Zhou Qionglan, Zhu Ying, Guo Qin, Wang Wei, Wang Ling, Zhang Xuejun, Yang Yan, Zhang Lei, Zhang Yiyi
Department of Endocrinology, People's Hospital of Yilong County, Nanchong, Sichuan, China.
Department of Endocrinology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
BMC Musculoskelet Disord. 2025 Sep 2;26(1):842. doi: 10.1186/s12891-025-09117-6.
To explore whether older adults with sarcopenia are at greater risk for falls, fractures, hospital readmissions, and all-cause mortality compared to those without sarcopenia.
An elderly population discharged from June 2020 to January 2022 from the Department of Endocrinology of Sichuan Provincial People's Hospital was collected. The cohort included patients with various endocrine disorders, primarily type 2 diabetes mellitus, thyroid dysfunction (hypo- and hyperthyroidism), adrenal insufficiency, and metabolic syndrome. Clinicopathologic data were collected, and sarcopenia was diagnosed based on muscle mass, handgrip strength, and gait speed. Multivariate logistic and Cox regression analyses were performed to identify risk factors for sarcopenia and evaluate its association with adverse outcomes.
Among 161 participants, 50 (31.06%) had sarcopenia. Sarcopenia significantly increased the risk of falls (adjusted HR: 2.38, 95% CI: 1.06-5.35, P = 0.036) but was not associated with hospital readmissions (adjusted HR: 0.87, 95% CI: 0.49-1.53, P = 0.630), fractures (adjusted HR: 1.01, 95% CI: 0.20-3.92, P = 0.992), or all-cause mortality (adjusted HR: 1.81, 95% CI: 0.49-6.67, P = 0.374). Impaired gait speed was a strong predictor of increased fall risk (adjusted HR: 5.00, 95%CI: 1.27 ~ 19.90, P = 0.022), suggesting that patients who failed the gait speed test were substantially more likely to experience falls, and grip strength was a better predictor of clinical prognosis (adjusted HR: 0.85, 95%CI: 0.77 ~ 0.95, P = 0.004).
Sarcopenia is independently associated with an increased risk of falls in elderly patients with endocrine-related diseases. Recognizing and treating sarcopenia can prevent falls and help improve clinical prognosis in older patients. However, the heterogeneity of underlying endocrine disorders may influence these associations and should be considered in clinical interpretation.
探讨与无肌肉减少症的老年人相比，患有肌肉减少症的老年人发生跌倒、骨折、再次入院和全因死亡的风险是否更高。
收集2020年6月至2022年1月从四川省人民医院内分泌科出院的老年人群。该队列包括患有各种内分泌疾病的患者，主要是2型糖尿病、甲状腺功能障碍（甲状腺功能减退和亢进）、肾上腺功能不全和代谢综合征。收集临床病理数据，并根据肌肉质量、握力和步速诊断肌肉减少症。进行多因素逻辑回归和Cox回归分析，以确定肌肉减少症的危险因素，并评估其与不良结局的关联。
161名参与者中，50名（31.06%）患有肌肉减少症。肌肉减少症显著增加了跌倒风险（调整后HR：2.38，95%CI：1.06 - 5.35，P = 0.036），但与再次入院（调整后HR：0.87，95%CI：0.49 - 1.53，P = 0.630）、骨折（调整后HR：1.01，95%CI：0.20 - 3.92，P = 0.992）或全因死亡（调整后HR：1.81，95%CI：0.49 - 6.67，P = 0.374）无关。步速受损是跌倒风险增加的有力预测因素（调整后HR：5.00，95%CI：1.27～19.90，P = 0.022），这表明步速测试未通过的患者发生跌倒的可能性显著更高，而握力是临床预后的更好预测因素（调整后HR：0.85，95%CI：0.77～0.95，P = 0.004）。
肌肉减少症与内分泌相关疾病老年患者跌倒风险增加独立相关。识别和治疗肌肉减少症可预防跌倒，并有助于改善老年患者的临床预后。然而，潜在内分泌疾病的异质性可能会影响这些关联，在临床解释中应予以考虑。
