试者中骨质疏松症的发生风险增加独立相关，而较高的体脂肪百分比（PBF）与超重人群中骨质疏松症的发生风险增加相关，而在其他体重组中则未发现这种相关性。不同量的脂肪组织和肌肉质量可能改变骨骼生物学。需要进一步的纵向随访研究来更准确地评估不同体重人群中骨质疏松症和肌肉减少症的风险。这项横断面研究发现，骨质疏松症的患病率在体重不足组最高，随着 BMI 的增加而逐渐降低。肌肉减少症与正常体重受试者中骨质疏松症的发生风险增加独立相关，不受潜在混杂因素的影响。
