Geriatric Assessment Center, Health Department, Iberoamerican University, Mexico City, Mexico.
National Institute of Public Health, Morelos, Mexico.
J Nutr Health Aging. 2024 Nov;28(11):100368. doi: 10.1016/j.jnha.2024.100368. Epub 2024 Sep 21.
Aging involves significant changes in body composition, marked by declines in muscle mass and bone mineral density alongside an increase in fat mass. Sarcopenia is characterized by low strength and muscle mass, and osteosarcopenia is the coexistence of sarcopenia and osteopenia/osteoporosis. Physiologically, there is a crosstalk between muscle and bone tissues mediated by several pathways. Both, sarcopenia and osteosarcopenia, have been related with adverse outcomes such as functional disability. However, there is a lack of longitudinal studies. Therefore, this study aimed to assess whether sarcopenia and osteosarcopenia phenotypes increased the risk of functional disability in a longitudinal cohort of community-dwelling adults.
This study constitutes a secondary longitudinal analysis of data derived from the prospective cohort FraDySMex (Frailty, Dynapenia, and Sarcopenia in Mexican adults).
FraDySMex is conducted in community-dwelling adults aged 50 years or older living in Mexico City. Data from 2014 to 2015 was considered as baseline evaluation, and the 2019 wave was the follow-up evaluation. Individuals with complete baseline and follow-up evaluations were included in the analysis.
Sarcopenia diagnosis adhered to the FNIH criteria, while osteopenia/osteoporosis classification followed WHO guidelines. Osteosarcopenia was defined as the concurrent presence of sarcopenia and osteopenia/osteoporosis. Functional disability was identified by the Lawton Instrumental Activities of Daily Living (IADL) Scale. Adjusted mixed-effects logistic regression models were estimated to evaluate the effect of body composition phenotype on the risk of functional disability.
The final sample included 320 adults with complete longitudinal data. The majority of were women (83.4%) and had 7-12 years of education (48.4%). At the baseline evaluation, 50.9% aged 50-70. The osteosarcopenia phenotype was associated with a higher risk of functional disability (OR: 2.17, p = 0.042) compared with the no osteopenia/sarcopenia group. Conversely, sarcopenia (OR: 1.50, p = 0.448) and osteopenia/osteoporosis (OR: 1.50, p = 0.185) phenotypes were not associated with functional disability.
Our study underscores that osteosarcopenia significantly increased the risk of functional disability, particularly in terms of Instrumental Activities of Daily Living (IADL). These results emphasize the importance of screening for sarcopenia, osteopenia/osteoporosis, and osteosarcopenia across various clinical settings. Early detection and intervention hold promise for averting functional disability and mitigating associated adverse outcomes in adults.
衰老涉及身体成分的显著变化，表现为肌肉质量和骨矿物质密度下降，同时脂肪质量增加。肌少症的特征是力量和肌肉质量低，而骨质肌少症是肌少症和骨量减少/骨质疏松症的并存。从生理上讲，肌肉组织和骨骼组织之间存在由几种途径介导的串扰。肌少症和骨质肌少症都与功能障碍等不良后果有关。然而，缺乏纵向研究。因此，本研究旨在评估在一个社区居住的成年人的纵向队列中，肌少症和骨质肌少症表型是否会增加功能障碍的风险。
这是一项来自前瞻性队列 FraDySMex（墨西哥成年人的脆弱性、动力不足和肌少症）的二次纵向分析研究。
FraDySMex 在墨西哥城居住的 50 岁或以上的社区居住成年人中进行。考虑到 2014 年至 2015 年的数据作为基线评估，2019 年的波次为随访评估。纳入了具有完整基线和随访评估的个体进行分析。
肌少症诊断遵循 FNIH 标准，而骨质疏松/骨质疏松症分类遵循世卫组织指南。骨质肌少症定义为肌少症和骨质疏松/骨质疏松症并存。功能障碍通过 Lawton 工具性日常生活活动（IADL）量表来确定。采用调整后的混合效应逻辑回归模型评估身体成分表型对功能障碍风险的影响。
最终样本包括 320 名具有完整纵向数据的成年人。大多数是女性（83.4%），受教育程度为 7-12 年（48.4%）。在基线评估时，50.9%的年龄在 50-70 岁之间。骨质肌少症表型与功能障碍的风险增加相关（OR：2.17，p=0.042），与无骨质疏松/肌少症组相比。相反，肌少症（OR：1.50，p=0.448）和骨质疏松/骨质疏松症（OR：1.50，p=0.185）表型与功能障碍无关。
我们的研究强调，骨质肌少症显著增加了功能障碍的风险，特别是在工具性日常生活活动（IADL）方面。这些结果强调了在各种临床环境中筛查肌少症、骨质疏松/骨质疏松症和骨质肌少症的重要性。早期发现和干预有可能避免成年人的功能障碍和减轻相关的不良后果。
