不同部位骨质疏松骨折女性患者肌肉减少症的患病率及相关危险因素分析
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摘要
目的研究不同骨折部位骨质疏松女性患者肌肉减少症的患病率,并探索骨质疏松性骨折并发肌肉减少症的相关危险因素。方法共有112名50岁以上患有骨质疏松性骨折(髋、脊柱或腕)的患者纳入本研究。使用双能X线吸收仪检测患者的骨密度和肌肉量。Logistic回归分析用于分析骨质疏松性骨折合并肌肉减少症的危险因素。结果 2015年4月至2017年8月期间112例女性骨质疏松性骨折患者中,42例(37.5%)确诊为肌肉减少症,髋部骨折41.8%(18/43),脊柱骨折36.7%(15/41),桡骨远端骨折32.1.6%(9/28)。各组之间的体质指数(BMI,P=0.005)、慢性肾病(CKD,P=0.002)和类风湿性关节炎(P=0.001)的患病率差异有统计学意义。在Logistic多变量回归分析中,BMI,CKD和RA与肌肉减少症风险增加相关。结论根据骨折部位评估了骨骼肌减少症的患病率,并确定了骨质疏松性骨折出现肌肉减少症的相关危险因素为BMI,CKD和RA。
Objective To determine the prevalence of sarcopenia according to fracture sites and to evaluate the associated risk factors in female patients with osteoporotic fractures. Methods A total of 112 patients aged 50 years or older with an osteoporotic fracture(hip, spine, or wrist) were enrolled in this study. A diagnosis of sarcopenia was confirmed using whole-body densitometry for skeletal muscle mass measurement. Logistic regression analysis was used to analyze the risk factors for sarcopenia. Results Of 112 female patients treated for osteoporotic fractures between April 2015 and August 2017, sarcopenia was diagnosed in 42 cases(37.5%). Among those, 41.8%(18/43) had hip fractures, 36.7%(15/41) had spine fractures, and 32.1.6%(9/28) had distal radius fractures. Body mass index(BMI; P=0.005) and prevalence of chronic kidney disease(CKD; P=0.002) and rheumatoid arthritis(P=0.001) were significantly different between the groups. In multivariable analysis, BMI, CKD, and RA were associated with an increased risk of sarcopenia, and there were statistically significant differences(P<0.05). Conclusion This study evaluated the prevalence of sarcopenia according to the fracture site and identified associated risk factors such as BMI, CKD, and RA in patients with osteoporotic fractures.
Objective To determine the prevalence of sarcopenia according to fracture sites and to evaluate the associated risk factors in female patients with osteoporotic fractures. Methods A total of 112 patients aged 50 years or older with an osteoporotic fracture(hip, spine, or wrist) were enrolled in this study. A diagnosis of sarcopenia was confirmed using whole-body densitometry for skeletal muscle mass measurement. Logistic regression analysis was used to analyze the risk factors for sarcopenia. Results Of 112 female patients treated for osteoporotic fractures between April 2015 and August 2017, sarcopenia was diagnosed in 42 cases(37.5%). Among those, 41.8%(18/43) had hip fractures, 36.7%(15/41) had spine fractures, and 32.1.6%(9/28) had distal radius fractures. Body mass index(BMI; P=0.005) and prevalence of chronic kidney disease(CKD; P=0.002) and rheumatoid arthritis(P=0.001) were significantly different between the groups. In multivariable analysis, BMI, CKD, and RA were associated with an increased risk of sarcopenia, and there were statistically significant differences(P<0.05). Conclusion This study evaluated the prevalence of sarcopenia according to the fracture site and identified associated risk factors such as BMI, CKD, and RA in patients with osteoporotic fractures.
引文
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[13] 陶周善, 周皖舒, 江云云, 等. 骨形成蛋白联合雷奈酸锶对成骨细胞增殖和分化的影响 [J]. 中国骨质疏松杂志, 2018, 24(2): 165-169.
[14] Drey M, Sieber CC, Bertsch T, et al. Osteosarcopenia is more than sarcopenia and osteopenia alone [J]. Aging Clin Exp Res, 2015,28(5): 1-5.
[15] Huo YR, Suriyaarachchi P, Gomez F, et al. Phenotype of osteosarcopenia in older individuals with a history of falling [J]. J Am Med Dir Assoc, 2014,16(4): 290-295.
[16] Wei H, Cheng Q, Zhu X, et al. Prevalence of sarcopenia and its relationship with sites of fragility fractures in elderly Chinese men and women [J]. PLoS One, 2015,10(9): e0138102.
[17] Targowski T. Sarcopaenia and rheumatoid arthritis [J]. Reumatologia, 2017,55(2): 84-87.
[18] Dodds RM, Granic A, Davies K, et al. Prevalence and incidence of sarcopenia in the very old: findings from the Newcastle 85+ Study [J]. J Cachexia Sarcopenia Muscle, 2017,8(2): 229-237.
[19] Rao M, Jaber BL, Balakrishnan VS. Chronic kidney disease and acquired mitochondrial myopathy [J]. Curr Opin Nephrol Hypertens, 2018,27(2): 113-120.
[2] Androga L, Sharma D, Amodu A, et al. Sarcopenia, obesity, and mortality in US adults with and without chronic kidney disease [J]. Kidney Intern Reports, 2017,2(2): 201.
[3] Dudgeon D, Baracos V E. Physiological and functional failure in chronic obstructive pulmonary disease, congestive heart failure and cancer: a debilitating intersection of sarcopenia, cachexia and breathlessness [J]. Cur Opin Support Palliat Care, 2016,10(3): 236-241.
[4] Tsuchida K, Fujihara Y, Hiroki J, et al. Significance of Sarcopenia Evaluation in Acute Decompensated Heart Failure [J]. Int Heart J, 2018,59(1):143-148.
[5] Ryo O, Reiko W, Daisuke I. Osteoporosis associated with chronic obstructive pulmonary disease [J]. J Bone Metab, 2016,23(3): 111.
[6] Liccini A, Malmstrom TK. Frailty and sarcopenia as predictors of adverse health outcomes in persons with diabetes mellitus [J]. J Am Med Dir Assoc, 2016,17(9): 846-851.
[7] Lipovec NC, Schols AMWJ, Borst BVD, et al. Sarcopenia in advanced COPD affects cardiometabolic risk reduction by short-term high-intensity pulmonary rehabilitation [J]. J Am Med Dir Assoc, 2016,17(9): 814-820.
[8] Edwards MH, Dennison EM, Aihie SA, et al. Osteoporosis and sarcopenia in older age [J]. Bone, 2015,80: 126-130.
[9] Jun-Il Y, Yong-Chan H, Hyeok-Bin K, et al. High Prevalence of Sarcopenia in Korean Patients after Hip Fracture: a Case-Control Study [J]. J Korean Med Sci, 2016,31(9): 1479-1484.
[10] Newton DH, Kim C, Lee N, et al. Sarcopenia predicts poor long-term survival in patients undergoing endovascular aortic aneurysm repair [J]. J Vascular Surgery, 2017,65(1): 453-459.
[11] Schuit SC, Van dKM, Weel AE, et al. Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study [J]. Bone, 2004,34(1): 195-202.
[12] Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia [J]. J Am Med Dir Assoc, 2014,15(2): 95.
[13] 陶周善, 周皖舒, 江云云, 等. 骨形成蛋白联合雷奈酸锶对成骨细胞增殖和分化的影响 [J]. 中国骨质疏松杂志, 2018, 24(2): 165-169.
[14] Drey M, Sieber CC, Bertsch T, et al. Osteosarcopenia is more than sarcopenia and osteopenia alone [J]. Aging Clin Exp Res, 2015,28(5): 1-5.
[15] Huo YR, Suriyaarachchi P, Gomez F, et al. Phenotype of osteosarcopenia in older individuals with a history of falling [J]. J Am Med Dir Assoc, 2014,16(4): 290-295.
[16] Wei H, Cheng Q, Zhu X, et al. Prevalence of sarcopenia and its relationship with sites of fragility fractures in elderly Chinese men and women [J]. PLoS One, 2015,10(9): e0138102.
[17] Targowski T. Sarcopaenia and rheumatoid arthritis [J]. Reumatologia, 2017,55(2): 84-87.
[18] Dodds RM, Granic A, Davies K, et al. Prevalence and incidence of sarcopenia in the very old: findings from the Newcastle 85+ Study [J]. J Cachexia Sarcopenia Muscle, 2017,8(2): 229-237.
[19] Rao M, Jaber BL, Balakrishnan VS. Chronic kidney disease and acquired mitochondrial myopathy [J]. Curr Opin Nephrol Hypertens, 2018,27(2): 113-120.