Oliveri Cecilia, Xourafa Anastasia, Morabito Nunziata, Di Giovanni Adele, Lupo Elisa, Basile Giorgio, Gaudio Agostino, Catalano Antonino
Unit and School of Geriatrics, Department of Clinical and Experimental Medicine, University Hospital of Messina, Via C. Valeria, 98125, Messina, Italy.
Unit of Talassemia, University Hospital of Catania, Catania, Italy.
Aging Clin Exp Res. 2025 May 5;37(1):141. doi: 10.1007/s40520-025-02989-7.
Aging is associated with deterioration of muscle and bone health, resulting in increased fragility fracture risk. It is not known whether muscle mass and strength could impact the osteoporosis pharmacological response.
The aim of this study was to analyze the association between muscle mass and strength with the response to denosumab in osteoporosis.
Postmenopausal women at high fracture risk receiving denosumab (60 mg subcutaneously administered every 6 months) were considered. The likelihood of sarcopenia was estimated by administering the SARC-F questionnaire, muscle mass and performance were assessed by measuring calf circumference (CC) and hand grip strength, respectively. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry.
130 women (age 70.2 ± 9.4 years) were recruited. Baseline BMD T-score values were - 2.6 ± 1.1 SD and - 2.3 ± 0.7 SD at lumbar spine and femoral neck, respectively; while CC and grip strength were 31.9 ± 2.9 cm and 22.7 ± 6.7 kg, respectively. The SARC-F score was associated with the 10-year probability of major osteoporotic fracture (r = 0.21, p < 0.05). The CC was positively associated with the T-score values of both lumbar spine (r = 0.262, p = 0.034) and femoral neck (r = 0.359, p = 0.004). Denosumab administration (treatment duration 43 months), lead to BMD improvement by + 9.6% at the lumbar spine and + 7.3% at the femoral neck (p < 0.05). After adjustment for comorbidities, fracture risk and treatment duration, the CC (β = 1.76, SE = 0.82, p = 0.03) and the baseline femoral BMD (β = - 94.19, SE = 26.09, p = 0.0009) were independently associated with femoral BMD gain over time.
In postmenopausal osteoporotic women, the CC was positively and independently associated with denosumab treatment response.
衰老与肌肉和骨骼健康恶化相关，导致脆性骨折风险增加。肌肉质量和力量是否会影响骨质疏松症的药物治疗反应尚不清楚。
本研究旨在分析肌肉质量和力量与骨质疏松症患者对狄诺塞麦治疗反应之间的关联。
纳入有高骨折风险且正在接受狄诺塞麦治疗（每6个月皮下注射60mg）的绝经后女性。通过SARC-F问卷评估肌肉减少症的可能性，分别通过测量小腿围（CC）和握力来评估肌肉质量和功能。采用双能X线吸收法测量骨密度（BMD）。
招募了130名女性（年龄70.2±9.4岁）。腰椎和股骨颈的基线骨密度T值分别为-2.6±1.1标准差和-2.3±0.7标准差；而小腿围和握力分别为31.9±2.9cm和22.7±6.7kg。SARC-F评分与主要骨质疏松性骨折的10年概率相关（r=0.21，p<0.05）。小腿围与腰椎（r=0.262，p=0.034）和股骨颈（r=0.359，p=0.004）的T值均呈正相关。给予狄诺塞麦治疗（治疗持续时间43个月）后，腰椎骨密度提高了9.6%，股骨颈提高了7.3%（p<0.05）。在调整合并症、骨折风险和治疗持续时间后，小腿围（β=1.76，SE=0.82，p=0.03）和基线股骨骨密度（β=-94.19，SE=26.09，p=0.0009）与股骨骨密度随时间的增加独立相关。
在绝经后骨质疏松症女性中，小腿围与狄诺塞麦治疗反应呈正相关且独立相关。
