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骨少肌少症对50岁及以上人群肌肉骨骼健康、跌倒和骨折风险以及日常生活活动的影响:一项年龄和性别匹配的横断面分析。

Impacts of osteosarcopenia on musculoskeletal health, risks of falls and fractures, and activities of daily living among population aged 50 and above: an age- and sex-matched cross-sectional analysis.

作者信息

Nguyen Bao Tu Thai, Lin Ashleigh Peng, Yang Wan-Wan, Cheng Shun-Jen, Kuo Yi-Jie, Nguyen Tan Thanh, Chen Yu-Pin

机构信息

The International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.

出版信息

Aging Clin Exp Res. 2024 Dec 27;37(1):8. doi: 10.1007/s40520-024-02902-8.

Abstract

AIMS

We conducted this study to investigate the impact of muscle loss on musculoskeletal health, fall and fracture risks, and activities of daily living (ADL) in elderly patients with osteoporosis.

MATERIALS AND METHODS

This age- and sex-matched cross-sectional study analyzed data from a medical center involving patients aged ≥ 50 from 2020 to 2022. The included participants were formed into three groups: 100 with osteoporosis only, 100 with osteosarcopenia, and 50 control individuals without osteoporosis and sarcopenia. We compared groups based on their baseline characteristics, bone and muscle health measurements, and the risks of falls and fractures using the STRATIFY scale and FRAX, respectively. Additionally, ADL was assessed using the Barthel Index. A multivariate analysis was performed to identify factors associated with declined ADL in osteosarcopenic patients.

RESULTS

The mean age was 76.17 years, and 82% were female. The osteosarcopenic group demonstrated poorer bone and muscle quality and quantity, with greater risks of major osteoporotic-related fractures, hip fractures, and falls, as well as significantly decreased ADL than other groups. When comparing sexes, females exhibited worse performance than males across groups. Slow gait speed and high STRATIFY score are independent predictors of declined ADL in osteosarcopenic patients.

CONCLUSION

Sarcopenia exacerbates osteoporotic patients, particularly women, worsening bone deterioration, increasing fall and fracture risks, and significantly impairing daily activities. Enhancing walking speed and reducing fall risk can boost independence in individuals with osteosarcopenia. Early detection, proper management, and preventive measures are essential for mitigating these adverse outcomes in high-risk individuals.

摘要

目的

我们开展这项研究以调查肌肉减少对老年骨质疏松症患者肌肉骨骼健康、跌倒及骨折风险和日常生活活动(ADL)的影响。

材料与方法

这项年龄和性别匹配的横断面研究分析了一家医疗中心2020年至2022年≥50岁患者的数据。纳入的参与者分为三组:仅患有骨质疏松症的100例、患有骨质疏松性肌少症的100例以及50例无骨质疏松症和肌少症的对照个体。我们分别使用STRATIFY量表和FRAX,根据基线特征、骨骼和肌肉健康测量指标以及跌倒和骨折风险对各组进行比较。此外,使用Barthel指数评估ADL。进行多变量分析以确定与骨质疏松性肌少症患者ADL下降相关的因素。

结果

平均年龄为76.17岁,82%为女性。骨质疏松性肌少症组的骨骼和肌肉质量及数量较差,发生主要骨质疏松相关骨折、髋部骨折和跌倒的风险更高,且ADL较其他组显著下降。在比较性别时,各组中女性的表现均比男性差。步态速度慢和STRATIFY评分高是骨质疏松性肌少症患者ADL下降的独立预测因素。

结论

肌少症会加重骨质疏松症患者,尤其是女性的病情,使骨质恶化加剧,增加跌倒和骨折风险,并严重损害日常活动。提高步行速度和降低跌倒风险可增强骨质疏松性肌少症患者的独立性。早期检测、适当管理和预防措施对于减轻高危个体的这些不良后果至关重要。

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