Miyagi Midori, Sekiya Hideki, Ebihara Satoru
Department of Rehabilitation Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Oral Surgery, School of Medicine, Toho University, Tokyo, Japan.
PLoS One. 2024 Dec 19;19(12):e0315091. doi: 10.1371/journal.pone.0315091. eCollection 2024.
Osteosarcopenia is a combination of sarcopenia and osteoporosis that increases mortality rates among older people compared with either alone. This study aimed to identify the contribution of osteosarcopenia to the development and severity of dysphagia.
We retrospectively reviewed the medical charts of 211 patients aged ≥ 65 years who were referred to the dysphagia rehabilitation team. Based on Functional Oral Intake Scale (FOIS) scores, we classified the patients with (FOIS scores 1-5) and without (FOIS scores 6, 7) dysphagia as Type A and those with (FOIS scores 1, 2) and without (FOIS score 3-7) enteral feeding as Type B. Based on chest computed tomography (CT) findings we then defined patients with T4 (MI) and pectoralis (PMI) muscle indexes, L1 attenuation, and T4MI, PMI, and L1 attenuation below the cutoff values as having sarcopenia, osteoporosis, and osteosarcopenia, respectively.
The FOIS scores were significantly lower among patients with osteosarcopenia than among those without sarcopenia or osteoporosis. Moreover, PMI and FOIS scores significantly and positively correlated, and PMI was significantly lower in the group with, than without, enteral feeding. Osteoporosis and osteosarcopenia were significant in the patients who were fed enterally (p = 0.032 and 0.047, respectively).
Patients with sarcopenia and osteoporosis undergoing swallowing rehabilitation tended to have severe dysphagia that required much medical attention.
骨少肌症是少肌症和骨质疏松症的组合，与单独的少肌症或骨质疏松症相比，会增加老年人的死亡率。本研究旨在确定骨少肌症对吞咽困难发生和严重程度的影响。
我们回顾性分析了211例年龄≥65岁、被转诊至吞咽困难康复团队的患者的病历。根据功能性经口摄食量表（FOIS）评分，我们将有吞咽困难（FOIS评分1 - 5）和无吞咽困难（FOIS评分6、7）的患者分为A组，将有肠内营养（FOIS评分1、2）和无肠内营养（FOIS评分3 - 7）的患者分为B组。然后根据胸部计算机断层扫描（CT）结果，将T4（MI）和胸大肌（PMI）肌肉指数、L1衰减以及T4MI、PMI和L1衰减低于临界值的患者分别定义为患有少肌症、骨质疏松症和骨少肌症。
骨少肌症患者的FOIS评分显著低于无少肌症或骨质疏松症的患者。此外，PMI与FOIS评分呈显著正相关，且有肠内营养组的PMI显著低于无肠内营养组。肠内营养患者的骨质疏松症和骨少肌症发生率显著升高（分别为p = 0.032和0.047）。
接受吞咽康复治疗的少肌症和骨质疏松症患者往往有严重的吞咽困难，需要密切医疗关注。
