跌倒与双足静力性平衡及羧化不全骨钙素水平的相关性分析
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摘要
目的探讨老年人跌倒与双足静力性平衡及羧化不全骨钙素(uc OC)水平的关系。方法收集我院2016年10月至2017年1月查体中心健康查体的125例健康老年人(1年内无跌倒史的31例、1次跌倒史的31例、2次跌倒史的30例、3次及更多跌倒史的33例)进行研究,使用酶联免疫吸附法(ELISA)测定血清uc OC水平,应用Footscan Balance 7.7平板式足底压力测试系统检测受试者双足静止站立时压力中心(center of pressure,COP)的移动轨迹,以及包绕压力中心移动轨迹的椭圆面积(95%confidence ellipse area,EA),评价静力性平衡能力,各组之间进行比较。结果各组受试者在年龄、性别、体重指数、腰臀比等方面差异均无统计学意义(P>0.05),老年人跌倒组较对照组,Cop X,Cop Y均无明显差异,跌倒组较对照组压力中心移动总长度TTW、包绕95%压力中心移动轨迹在内的椭圆面积(EA)差异有统计学意义(P<0.05),同时跌倒组较对照组羧化不全骨钙素升高,差异具有统计学意义(P<0.05)。结论老年人跌倒次数与静力性平衡能力呈负相关,且与羧化不全骨钙素水平呈正相关。
Objective To investigate the relationship between falls,static balance of the feet and serum undercarboxylated osteocalcin(UC) concentration in elderly patients.Methods Ninety-six healthy old people who had health examination in the examination center of our hospital from October 2016 to January 2017(including 31 cases with no history of falls,31 cases with 1 fall,30 cases with 2 falls and 33 cases with 3 or more falls in the past year) were included in this study.Using enzyme-linked immunosorbent assay(ELISA),the serum levels of undercarboxylated osteocalcin were determined,and using Footscan Balance7.7 flat plantar pressure measurement system,the moving track of standing pressure center(center of pressure,COP) and the elliptical area around the moving track of pressure center(95% confidence ellipse area,EA) were determined.The static balance ability was compared between the groups.Results There were no significant differences in age,sex,body mass index and waist hip ratio between the groups(P>0.05).Compare with the control group,the experimental group was not significantly different in Cop X and Cop Y.However,the total length around 95% of pressure center moving track(TTW) and the center of pressure ellipse area(EA) of the fall group were significantly different from that of the control group(P<0.05),and the fall group had increased level of undercarboxylated osteocalcin compared with the control group(P<0.05).Conclusion We found a negative correlation between the number of falls and the static balance ability in elderly people.
Objective To investigate the relationship between falls,static balance of the feet and serum undercarboxylated osteocalcin(UC) concentration in elderly patients.Methods Ninety-six healthy old people who had health examination in the examination center of our hospital from October 2016 to January 2017(including 31 cases with no history of falls,31 cases with 1 fall,30 cases with 2 falls and 33 cases with 3 or more falls in the past year) were included in this study.Using enzyme-linked immunosorbent assay(ELISA),the serum levels of undercarboxylated osteocalcin were determined,and using Footscan Balance7.7 flat plantar pressure measurement system,the moving track of standing pressure center(center of pressure,COP) and the elliptical area around the moving track of pressure center(95% confidence ellipse area,EA) were determined.The static balance ability was compared between the groups.Results There were no significant differences in age,sex,body mass index and waist hip ratio between the groups(P>0.05).Compare with the control group,the experimental group was not significantly different in Cop X and Cop Y.However,the total length around 95% of pressure center moving track(TTW) and the center of pressure ellipse area(EA) of the fall group were significantly different from that of the control group(P<0.05),and the fall group had increased level of undercarboxylated osteocalcin compared with the control group(P<0.05).Conclusion We found a negative correlation between the number of falls and the static balance ability in elderly people.
引文
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[12]Schone D,Freiberger E,Sieber CC.Influence of skeletal muscles on the risk of falling in old age.Internist(Berl),2017,58:359-370.
[13]Mikolaizak AS,Lord SR,Tiedemann A,et al.A multidisciplinary intervention to prevent subsequent falls and health service use following fall-related paramedic care:a randomised controlled trial.Age Ageing,2017,46:200-207.
[14]Talarska D,Strugala M,Szewczyczak M,et al.Is independence of older adults safe considering the risk of falls?BMC Geriatr,2017,17:66.
[15]李娟娟.维生素D水平与2型糖尿病患者双足静力性平衡的相关性研究.青岛大学医学院,2016.Li JJ.Study on the relationship between vitamin D level and static balance of biped in patients with type 2 diabetes mellitus.Qingdao University Medical College,2016.
[16]郑昱新,石印玉.老年人摔倒对骨质疏松性骨折的预测及其危险因素分析.中国骨质疏松杂志,2004,10(3):369-370.Zheng YX,Shi YY.Prediction and risk factors of osteoporotic fractures in elderly patients.Chin J Osteoporos,2004,10(3):369-370.
[2]于普林.老年人跌倒研究的现状及进展.中国老年学学会老年医学委员会委员代表大会暨全国老年常见病与危机疑难病症学术研讨会,2006:711-714.Yu PL,Current status and progress of fall research in the elderly.The Common Diseases and Crisis Committee of Gerontology Committee of Congress and the National Old Disease Symposium Gerontological Society Chinese,2006:711-714.
[3]Sousa LM,Marques-Vieira CM,Caldevilla MN,et al.Risk for falls among community-dwelling older people:systematic literature review.Rev Gaucha Enferm,2017,37:e55030.
[4]Pozaic T,Lindemann U,Grebe AK,et al.Sit-to-stand transition reveals acute fall risk in activities of daily living.IEEE J Transl Eng Health Med,2016,4:2700211.
[5]Fu WW,Fu TS,Jing R,et al.Predictors of falls and mortality among elderly adults with traumatic brain injury:A nationwide,population-based study.PLo S One,2017,12:e0175868.
[6]Duray M,Genc A.The relationship between physical fitness and falling risk and fear of falling in community-dwelling elderly people with different physical activity levels.Turk J Med Sci,2017,47:455-462.
[7]Patti A,Gennari L,Merlotti D,et al.Endocrine actions of osteocalcin.Int J Endocrinol,2013,2013:846480.
[8]Lee NK,Sowa H,Hinoi E,et al.Endocrine regulation of energy metabolism by the skeleton.Cell,2007,130:456-469.
[9]Ferron M,Lacombe J.Regulation of energy metabolism by the skeleton:osteocalcin and beyond.Arch Biochem Biophys,2014,561:137-146.
[10]刘朝阳,高德伟.老年跌倒评估和预防.实用老年医学,2016:364-367.Liu CY,Gao DW.Assessment and prevention of falls in elderly patients.Practical Geriatrics,2016:364-367.
[11]Zhao R,Feng F,Wang X.Exercise interventions and prevention of fall-related fractures in older people:a meta-analysis of randomized controlled trials.Int J Epidemiol,2016.
[12]Schone D,Freiberger E,Sieber CC.Influence of skeletal muscles on the risk of falling in old age.Internist(Berl),2017,58:359-370.
[13]Mikolaizak AS,Lord SR,Tiedemann A,et al.A multidisciplinary intervention to prevent subsequent falls and health service use following fall-related paramedic care:a randomised controlled trial.Age Ageing,2017,46:200-207.
[14]Talarska D,Strugala M,Szewczyczak M,et al.Is independence of older adults safe considering the risk of falls?BMC Geriatr,2017,17:66.
[15]李娟娟.维生素D水平与2型糖尿病患者双足静力性平衡的相关性研究.青岛大学医学院,2016.Li JJ.Study on the relationship between vitamin D level and static balance of biped in patients with type 2 diabetes mellitus.Qingdao University Medical College,2016.
[16]郑昱新,石印玉.老年人摔倒对骨质疏松性骨折的预测及其危险因素分析.中国骨质疏松杂志,2004,10(3):369-370.Zheng YX,Shi YY.Prediction and risk factors of osteoporotic fractures in elderly patients.Chin J Osteoporos,2004,10(3):369-370.