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Ishimoto R, Mutsuzaki H, Shimizu Y, Takeuchi R, Matsumoto S, Hada Y. Association between Sarcopenia and Balance in Patients Undergoing Inpatient Rehabilitation after Hip Fractures: A Retrospective Cohort Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:742. [PMID: 38792925 PMCID: PMC11123061 DOI: 10.3390/medicina60050742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/21/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Sarcopenia is characterized by a decline in skeletal muscle mass, strength, and function and is associated with advancing age. This condition has been suggested as a factor that negatively influences the functional outcomes of patients with hip fractures. However, the association between sarcopenia and balance impairment in patients undergoing inpatient rehabilitation after hip fractures remains unclear. In this retrospective cohort study, we aimed to investigate the impact of sarcopenia on balance outcomes in patients undergoing inpatient rehabilitation following hip fractures. Materials and Methods: Baseline sarcopenia was diagnosed using skeletal muscle mass index and handgrip strength, with cut-off values recommended by the Asian Working Group for Sarcopenia. The primary outcome was balance, which was assessed using the Berg Balance Scale (BBS) at the time of discharge. A multiple linear regression model analyzed the association between sarcopenia and balance. The model was adjusted for age, sex, comorbidities, and cognitive function. Results: Among the 62 patients (mean age: 78.2; sex: 75.8% women), 24.2% had sarcopenia. Patients with sarcopenia had significantly lower BBS scores than did those without sarcopenia (41 vs. 49 points, p = 0.004). Multiple linear regression analysis revealed that baseline sarcopenia was independently associated with BBS scores at discharge (β = -0.282, p = 0.038). Conclusions: Following inpatient rehabilitation, patients with baseline sarcopenia had inferior balance outcomes than did those without sarcopenia at discharge. Sarcopenia should be assessed on admission to consider and provide additional care for those with a higher risk of poor functional outcomes. More studies are needed to investigate the association between sarcopenia and functional outcomes, examine the impact of sarcopenia treatment on these outcomes, and reduce the risk of recurrent falls and fractures in patients with hip fractures.
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Affiliation(s)
- Ryu Ishimoto
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8575, Japan;
- Department of Rehabilitation Medicine, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
| | - Hirotaka Mutsuzaki
- Center for Medical Science, Ibaraki Prefectural University of Health Sciences, Ami 300-0394, Japan
- Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
| | - Yukiyo Shimizu
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Ryoko Takeuchi
- Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
| | - Shuji Matsumoto
- Department of Rehabilitation Medicine, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
- Center for Medical Science, Ibaraki Prefectural University of Health Sciences, Ami 300-0394, Japan
| | - Yasushi Hada
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
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Chen PY, Lee YH, Chiang CH, Chang HH, Lu CW, Huang KC. Sex Differences and Positive Dose-Response Relationships between Serum Osteocalcin Levels and Low Muscle Strength. Gerontology 2023; 69:1056-1064. [PMID: 37276853 DOI: 10.1159/000531371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/30/2023] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Impaired handgrip strength is an indication for sarcopenia and frailty screening, and is associated with increased osteoporotic risks and all-cause mortality. Osteocalcin, secreted by osteoblasts, is a versatile factor that participates in bone turnover and muscle adaptation. The role of osteocalcin in muscle strength has mainly been discussed in animal models and requires more human data. The study aimed to investigate the association between the serum osteocalcin level and handgrip strength in middle-aged individuals and older adults with diabetes. METHODS Adult participants (aged 40 and above, N = 237) with diabetes were enrolled in a medical center in northern Taiwan. Subjects were divided into normal, low muscle mass without dynapenia, dynapenia without low muscle mass, and groups of low muscle mass with dynapenia according to their handgrip strength and muscle mass measurements. Physical performance, including handgrip strength, repeated sit-to-stand tests, walking speed, and short physical performance batteries, was documented. Body composition was measured by bioelectrical impedance analysis. RESULTS The median serum osteocalcin level was highest in the dynapenic group without low muscle mass (median [Q1, Q3], 14.1 [11.2, 16.3] ng/mL). Multivariate logistic regression showed that a higher serum osteocalcin level was associated with worse handgrip strength (OR: 3.89, 95% CI: 1.66-9.10) after adjusting for body mass index (adiposity), skeletal muscle mass index (muscle), and medication with dipeptidyl peptidase-4 inhibitor. Further sex stratification revealed a more significant association between serum osteocalcin level and impaired handgrip strength in women but not in men. The female groups showed increases in the risk of impaired handgrip strength: 4.84-fold in the osteocalcin T2 group (11.4 ≤ osteocalcin <15.0 ng/mL) and 4.54-fold in the osteocalcin T3 group (osteocalcin ≥15.0 ng/mL). Moreover, after adjusting for various confounders, 8.41-fold and 8.03-fold increases in the risk of impaired handgrip strength were observed in the osteocalcin T2 group (11.4≤ osteocalcin <15.0 ng/mL) and osteocalcin T3 group (osteocalcin ≥14.5 ng/mL), respectively. CONCLUSION Higher serum osteocalcin is associated with increased risks of impaired handgrip strength and impaired physical performance. Dose-dependent associations were found especially in postmenopausal women but not in men.
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Affiliation(s)
- Pei-Yun Chen
- Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Hsuan Lee
- Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Hsieh Chiang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hao-Hsiang Chang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chia-Wen Lu
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
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Morbidity Associated with Chronic Hyponatremia. J Clin Med 2023; 12:jcm12030978. [PMID: 36769626 PMCID: PMC9917626 DOI: 10.3390/jcm12030978] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 02/01/2023] Open
Abstract
This article will discuss the consequences of chronic hyponatremia. In conditions such as cancer, heart failure, liver cirrhosis, or chronic kidney disease, the presence and magnitude of hypotonic hyponatremia are considered to reflect the severity of the underlying disease and are associated with increased morbidity as well as mortality. Hyponatremia can be acute (<48 h) or chronic (>2-3 days). Chronic hyponatremia is associated with attention deficit, dizziness, tiredness, gait disturbance, falls, sarcopenia, bone fractures, osteoporosis, hypercalciuria (in the syndrome of inappropriate antidiuresis-SIADH), and kidney stones. In vitro studies have shown that cells grown in a low concentration of extracellular sodium have a greater proliferation rate and motility. Patients with chronic hyponatremia are more likely to develop cancer. We will not review the clinical consequences of respiratory arrest and osmotic demyelination syndrome (ODS) of the too-late or excessive treatment of hyponatremia.
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The Urine Calcium/Creatinine Ratio and Uricemia during Hyponatremia of Different Origins: Clinical Implications. J Clin Med 2023; 12:jcm12020723. [PMID: 36675652 PMCID: PMC9863532 DOI: 10.3390/jcm12020723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Background: Chronic hyponatremia is known to be associated with osteoporosis. It has been shown that chronic hyponatremia increases bone resorption in an attempt to release body stores of exchangeable sodium by different mechanisms. We wanted to know the calciuria of patients with hyponatremia of different origins. Material and Methods: We made a retrospective study of 114 consecutive patients with asymptomatic hyponatremia of different origins with the usual serum and urine chemistry. Result: In hyponatremia due to SIADH, we had a high urine calcium/creatinine ratio of 0.23 ± 0.096 while in patients with salt depletion the UCa/UCr ratio was low (0.056 ± 0.038), in patients with hyponatremia secondary to thiazide intake the value was also low (0.075 ± 0.047) as in hypervolemic patients (0.034 ± 0.01). In hyponatremia due to polydipsia, the value was high (0.205 ± 0.10). Correction of hyponatremia in the euvolemic patients was associated with a significant decrease in the UCa/UCr ratio. In patients with hyponatremia secondary to thiazide intake, we noted that in the patients with low uric acid levels (<4 mg/dL, suggesting euvolemia) we also observed a low UCa/UCr (<0.10). In nine patients with chronic SIADH (SNa 125.1 ± 3.6 mEq/L), the 24 h urine calcium excretion was 275 ± 112 mg and decreased to 122 ± 77 mg (p < 0.01) after at least 2 weeks of treatment. Conclusions: Patients with chronic hyponatremia due to SIADH usually have a high UCa/UCr ratio (>0.15). This is also observed in hyponatremia secondary to polydipsia. Patients with thiazide-induced hyponatremia usually have low UCa/UCr levels and this is the case even among those with a biochemistry similar to that in SIADH (uric acid < 4 mg/dL).
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Okuwaki S, Funayama T, Ikumi A, Matsuura S, Kawamura H, Yamazaki M. Relationship between Vertebral Instability and the Cross-Sectional Area of Lumbar Muscles in Postmenopausal Acute Osteoporotic Vertebral Fractures. Spine Surg Relat Res 2022; 6:51-57. [PMID: 35224247 PMCID: PMC8842355 DOI: 10.22603/ssrr.2021-0029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/15/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Methods Results Conclusions
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Affiliation(s)
- Shun Okuwaki
- Department of Orthopedic Surgery, Kenpoku Medical Center Takahagi Kyodo Hospital
| | - Toru Funayama
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba
| | - Akira Ikumi
- Department of Orthopedic Surgery, Kenpoku Medical Center Takahagi Kyodo Hospital
| | - Satoshi Matsuura
- Department of Orthopedic Surgery, Kenpoku Medical Center Takahagi Kyodo Hospital
| | - Haruo Kawamura
- Department of Orthopedic Surgery, Kenpoku Medical Center Takahagi Kyodo Hospital
| | - Masashi Yamazaki
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba
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Does Unilateral Lumbosacral Radiculopathy Affect the Association between Lumbar Spinal Muscle Morphometry and Bone Mineral Density? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413155. [PMID: 34948767 PMCID: PMC8701069 DOI: 10.3390/ijerph182413155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022]
Abstract
Age-related degenerative changes lead to a gradual decrease in bone mineral density (BMD) and muscle mass. We aimed to assess the effects of decreased BMD and lumbar denervation on lumbar spinal muscle morphometry and the relationship between BMD and lumbar spinal muscular morphometry, respectively. Eighty-one patients, aged 50–85 years, diagnosed with unilateral lumbosacral radiculopathy based on electrodiagnostic studies between January 2016 and April 2021 were enrolled. BMD T scores in the lumbar spine and hip were measured using dual-energy X-ray absorptiometry. The cross-sectional area (CSA) of the psoas, multifidus, and erector spinae located in the middle of the lumbar spine, between the L3 and L4 and between the L4 and L5 levels, respectively, was measured using axial MRI. Functional CSA (FCSA) was defined as the CSA of lean muscle mass. Pearson correlation analyses were performed to evaluate the association between BMD T scores and the CSA, FCSA, and the ratio of the FCSA to the CSA (functional ratio) for each side. The CSA of lumbar spinal muscles showed no significant correlation with lumbar BMD. The FCSA and functional ratio of lumbar spinal muscles were significantly correlated with lumbar BMD. There was no correlation between femur BMD and lumbar spinal muscle morphometry.
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Lee Y, Lee HJ, Yoon S, Shin J, Park KC, Lee SY, Lee S. Association Between Overweight Sarcopenic Population and Acute Vertebral Osteoporotic Compression Fractures in Females: Retrospective, Cross-Sectional Study. Front Med (Lausanne) 2021; 8:790135. [PMID: 34926531 PMCID: PMC8678084 DOI: 10.3389/fmed.2021.790135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: This study aimed to determine whether the prevalence of acute vertebral osteoporotic compression fractures (VOCF) in the elderly population is related to the distribution of muscles and fat in the human body. Methods: Data of acute VOCF and non-VOCF patients presenting at our institution between January 2018 and May 2020 were analyzed. Patients aged 65 years and older, who underwent body composition test and dual-energy X-ray absorptiometry at the same time were enrolled. After applying exclusion criteria, patients were divided into four groups: normal, sarcopenia without obesity, obesity without sarcopenia, and sarcopenic obesity. Body mass index ≥25 kg/m2 was considered obesity, and sarcopenia was defined as skeletal muscle index lower than 7.0 kg/m2 in males and 5.4 kg/m2 in females. The VOCF rate was analyzed between the groups. Discussion: A total of 461 patients were included, of whom 103 were males. Among them, 163 (35.36%) had normal body composition, 151 (32.75%) had sarcopenia without obesity, 110 (23.86%) had obesity without sarcopenia, and 37 (8.03%) had sarcopenic obesity. The sarcopenic obesity group had the highest rate of acute VOCF (37.8%), which was statistically significant. Specifically, females with sarcopenic obesity and sarcopenia without obesity had significantly higher acute VOCF rates compared to those with normal body compositions. Multivariate analysis showed that sarcopenic obesity was significantly associated with acute VOCF rate overall, as well as in females. Conclusion: Sarcopenic obesity is strongly associated with acute VOCF, especially in females, and it could be an essential criterion for the prevention of acute VOCF.
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Affiliation(s)
- Younghun Lee
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Ho-Jae Lee
- Department of Orthopaedic Surgery, CHA Gumi Medical Center, Gumi, South Korea
| | - Siyeong Yoon
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Jaeyeon Shin
- Department of Computer Science, College of IT Engineering, SeMyung University, Jecheon, South Korea
| | - Kyung-Chae Park
- Department of Family Medicine, Health Promotion Center, CHA Bundang Medical Center, CHA University School of Medicine, Pocheon, South Korea
| | - So-young Lee
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Soonchul Lee
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
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Pizzonia M, Casabella A, Natali M, Petrocchi L, Carmisciano L, Nencioni A, Molfetta L, Giannotti C, Bianchi G, Giusti A, Santolini F, Monacelli F. Osteosarcopenia in Very Old Age Adults After Hip Fracture: A Real-World Therapeutic Standpoint. Front Med (Lausanne) 2021; 8:612506. [PMID: 34095158 PMCID: PMC8172785 DOI: 10.3389/fmed.2021.612506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/24/2021] [Indexed: 12/16/2022] Open
Abstract
Loss of bone and muscle mass and strength (i. e., osteosarcopenia) is a highly prevalent clinical condition in older adults, associated with an increased risk of fragility fractures and unfavorable clinical outcomes. Although sarcopenia is a potential risk factor for osteoporosis and subsequent fracture, and the management of this hazardous duet is the key to preventing osteoporotic fracture, evidence pertaining to the treatment of sarcopenia for the purpose of preventing fragile fractures remains insufficient. Given this scenario we aimed at prospectively compare the long-term effectiveness of bisphosphonates vs. denosumab, on bone and muscle, in a cohort of old age hip fractured patients by virtue of a timely osteo-metabolic and sarcopenic assessment. Ninety-eight patients consecutively enrolled at the IRCCS Hospital San martino, Genoa, Italy, received at baseline comprehensive geriatric assessment and Bone Densitometry (DXA) with the quantitative and quantitative bone analysis and evaluation of relative skeletal muscle index (RSMI) and longitudinally after 1 year form hip surgery. The results showed a slightly and non-significant osteo-metabolic improvement in the Alendronate group compared to the Denosumab group, and a positive trend of RSMI measurements in the Denosumab group. Although preliminary in nature, this is the first report to longitudinally analyze osteosarcopenia in a real-world cohort of very old age patients after hip fracture and moved a step forward in the understanding of the best osteo-metabolic therapy for long- term treatment, exploring as well the potential dual role of denousumab as antiresorptive and muscle strength specific drug for osteosarcopenia in this vulnerable population.
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Affiliation(s)
- Monica Pizzonia
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Casabella
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.,DIMI, Department of Internal Medicine and Medical Specialties, Section of Geriatrics, University of Genoa, Genoa, Italy
| | - Marta Natali
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.,DIMI, Department of Internal Medicine and Medical Specialties, Section of Geriatrics, University of Genoa, Genoa, Italy
| | - Lorena Petrocchi
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.,DIMI, Department of Internal Medicine and Medical Specialties, Section of Geriatrics, University of Genoa, Genoa, Italy
| | - Luca Carmisciano
- DISSAL, Department of Health Science, University of Genoa, Genoa, Italy
| | - Alessio Nencioni
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.,DIMI, Department of Internal Medicine and Medical Specialties, Section of Geriatrics, University of Genoa, Genoa, Italy
| | - Luigi Molfetta
- DISC, Department of Integrated Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | - Chiara Giannotti
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.,DIMI, Department of Internal Medicine and Medical Specialties, Section of Geriatrics, University of Genoa, Genoa, Italy
| | - Gerolamo Bianchi
- Rheumatology Unit, Department of Musculoskeletal Sciences, Local Health Trust 3, La Colletta Hospital, Genoa, Italy
| | - Andrea Giusti
- Rheumatology Unit, Department of Musculoskeletal Sciences, Local Health Trust 3, La Colletta Hospital, Genoa, Italy
| | - Federico Santolini
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy
| | - Fiammetta Monacelli
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.,DIMI, Department of Internal Medicine and Medical Specialties, Section of Geriatrics, University of Genoa, Genoa, Italy
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Abdala R, Elena Del Valle E, Negri AL, Bridoux P, Paganti LG, Bravo M, Sintado L, Di Rienzo P, Schiavelli OR, Zanchetta MB, Guinsburg A. Sarcopenia in hemodialysis patients from Buenos Aires, Argentina. Osteoporos Sarcopenia 2021; 7:75-80. [PMID: 34278003 PMCID: PMC8261721 DOI: 10.1016/j.afos.2021.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives Sarcopenia is the loss of skeletal muscle mass and function that occurs with aging that can lead to greater morbidity and mortality. Chronic kidney disease and hemodialysis (HD) favors the development of sarcopenia. We studied the prevalence of sarcopenia and its components using European Working Group on Sarcopenia in Elderly People 2 proposed criteria and risk factors for its development in HD patients. Methods In 100 adult HD patients, we evaluated: hand grip strength (HGS), muscle mass by dual energy X-ray absorptiometry and physical performance (gait-speed and sit-stand test). Results Sixty patients were male and 40 were female; mean age 55.6 years. Prevalence of sarcopenia was 16% (11.1% in males and 25% in females; P = 0.05); 7% had severe sarcopenia. Prevalence of low HGS was 33% in males and 28% in females; low muscle mass was 30% in males but 70% in females and low physical performance 23% in males and 45% in females. Falls were reported by 23 patients. Patients with lower HGS had a higher prevalence of falls in the last year (40% two or more falls; P = 0.03). Only females with sarcopenia had lower bone mineral content. Neither age, body mass index, time on dialysis, or prevalence of diabetes predicted sarcopenia. Conclusions A significant proportion of dialysis patients had sarcopenia, more frequent in females. Low HGS was associated with a higher prevalence of falls. Only females with sarcopenia had lower bone mineral content.
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Affiliation(s)
- Ruben Abdala
- Nephrology and Osteology Department, Metabolic Research Institute, Buenos Aires, Argentina
| | - Elisa Elena Del Valle
- Nephrology and Osteology Department, Metabolic Research Institute, Buenos Aires, Argentina.,Fresenius Medical Care Argentina, Buenos Aires, Argentina
| | - Armando Luis Negri
- Nephrology and Osteology Department, Metabolic Research Institute, Buenos Aires, Argentina
| | - Pablo Bridoux
- Fresenius Medical Care Argentina, Buenos Aires, Argentina
| | | | - Marina Bravo
- Fresenius Medical Care Argentina, Buenos Aires, Argentina
| | - Luis Sintado
- Fresenius Medical Care Argentina, Buenos Aires, Argentina
| | | | | | - Maria Belén Zanchetta
- Nephrology and Osteology Department, Metabolic Research Institute, Buenos Aires, Argentina
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Kuriyama N, Ozaki E, Koyama T, Matsui D, Watanabe I, Tomida S, Nagamitsu R, Hashiguchi K, Inaba M, Yamada S, Horii M, Mizuno S, Yoneda Y, Kurokawa M, Kobayashi D, Fukuda S, Iwasa K, Watanabe Y, Uehara R. Evaluation of myostatin as a possible regulator and marker of skeletal muscle-cortical bone interaction in adults. J Bone Miner Metab 2021; 39:404-415. [PMID: 33044569 DOI: 10.1007/s00774-020-01160-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/21/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Bone mass was recently reported to be related to skeletal muscle mass in humans, and a decrease in cortical bone is a risk factor for osteoporosis. Because circulating myostatin is a factor that primarily controls muscle metabolism, this study examined the role of myostatin in bone mass-skeletal muscle mass interactions. METHODS The subjects were 375 middle-aged community residents with no history of osteoporosis or sarcopenia who participated in a health check-up. Cortical bone thickness and cancellous bone density were measured by ultrasonic bone densitometry in a health check-up survey. The subjects were divided into those with low cortical bone thickness (LCT) or low cancellous bone density (LBD) and those with normal values (NCT/NBD). Bone metabolism markers (TRACP-5b, etc.), skeletal muscle mass, serum myostatin levels, and lifestyle were then compared between the groups. RESULTS The percentage of diabetic participants, TRACP-5b, and myostatin levels were significantly higher, and the frequency of physical activity, skeletal muscle mass, grip strength, and leg strength were significantly lower in the LCT group than in the NCT group. The odds ratio (OR) of high myostatin levels in the LCT group compared with the NCT group was significant (OR 2.17) even after adjusting for related factors. Between the low cancellous bone density (LBD) and normal cancellous bone density (NBD) groups, significant differences were observed in the same items as between the LCT and NCT groups, but no significant differences were observed in skeletal muscle mass and blood myostatin levels. The myostatin level was significantly negatively correlated with cortical bone thickness and skeletal muscle mass. CONCLUSIONS A decrease in cortical bone thickness was associated with a decrease in skeletal muscle mass accompanied by an increase in the blood myostatin level. Blood myostatin may regulate the bone-skeletal muscle relationship and serve as a surrogate marker of bone metabolism, potentially linking muscle mass to bone structure.
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Affiliation(s)
- Nagato Kuriyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Daisuke Matsui
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Isao Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Satomi Tomida
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Reo Nagamitsu
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Kanae Hashiguchi
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masaaki Inaba
- Department of Metabolism, Endocrinology, and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Shinsuke Yamada
- Department of Metabolism, Endocrinology, and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Motoyuki Horii
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shigeto Mizuno
- Department of Endoscopy, Kindai University Nara Hospital, Ikoma City, Nara Prefecture, Japan
| | - Yutaro Yoneda
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masao Kurokawa
- Department of Orthopaedics, Saiseikai Suita Hospital, Osaka, Japan
| | - Daiki Kobayashi
- Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Shinpei Fukuda
- Department of Health Promoting and Geriatric Acupuncture and Moxibustion, Meiji University of Integrative Medicine, Kyoto, Japan
| | - Koichi Iwasa
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiyuki Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Ritei Uehara
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
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11
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Teng Z, Zhu Y, Yu X, Liu J, Long Q, Zeng Y, Lu S. An analysis and systematic review of sarcopenia increasing osteopenia risk. PLoS One 2021; 16:e0250437. [PMID: 33909650 PMCID: PMC8081219 DOI: 10.1371/journal.pone.0250437] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/07/2021] [Indexed: 12/11/2022] Open
Abstract
Sarcopenia is a progressive generalized skeletal muscle disorder, which may increase the risk of osteopenia. The aim of this study was to systematically review studies on the association between sarcopenia and osteopenia by pooled analysis. The PubMed and Embase databases were searched from inception to October 2020 for studies focusing on the association between sarcopenia and osteopenia. Two reviewers independently extracted data and assessed study quality. A pooled analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) using random-effects models. Subgroup analysis was conducted to explore the source of heterogeneity and the stability of outcome. A total of 25 independent studies involving 47,744 participants fulfilled the inclusion criteria. Sarcopenia significantly increased the risk of osteopenia (OR, 2.08; 95% CI, 1.66–2.60); Sensitivity analyses indicated the outcome was stable. Subgroup analyses showed that sarcopenia significantly increased osteopenia risk in each subgroup. No evidence of publication bias among the studies existed. In this study, our findings showed that sarcopenia significantly increased the risk of osteopenia. Thus, we suggest that sarcopenia can be a predictor of osteopenia risk.
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Affiliation(s)
- Zhaowei Teng
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
- Yunnan Key Laboratory of Digital Orthopedics, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Yun Zhu
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Xiaochao Yu
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Jie Liu
- Yunnan Key Laboratory of Digital Orthopedics, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Qing Long
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Yong Zeng
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
- * E-mail: (YZ); (SL)
| | - Sheng Lu
- Yunnan Key Laboratory of Digital Orthopedics, The First People’s Hospital of Yunnan Province, Kunming, China
- * E-mail: (YZ); (SL)
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12
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Moriwaki K, Matsumoto H, Tanimura C, Osaki M, Nagashima H, Hagino H. Urinary pentosidine level is associated with grip strength and gait speed in community-dwelling adults: a cross-sectional study. BMC Musculoskelet Disord 2021; 22:392. [PMID: 33902533 PMCID: PMC8077690 DOI: 10.1186/s12891-021-04279-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 04/20/2021] [Indexed: 01/22/2023] Open
Abstract
Background Muscle and bone interactions might be associated with osteoporosis and sarcopenia. Urinary pentosidine and serum 25-hydroxyvitamin D (25(OH)D) might affect muscle and bone interactions. It is unclear whether these biomarkers are affected by age and sex or play a role in muscle and physical functions. We aimed to investigate the association between urinary pentosidine and serum 25(OH)D levels with muscle mass, muscle strength, and physical performance in community-dwelling adults. Methods Two-hundred and fifty-four middle-aged and elderly adults were enrolled. There was no significant difference in age between 97 men (75.0 ± 8.9 years) and 157 women (73.6 ± 8.1 years). The skeletal muscle mass index (SMI), grip strength, and gait speed were assessed. The urinary pentosidine level was measured. We evaluated the association of urinary pentosidine and serum 25(OH)D levels with age and sex (student’s t-test) and correlations between biomarker and each variable (Pearson’s correlation coefficients). Multiple regression analysis was performed with grip strength and gait speed as dependent variables and with age, height, weight, body mass index (BMI), speed of sound (SOS), SMI, glycated hemoglobin (HbA1c), estimated glomerular filtration rate (eGFR), 25(OH)D, and pentosidine as independent variables using the stepwise method. Results The urinary pentosidine level was negatively correlated with grip strength, gait speed, eGFR, and insulin-like growth factor-1 (IGF-1) in men and with SOS, grip strength, and gait speed in women. The serum 25(OH)D level was positively correlated with IGF-1 in women and grip strength in men. Grip strength was associated with age, height, and pentosidine in men and height and pentosidine in women. Gait speed was associated with age, BMI, and pentosidine in men and age, height, and pentosidine in women. Conclusion Urinary pentosidine levels are significantly associated with grip strength and gait speed and may serve as a biomarker of muscle and bone interactions.
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Affiliation(s)
- Kenta Moriwaki
- Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Nishicho 36-1, Yonago, Tottori, 683-8504, Japan. .,Department of Orthopedic Surgery, Misasa Onsen Hospital, Yamada 690Misasa, Tottori, 682-0122, Japan.
| | - Hiromi Matsumoto
- Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Matsushima 288, Kurashiki, Okayama, 701-0193, Japan
| | - Chika Tanimura
- School of Health Science, Faculty of Medicine, Tottori University, Nishicho 86, Yonago, Tottori, 683-8504, Japan
| | - Mari Osaki
- Rehabilitation Division, Tottori University Hospital, Nishicho 36-1, Yonago, Tottori, 683-8504, Japan
| | - Hideki Nagashima
- Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Nishicho 36-1, Yonago, Tottori, 683-8504, Japan
| | - Hiroshi Hagino
- School of Health Science, Faculty of Medicine, Tottori University, Nishicho 86, Yonago, Tottori, 683-8504, Japan.,Rehabilitation Division, Tottori University Hospital, Nishicho 36-1, Yonago, Tottori, 683-8504, Japan
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13
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Chen YF, Zong HX, Xu SQ, Chu YR, Wang JX, Li WJ, Chen KM. Synergistic effect of sarcopenia and poor balance on osteoporotic vertebral fracture in Chinese patients with rheumatoid arthritis. Clin Rheumatol 2021; 40:3627-3637. [PMID: 33774766 DOI: 10.1007/s10067-021-05703-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/13/2021] [Accepted: 03/16/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES This study aimed to investigate the synergistic effect of sarcopenia and poor balance on osteoporotic vertebral fracture (VOPF) in Chinese patients with rheumatoid arthritis (RA). METHODS A total of 238 RA patients and 158 normal subjects were enrolled in the case-control study. Poor balance capability (Berg balance scale (BBS) score < 40) and sarcopenia (skeletal muscle mass index (SMI) <7.0 (male)/5.7 (female)) between RA patients and normal subjects were compared. Associations of poor balance capability or sarcopenia with disease activity, structural damage, and joint function in different groups were also investigated. RESULTS The incidence of sarcopenia in RA was 58.4%, significantly higher than that in controls (P<0.0001). Moreover, the percentages of low balance capacity (BBS<40) in RA were 43.7%, which was higher than that in controls (P<0.0001). The prevalence of VOPF in the case group was 19.3%, which was higher than that in the controls (P<0.0001). In the RA group, compared to RA patients without VOPF, RA patients with VOPF had higher percentages of poor balance and sarcopenia (P<0.05). Compared with RA patients without sarcopenia or good balance, RA patients with sarcopenia or poor balance had a higher incidence of VOPF, higher disease activity, severer structural damage, and worse joint function (P<0.05). The incidence of VOPF in patients combined with good balance and non-sarcopenia (4.8%) was significantly lower than that in patients combined with poor balance and sarcopenia (38.2%) (P<0.0001). Logistic regression indicated that higher SMI and higher BBS scores were protective factors for VOPF in RA patients, while age was a risk factor for VOPF in RA patients (P<0.0001). CONCLUSION Sarcopenia and poor balance are popular in Chinese patients with RA, and they are associated with disease activity and structural damage. There is a synergistic effect of sarcopenia and poor balance on VOPF in RA. Key Points • Sarcopenia and balance capability were popular (about a half) in patients with RA. • Sarcopenia and poor balance had a synergistic effect on VOPF in RA.
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Affiliation(s)
- Yang-Fan Chen
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China
| | - He-Xiang Zong
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China
| | - Sheng-Qian Xu
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China.
| | - Yi-Ran Chu
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China
| | - Jian-Xiong Wang
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China
| | - Wan-Jun Li
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China
| | - Ke-Ming Chen
- Department of Rheumatology and Immunology, The First Affiliated hospital of Anhui Medical University, NO.218, Ji-xi Road, Hefei, 230022, China
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14
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Seo MW, Jung SW, Kim SW, Jung HC, Kim DY, Song JK. Comparisons of Muscle Quality and Muscle Growth Factor Between Sarcopenic and Non-Sarcopenic Older Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186581. [PMID: 32927586 PMCID: PMC7558172 DOI: 10.3390/ijerph17186581] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 12/25/2022]
Abstract
Sarcopenia, an age-related disease, is one of the important health problems in the elderly and the prevalence of sarcopenia is rapidly increased among the Korean population. This study examined the muscle quality and muscle growth factors of elderly women to identify the potential diagnostic tool for sarcopenia. One hundred and thirty-six elderly women, aged over 65 years old, initially enrolled, but only 59 participants who met the criteria (sarcopenic group, n = 27; non-sarcopenic group, n = 32) completed the study. Muscle quality assessment included thigh cross-sectional computed tomography scan and maximal isometric muscle strength. Muscle growth factors such as GDF-15, myostatin, activin A, and follistatin were analyzed, and a battery of Senior Fitness Test was used to examine functional fitness. The statistical significance level was set at 0.05. Elderly women with sarcopenia had a lower thigh muscle volume (-20.1%), and a higher thigh intermuscular adipose tissue (15.8%) than those of the non-sarcopenic group (p < 0.05). However, no significant differences in muscle growth factors were observed between the groups. Muscle quality variables including maximal voluntary isometric contraction (OR: 0.968, p < 0.001), relative maximal voluntary isometric contraction (OR: 0.989, p < 0.05), thigh muscle volume (OR: 0.836, p < 0.001), and thigh intermuscular adipose tissue (OR: 1.138, p < 0.05) were associated with a risk of sarcopenia. Our findings suggest that the sarcopenic group exhibits a poor thigh muscle quality in comparison with the non-sarcopenic group. Muscle quality assessment can be utilized for sarcopenia identification, but our study remains inconclusive for the causality of muscle growth factors in sarcopenia.
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Affiliation(s)
- Myong-Won Seo
- Department of Taekwondo, College of Physical Education, Kyung Hee University, 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014, Korea;
| | - Sung-Woo Jung
- Department of Physical Education, Graduate School, Kyung Hee University, 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014, Korea; (S.-W.J.); (S.-W.K.)
| | - Sung-Woo Kim
- Department of Physical Education, Graduate School, Kyung Hee University, 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014, Korea; (S.-W.J.); (S.-W.K.)
| | - Hyun Chul Jung
- Department of Coaching, College of Physical Education, Kyung Hee University, 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014, Korea;
| | - Deog-Yoon Kim
- Department of Nuclear Medicine, Kyung Hee University School of Medicine, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea;
| | - Jong Kook Song
- Department of Sports & Science, Graduate School of Physical Education, Kyung Hee University, 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014, Korea
- Correspondence: ; Tel.: +82-31-201-2708
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15
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Wang WF, Lin CW, Xie CN, Liu HT, Zhu MY, Huang KL, Teng HL. The association between sarcopenia and osteoporotic vertebral compression refractures. Osteoporos Int 2019; 30:2459-2467. [PMID: 31482304 DOI: 10.1007/s00198-019-05144-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 08/21/2019] [Indexed: 12/24/2022]
Abstract
UNLABELLED Sarcopenia was reported to be significantly associated with osteoporosis. In this study, we reported for the first time that sarcopenia was an independent risk predictor of osteoporotic vertebral compression refractures (OVCRFs). Other risk factors of OVCRFs are low bone mass density T-scores, female sex, and advanced age. INTRODUCTION The purpose of this study was to investigate the association between osteoporotic vertebral compression refractures (OVCRFs) and sarcopenia, and to identify other risk factors of OVCRFs. METHODS We evaluated 237 patients with osteoporotic vertebral compression fracture who underwent percutaneous kyphoplasty (PKP) in our hospital from August 2016 to December 2017. To diagnose sarcopenia, a cross-sectional computed tomography (CT) image at the inferior aspect of the third lumbar vertebra (L3) was selected for estimating muscle mass. Grip strength was used to assess muscle strength. Possible risk factors, such as age, sex, body mass index (BMI), bone mineral density (BMD), location of the treated vertebra, anterior-posterior ratio (AP ratio) of the fractured vertebra, cement leakage, and vacuum clefts, were assessed. The multivariable analysis was used to determine the risk factors of OVCRFs. RESULTS During the follow-up period, OVCRFs occurred in 64 (27.0%) patients. Sarcopenia was present in 48 patients (20.3%), including 21 OVCRFs and 27 non-OVCRFs patients. Sarcopenia was significantly correlated with advanced age, lower BMI, lower BMD, and hypoalbuminemia. Compared with non-sarcopenic patients, sarcopenic patients had higher OVCRFs risk. In univariate analysis, sarcopenia (p = 0.003), female (p = 0.024), advanced age (≥ 75 years; p < 0.001), lower BMD (p < 0.001), lower BMI (p = 0.01), TL junction (vertebral levels at the thoracolumbar junction) (p = 0.01), cardiopulmonary comorbidity (p = 0.042), and hypoalbuminemia (p = 0.003) were associated with OVCRFs. Multivariable analysis revealed that sarcopenia (OR 2.271; 95% CI 1.069-4.824, p = 0.033), lower BMD (OR 1.968; 95% CI 1.350-2.868, p < 0.001), advanced age (≥ 75 years; OR 2.431; 95% CI 1.246-4.744, p = 0.009), and female sex (OR 4.666; 95% CI 1.400-15.552, p = 0.012) were independent risk predictors of OVCRFs. CONCLUSIONS Sarcopenia is an independent risk predictor of osteoporotic vertebral compression refractures. Other factors affecting OVCRFs are low BMD T-scores, female sex, and advanced age.
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Affiliation(s)
- W-F Wang
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - C-W Lin
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - C-N Xie
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - H-T Liu
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - M-Y Zhu
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - K-L Huang
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - H-L Teng
- Department of Spine Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China.
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16
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Kim KM, Lim S, Oh TJ, Moon JH, Choi SH, Lim JY, Kim KW, Park KS, Jang HC. Longitudinal Changes in Muscle Mass and Strength, and Bone Mass in Older Adults: Gender-Specific Associations Between Muscle and Bone Losses. J Gerontol A Biol Sci Med Sci 2019; 73:1062-1069. [PMID: 29985994 DOI: 10.1093/gerona/glx188] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 09/28/2017] [Indexed: 12/11/2022] Open
Abstract
Background The aims of this study were to investigate the longitudinal changes in muscle and bone with aging, and to clarify the muscle-bone relationships. Methods In a community-based prospective study, a total of 172 men and 165 women aged ≥ 65 years who had performed body composition analysis and bone mineral density (BMD) by dual-energy x-ray absorptiometry at baseline and 5-year follow-up evaluations were included. Results The rate of BMD loss in total hip was significantly associated with baseline legs lean mass and loss rate of leg strength, but not with the rate of muscle mass losses in men (r = .205 in leg lean mass, r = .170 in loss rate of leg muscle strength, p < .05 respectively). However, in women, it was significantly correlated with the rate of leg lean mass loss, but not with baseline values, and the rate of loss in leg muscle strength (r = .169 in the rate of loss in leg lean mass, r = .246 in the rate of loss in leg muscle strength, p < .05 respectively). In multivariate analyses, the rates of decrease in leg muscle strength showed independent positive associations with loss in total hip BMD in both men and women (β = 0.023 for men and β = 0.045 for women, both p < .05 respectively). Conclusion There was a gender difference in muscle and bone mass changes with aging, and muscle-bone interactions as well. However, a longitudinal change in muscle strength was the most significant independent factor associated with bone loss for both genders.
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Affiliation(s)
- Kyoung Min Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Korea
| | - Tae Jung Oh
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Korea
| | - Jae Hoon Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Korea
| | - Jae Young Lim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Korea
| | - Kyong Soo Park
- Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Korea
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17
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Moriwaki K, Matsumoto H, Tanishima S, Tanimura C, Osaki M, Nagashima H, Hagino H. Association of serum bone- and muscle-derived factors with age, sex, body composition, and physical function in community-dwelling middle-aged and elderly adults: a cross-sectional study. BMC Musculoskelet Disord 2019; 20:276. [PMID: 31164134 PMCID: PMC6549364 DOI: 10.1186/s12891-019-2650-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 05/22/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Understanding interactions between bone and muscle based on endocrine factors may help elucidate the relationship between osteoporosis and sarcopenia. However, whether the abundance or activity of these endocrine factors is affected by age and sex or whether these factors play a causal role in bone and muscle formation and function is unclear. We aimed to evaluate the association of serum bone- and muscle-derived factors with age, sex, body composition, and physical function in community-dwelling middle-aged and elderly adults. METHODS In all, 254 residents (97 men, 157 women) participated in this cross-sectional study conducted in Japan. The calcaneal speed of sound (SOS) was evaluated by quantitative ultrasound examination. Skeletal muscle mass index (SMI) was calculated by bioelectrical impedance analysis. Grip strength was measured using a dynamometer. Gait speed was measured by optical-sensitive gait analysis. Serum sclerostin, osteocalcin (OC), insulin-like growth factor-1 (IGF-1), myostatin, and tartrate-resistant acid phosphatase-5b (TRACP-5b) concentrations were measured simultaneously. The difference by sex was determined using t test. Correlations between serum bone- and muscle-derived factors and age, BMI, SOS, SMI, grip strength, gait speed, and TRACP-5b in men and women were determined based on Pearson's correlation coefficients. Multiple regression analysis was performed using the stepwise method. RESULTS There was no significant difference with regard to age between men (75.0 ± 8.9 years) and women (73.6 ± 8.1 years). Sclerostin was significantly higher in men than in women and tended to increase with age in men; it was significantly associated with SOS and TRACP-5b levels. OC was significantly higher in women than in men and was significantly associated with TRACP-5b levels and age. IGF-1 tended to decrease with age in both sexes and was significantly associated with SOS and body mass index. Myostatin did not correlate with any assessed variables. CONCLUSIONS Sclerostin was significantly associated with sex, age, and bone metabolism, although there was no discernable relationship between serum sclerostin levels and muscle function. There was no obvious relationship between OC and muscle parameters. This study suggests that IGF-1 is an important modulator of muscle mass and function and bone metabolism in community-dwelling middle-aged and elderly adults.
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Affiliation(s)
- Kenta Moriwaki
- Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Nishicho 36-1, Yonago, Tottori, 683-8504, Japan.
| | - Hiromi Matsumoto
- Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Matsushima 288, Kurashiki, Okayama, 701-0193, Japan
| | - Shinji Tanishima
- Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Nishicho 36-1, Yonago, Tottori, 683-8504, Japan
| | - Chika Tanimura
- School of Health Science, Faculty of Medicine, Tottori University, Nishicho 86, Yonago, Tottori, 683-8504, Japan
| | - Mari Osaki
- Rehabilitation Division, Tottori University Hospital, Nishicho 36-1, Yonago, Tottori, 683-8504, Japan
| | - Hideki Nagashima
- Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Nishicho 36-1, Yonago, Tottori, 683-8504, Japan
| | - Hiroshi Hagino
- School of Health Science, Faculty of Medicine, Tottori University, Nishicho 86, Yonago, Tottori, 683-8504, Japan.,Rehabilitation Division, Tottori University Hospital, Nishicho 36-1, Yonago, Tottori, 683-8504, Japan
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18
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Mika AP, Mesfin A, Rubery PT, Molinari R, Kebaish KM, Menga EN. Proximal Junctional Kyphosis. JBJS Rev 2019; 7:e4. [DOI: 10.2106/jbjs.rvw.18.00059] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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19
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Kobayashi K, Ando K, Tsushima M, Machino M, Ota K, Morozumi M, Tanaka S, Kanbara S, Ishiguro N, Hasegawa Y, Imagama S. Predictors of presarcopenia in community-dwelling older adults: A 5-year longitudinal study. Mod Rheumatol 2019; 29:1053-1058. [PMID: 30474461 DOI: 10.1080/14397595.2018.1551171] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objectives: Sarcopenia is an aging-induced decrease in muscle mass that increases frailty and fall in elderly people. Presarcopenia corresponds to the preliminary stage of sarcopenia. The purpose of this prospective study is to examine predictors of presarcopenia in health screening.Methods: The subjects were 124 community residents aged ≥60 years (55 males, 69 females, average age 70.2 years) who attended local government health checkups in 2010 and 2015, as part of the Yakumo study, and did not have presarcopenia in 2010. Body mass index (BMI), waist and hip circumferences, grip strength, bone mineral density (BMD), 10-m gait time, back muscle strength, and stride length were measured. Presarcopenia was defined using the appendicular skeletal muscle index (arm and leg skeletal muscle mass/height2).Results: The prevalences of presarcopenia in 2015 in males and females were 21.8% (12/55) and 30.4% (21/69), respectively. BMI, grip strength, BMD, back muscle strength, and osteoporosis deteriorated significantly more in the pre-sarcopenia group (n = 33) compared with controls (n = 91; no presarcopenia in 2015). In multivariate analysis, osteoporosis (OR 3.12, 95% CI 1.07-9.09; p < .05) was significantly associated with presarcopenia after 5 years.Conclusions: Establishment of risk factors for future pre-sarcopenia may allow development of evidence-based prevention strategies for this condition.
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Affiliation(s)
- Kazuyoshi Kobayashi
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kei Ando
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mikito Tsushima
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masaaki Machino
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kyotaro Ota
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masayoshi Morozumi
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Satoshi Tanaka
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shunsuke Kanbara
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoki Ishiguro
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yukiharu Hasegawa
- Department of Rehabilitation, Kansai University of Welfare Science, Osaka, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Tachiki T, Kouda K, Dongmei N, Tamaki J, Iki M, Kitagawa J, Takahira N, Sato Y, Kajita E, Fujita Y, Yura A, Kagamimori S. Muscle strength is associated with bone health independently of muscle mass in postmenopausal women: the Japanese population-based osteoporosis study. J Bone Miner Metab 2019; 37:53-59. [PMID: 29282553 DOI: 10.1007/s00774-017-0895-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/30/2017] [Indexed: 12/18/2022]
Abstract
There are conflicting reports on whether muscle strength is associated with bone mineral density (BMD) independently of muscle mass. Here, we examined the association between muscle strength and BMD in a representative population of Japanese women. Cross-sectional data from 680 postmenopausal women, who were participants in the 15th-year follow-up survey of the Japanese Population-based Osteoporosis cohort study, were analyzed. Areal BMD (aBMD) at the femoral neck and lumbar spine, whole-body bone mineral density, and appendicular skeletal muscle mass (ASM, kg) were measured by dual-energy X-ray absorptiometry. The ASM index (ASMI, kg/m2) was calculated as ASM divided by height squared (m2). Grip strength (kg) was measured as an indicator of muscle strength. Grip strength showed significantly (P < 0.05) positive relationships with aBMDs at several skeletal sites after adjusting for ASMI and age (standardized partial regression coefficient (β) = 0.102 at femoral neck, β = 0.126 at lumbar spine). Adjusted means of aBMD at the femoral neck and lumbar spine showed significant increasing trends from the lowest to highest tertile of grip strength. Our findings indicate that muscle strength is associated with aBMD at several sites independently of muscle mass in Japanese postmenopausal women. Thus, postmenopausal women with strong muscle strength tend to have a healthy bone status regardless of muscle size.
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Affiliation(s)
- Takahiro Tachiki
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Katsuyasu Kouda
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Namiraa Dongmei
- Department of Orthopedic Medicine, Second Affiliated Hospital of Inner Mongolia Medical University, No. 1 Yingfang Road, Huimin District, Hohhot, 010030, China
| | - Junko Tamaki
- Department of Hygiene and Public Health, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, 569-8686, Japan
| | - Masayuki Iki
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, 589-8511, Japan.
| | - Jun Kitagawa
- Center for Human and Social Sciences, Kitasato University College of Liberal Arts and Sciences, 1-15-1 Kitasato, Minami, Sagamihara, 252-0373, Japan
| | - Naonobu Takahira
- Department of Rehabilitation, Kitasato University School of Allied Health Sciences, 1-15-1 Kitasato, Minami, Sagamihara, 252-0373, Japan
| | - Yuho Sato
- Department of Human Life, Jin-ai University, 3-1-1 Ohde-cho, Echizen, 915-8586, Japan
| | - Etsuko Kajita
- Department of Nursing, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi, Nagoya, 461-8673, Japan
| | - Yuki Fujita
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Akiko Yura
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, 589-8511, Japan
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The effect of muscle ageing and sarcopenia on spinal segmental loads. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:2650-2659. [DOI: 10.1007/s00586-018-5729-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/09/2018] [Accepted: 08/09/2018] [Indexed: 12/18/2022]
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Abstract
OBJECTIVE This study evaluated whether low bone density, a condition related to aging, is associated with low muscle mass, a surrogate for sarcopenia, and whether it could be used as a marker of the condition. METHODS We studied 483 women aged 35 to 69 years old who appeared healthy and attended a preventive gynecological examination. Dual-energy X-ray absorptiometry was used to measure bone mineral density (BMD) and regional body composition. BMD was assessed using the T-score. Low appendicular lean mass (aLM) adjusted by height (aLM index) was defined according to Baumgartner et al (<5.45 kg/m). The association of low aLM index with bone mass was evaluated with a binary logistic regression using a cutoff point on the receiver operating characteristic curves for the T-score of -1.5. RESULTS The participants had a mean age of 54.7 ± 9.1 years, body mass index of 24.6 ± 3.6 kg/m, aLM index of 5.9 ± 0.6 kg/m (22.6% showed sarcopenia), abdominal fat percentage of 44.0 ± 9.1%, and T-score of -0.48 ± 0.97. In the logistic regression model, we found that low BMD implied a significant risk for sarcopenia (odds ratio [OR] 1.77; 95% CI, 1.02-3.06). In contrast, excess body weight was a protective factor (OR 0.12; 95% CI, 0.06-0.25). Neither age nor abdominal fat percentage, however, influenced the likelihood of sarcopenia in these women. CONCLUSIONS A BMD T-score below -1.5 suggests low muscle mass in middle-aged women, which is a central element in the diagnosis of sarcopenia. Early diagnosis provides the opportunity to introduce preventive and therapeutic options.
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Kim KM, Lee EY, Lim S, Jang HC, Kim CO. Favorable effects of skeletal muscle on bone are distinguished according to gender and skeletal sites. Osteoporos Sarcopenia 2016; 3:32-36. [PMID: 30775500 PMCID: PMC6372766 DOI: 10.1016/j.afos.2016.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 10/31/2016] [Accepted: 11/08/2016] [Indexed: 01/21/2023] Open
Abstract
Objectives The aim of this study was to investigate associations between skeletal muscle mass and bone mineral density according to gender and skeletal sites. Methods Using the data from Korean National Health and Nutrition Examination Survey (KNHANES IV) 2009, a total of 711 males and 847 females over 65 years of age were evaluated. Bone mineral density (BMD) and body composition were assessed using dual-energy X-ray absorptiometry. Results Relative appendicular skeletal muscle (RASM) was positively related with the femur BMD with a stronger relationship in males (r = 0.207, p < 0.001) than in females (r = 0.095, p < 0.05). However, lumbar spine BMDs in both males and females did not show any significant associations with the RASM value. In the logistic regression for osteoporosis expressed as a decrease of risk per increase of RASM by 1 standard deviation (SD) of the same sex healthy reference group, the age- and BMI-adjusted odds ratio (OR) for osteoporosis was 0.42 (95% CI 0.12–0.76) in the femur neck and 0.24 (95% CI 0.07–0.76) in the total hip for males. Among females, the age- and BMI-adjusted OR for osteoporosis was 0.65 (95% CI 0.33–1.00), which showed importance only in the total hip. Conclusions Higher RASM was significantly associated with lower risk for osteoporosis and the areas at the femur neck and total hip appeared to more likely be affected positively by muscle. Moreover, because males showed faster muscle loss with aging than females, the bones of males may be more prone to favorable effects of muscle.
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Affiliation(s)
- Kyoung Min Kim
- Division of Endocrinology, Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, South Korea.,Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Young Lee
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Soo Lim
- Division of Endocrinology, Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, South Korea
| | - Hak-Chul Jang
- Division of Endocrinology, Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, South Korea
| | - Chang-Oh Kim
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
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Sarcopenia as an Independent Risk Factor for Decreased BMD in COPD Patients: Korean National Health and Nutrition Examination Surveys IV and V (2008-2011). PLoS One 2016; 11:e0164303. [PMID: 27749901 PMCID: PMC5066961 DOI: 10.1371/journal.pone.0164303] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 09/22/2016] [Indexed: 11/19/2022] Open
Abstract
Background A decrease in bone mineral density (BMD) is a systemic consequence of chronic obstructive pulmonary disease (COPD). Past reports have rarely examined any correlation between sarcopenia and BMD. We investigated the relationship cross-sectionally between the presence of sarcopenia and BMD reduction in COPD patients. Methods COPD patients aged 50 or older with qualifying spirometry and dual-energy X-ray absorptiometry data were from participants in the Korean National Health and Nutrition Examination Surveys IV and V (2008–2011). Results There were 286 (33.3%) subjects in the sarcopenia group and 572 (66.7%) in the non-sarcopenia group. The sarcopenia group had lower T-scores than the non-sarcopenia group (femur: -0.73±0.88 vs. -0.18±0.97, p < 0.001; femur neck: -1.44±0.98 vs. -0.99±1.06, p < 0.001; lumbar: -1.38±1.36 vs. -0.84±1.38, p < 0.001). The prevalences of osteopenia and osteoporosis were 60.8% and 22.0%, respectively, in the sarcopenia group and 45.6% and 13.3% in the non-sarcopenia group (both p < 0.001). After adjusting for multiple variables, the presence of sarcopenia associated with increased the risk of osteopenia, osteoporosis, and a low BMD (OR = 3.227, 95% CI = 2.125–4.899, p < 0.001, OR = 6.952, 95% CI = 3.418–14.139, p < 0.001, and OR = 3.495, 95% CI = 2.315–5.278, p < 0.001, respectively). In a subgroup analysis, similar OR changes were confirmed in the high-body-weight group (n = 493) (OR = 2.248, 95% CI = 1.084–4.665, p = 0.030, OR = 4.621, 95% CI = 1.167–18.291, p = 0.029, and OR = 2.376, 95% CI = 1.158–4.877, p = 0.018, respectively). Conclusions The presence of sarcopenia was associated with increased the risk for decreased BMD in COPD.
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Rotator cuff tear and sarcopenia: are these related? J Shoulder Elbow Surg 2016; 25:e249-55. [PMID: 27083579 DOI: 10.1016/j.jse.2016.02.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 01/29/2016] [Accepted: 02/12/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND Sarcopenia is the loss of muscle mass and consequent loss of muscle function with aging. Its prevalence among the general population is 12% to 30% in those aged >60 years. We evaluated (1) the difference in the prevalence of sarcopenia between patients with rotator cuff tear and controls and (2) the sarcopenia severity according to the size of the rotator cuff tear. METHODS Group 1 included 48 consecutive patients with chronic symptomatic full-thickness rotator cuff tears (mean age, 60.1 ± 6.5 years; range, 46-76 years), and group 2 included 48 age- and sex-matched patients. The sarcopenic index was evaluated by using the grip strength of the asymptomatic contralateral side and the skeletal muscle mass. RESULTS No significant differences were found in the baseline data and demographic factors between the groups. The sarcopenic index was significantly inferior in the rotator cuff tear group than in the age- and sex-matched control groups (P = .041, .007, and .05, respectively). Patients with large to massive tears had a significantly inferior sarcopenic index than those with small and medium tears. CONCLUSION The results showed that sarcopenia was more severe in patients with a chronic symptomatic full-thickness rotator cuff tear than in the age- and sex-matched control population and was correlated with the size of the tear, with the numbers available. Despite the individual variance in the underlying medical condition and physical activities, this study suggests that clinicians should consider the sarcopenic condition of patients with a rotator cuff tear, especially in elderly patients with large to massive tears.
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The Association between Total Protein and Vegetable Protein Intake and Low Muscle Mass among the Community-Dwelling Elderly Population in Northern Taiwan. Nutrients 2016; 8:nu8060373. [PMID: 27322317 PMCID: PMC4924214 DOI: 10.3390/nu8060373] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 06/02/2016] [Accepted: 06/08/2016] [Indexed: 12/21/2022] Open
Abstract
Sarcopenia, highly linked with fall, frailty, and disease burden, is an emerging problem in aging society. Higher protein intake has been suggested to maintain nitrogen balance. Our objective was to investigate whether pre-sarcopenia status was associated with lower protein intake. A total of 327 community-dwelling elderly people were recruited for a cross-sectional study. We adopted the multivariate nutrient density model to identify associations between low muscle mass and dietary protein intake. The general linear regression models were applied to estimate skeletal muscle mass index across the quartiles of total protein and vegetable protein density. Participants with diets in the lowest quartile of total protein density (<13.2%) were at a higher risk for low muscle mass (odds ratio (OR) 3.03, 95% confidence interval (CI) 1.37–6.72) than those with diets in the highest quartile (≥17.2%). Similarly, participants with diets in the lowest quartile of vegetable protein density (<5.8%) were at a higher risk for low muscle mass (OR 2.34, 95% CI 1.14–4.83) than those with diets in the highest quartile (≥9.4%). Furthermore, the estimated skeletal muscle mass index increased significantly across the quartiles of total protein density (p = 0.023) and vegetable protein density (p = 0.025). Increasing daily intakes of total protein and vegetable protein densities appears to confer protection against pre-sarcopenia status.
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Abstract
PURPOSE OF REVIEW The interaction between fall and fracture risk factors is an area of increasing clinical relevance, but little information is known about the age-specific issues in bone health unique to HIV-infected adults. The present review will focus on what is known about falls and fall risk factors among HIV-infected adults, and then review the association between decreased muscle, increased adiposity, and frailty with both low bone mineral density (BMD) and falls. RECENT FINDINGS The rate of falls among middle-aged HIV-infected adults is similar to that of HIV-uninfected adults 65 years and older. Many of the clinical factors that contribute to low BMD overlap with risk factors for falls, resulting in a high risk of a serious fall among older adults with the greatest risk for a fracture. Low muscle mass, increased adiposity and metabolic syndrome, physical function impairment and frailty, common among older HIV-infected adults, contribute to an increased risk for low BMD and falls, and subsequently, may increase the risk of fracture among HIV-infected older adults. SUMMARY Interventions with dual benefit on reducing fall risk and improving BMD are likely to have the greatest impact on fracture prevention in the older, HIV-infected adult.
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Affiliation(s)
- Kristine M Erlandson
- aUniversity of Colorado, Aurora, Colorado, USA bUniversity of Modena and Reggio Emilia, Modena, Italy cMcGill University, Montreal, Quebec, Canada
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Pereira FB, Leite AF, de Paula AP. Relationship between pre-sarcopenia, sarcopenia and bone mineral density in elderly men. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2015; 59:59-65. [PMID: 25926116 DOI: 10.1590/2359-3997000000011] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 10/10/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Analyze the influence of sarcopenia in bone health of elderly men. SUBJECTS AND METHODS This cross-sectional study evaluated 198 men aged over 60 years. Body composition was measured by dual energy X-ray absorptiometry. The BMD was measured at the femoral neck, total hip, lumbar spine and 33% radius. The diagnosis of abnormal BMD was defined for men who presented densitometric diagnosis of osteopenia or osteoporosis defined by T-score of femoral neck, total hip and lumbar spine. The pre-sarcopenia and sarcopenia were defined according to the European Working Group on Sarcopenia in Older People. RESULTS The group diagnosed with normal BMD, compared to the group of abnormal BMD, have significantly higher body weight, body mass index, grip strength, lean mass, fat mass, and relative appendicular skeletal muscle mass (RASM). However, after multiple linear regression analysis, we found that only the RASM, lean mass, and handgrip strength in the dominant hand influenced the variability of the BMD after adjustment for age and weight. Regression analyzes showed a positive association between greater appendicular lean mass and a smaller number of elderly patients with abnormal BMD diagnostic. The regression analyzes showed that elderly men diagnosed with pre-sarcopenia and sarcopenia had more abnormal BMD than non-sarcopenic elderly men. CONCLUSION We concluded that pre-sarcopenia and sarcopenia were associated with abnormal BMD. The lean mass, compared to fat mass, has a greater positive influence on the BMD of elderly men. This result suggests the importance of the increase in lean mass for the bone health of elderly men.
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Sarcopenia and sarcopenic leg as potential risk factors for acute osteoporotic vertebral fracture among older women. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 25:3424-3431. [DOI: 10.1007/s00586-015-3805-5] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 02/07/2015] [Accepted: 02/08/2015] [Indexed: 12/25/2022]
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Chen YL, Yang KC, Chang HH, Lee LT, Lu CW, Huang KC. Low serum selenium level is associated with low muscle mass in the community-dwelling elderly. J Am Med Dir Assoc 2014; 15:807-11. [PMID: 25112230 DOI: 10.1016/j.jamda.2014.06.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 06/14/2014] [Accepted: 06/19/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Elderly persons with low muscle mass (LMM) or sarcopenia are prone to frailty and functional decline. This study aimed to investigate the relationship between serum selenium level and skeletal muscle mass in community-dwelling elderly. DESIGN Cross-sectional observational study. SETTING AND PARTICIPANTS A total of 327 elderly Taipei citizens (mean age 71.5 ± 4.7 years) were recruited from the community. MEASUREMENTS Skeletal muscle mass was measured by bioelectrical impedance analysis. LMM was defined by low skeletal muscle index (SMI: muscle mass (kg)/[height (m)](2)). All participants were further divided into quartiles by serum selenium level and the risk for LMM among these quartiles was examined using multivariate logistic regression analyses. Estimated serum selenium levels for the LMM group vs the normal group and estimated SMI in the quartiles of serum selenium were computed by least square method in linear regression models. RESULTS The estimated mean (±standard deviation) of serum selenium level was significantly lower in the LMM group compared with the normal group after adjusting for confounders (1.01 ± 0.03 μmol/L vs 1.14 ± 0.02 μmol/L, P < .001). After adjusting for age, sex, lifestyle, and physical and metabolic factors, the odds ratios (95% confidence interval, P value) of LMM in the bottom, second, and third selenium quartile groups were 4.62 (95% CI 2.11-10.10, P < .001), 2.30 (95% CI 1.05-5.03, P < .05) and 1.51 (95% CI 0.66-3.46, P = .327), respectively, compared with the top quartile group of serum selenium level. The least square mean of SMI increased with the quartiles of serum selenium (P < .001). CONCLUSIONS This is the first study to demonstrate that low serum selenium is independently associated with low muscle mass in the elderly. The causality and underlying mechanism between selenium and low muscle mass or sarcopenia warrant further research.
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Affiliation(s)
- You-Ling Chen
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuen-Cheh Yang
- Department of Community and Family Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
| | - Hao-Hsiang Chang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Long-Teng Lee
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Wen Lu
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
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Hida T, Harada A, Imagama S, Ishiguro N. Managing sarcopenia and its related-fractures to improve quality of life in geriatric populations. Aging Dis 2014; 5:226-37. [PMID: 25110607 DOI: 10.14336/ad.2014.0500226] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 11/19/2013] [Accepted: 11/24/2013] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia, an aging-induced generalized decrease in muscle mass, strength, and function, is known to affect elderly individuals by decreasing mobile function and increasing frailty and imbalance that lead to falls and fragile fractures. Sarcopenia is a known risk factor for osteoporotic fractures, infections, and early death in some specific situations. The number of patients with sarcopenia is estimated to increase to 500 million people in the year 2050. Sarcopenia is believed to be caused by multiple factors such as disuse, malnutrition, age-related cellular changes, apoptosis, and genetic predisposition; however, this remains to be determined. Various methods have been developed, but no safe or effective treatment has been found to date. This paper is a review on the association between sarcopenia and its related-fractures and their diagnoses and management methods to prevent fractures.
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Affiliation(s)
| | - Atsushi Harada
- Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine
| | - Naoki Ishiguro
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine
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Armamento-Villareal R, Aguirre L, Napoli N, Shah K, Hilton T, Sinacore DR, Qualls C, Villareal DT. Changes in thigh muscle volume predict bone mineral density response to lifestyle therapy in frail, obese older adults. Osteoporos Int 2014; 25:551-8. [PMID: 23892583 PMCID: PMC3903658 DOI: 10.1007/s00198-013-2450-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 06/14/2013] [Indexed: 12/14/2022]
Abstract
UNLABELLED We studied the relationships among strength, muscle mass, and bone mineral density (BMD) with lifestyle change. Lifestyle therapy consisted of exercise, diet, and diet plus exercise. Diet was by caloric restriction to induce and maintain a weight loss of 10 % from baseline body weight. Exercise attenuated weight loss-induced muscle and bone losses. Exercise improved strength despite muscle loss in patients on diet and exercise. Changes in strength did not correlate with changes in BMD. However, changes in thigh muscle volume correlated with, and predicted changes in hip BMD. INTRODUCTION Losses of hip BMD and lean body mass are major complications of lifestyle therapy in frail, obese older adults; however, the contribution of mechanical strain loss from muscle loss is poorly defined. We determined the effect of changes in thigh muscle volume and muscle strength on BMD in frail, obese older adults undergoing lifestyle therapy aimed at intentional weight loss with or without exercise. METHODS One hundred seven obese older adults were randomized to control, diet, exercise, and diet-exercise groups for 1 year. Thigh muscle volume was measured by magnetic resonance imaging, BMD by DXA, knee strength by dynamometry, total strength by one-repetition maximum (1-RM), and bone markers by immunoassay. RESULTS Thigh muscle volume decreased in the diet group (-6.2 ± 4.8 %) and increased in the exercise group (2.7 ± 3.1 %), while it was not significantly different from the control in the diet-exercise group. Changes in hip BMD followed similar pattern as those in thigh muscle volume. Knee extension and flexion increased in the exercise group (23 ± 20 %; 25 ± 19 %) and diet-exercise group (20 ± 19 %; 20.6 ± 27 %) but were unchanged in the control and diet groups. Changes in thigh muscle volume correlated with changes in hip BMD (r = 0.55, P = <0.001) and were an independent predictor of changes in hip BMD (β = 0.12, P = 0.03) in the multiple regression analyses after accounting for demographic factors and changes in weight and physical activity. There were no correlations between BMD changes and knee strength, 1-RM, and sclerostin changes. CONCLUSIONS Changes in thigh muscle volume predict hip BMD changes in obese older patients undergoing lifestyle therapy. The effect of exercise in attenuating thigh muscle loss when added to diet may in part account for the reduction in weight loss-induced bone loss in the diet-exercise group.
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Affiliation(s)
- R. Armamento-Villareal
- New Mexico VA Health Care System, Albuquerque, NM, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - L. Aguirre
- New Mexico VA Health Care System, Albuquerque, NM, USA
| | - N. Napoli
- Campus Biomedico, Rome, Italy
- Washington University School of Medicine, St. Louis, MO, USA
| | - K. Shah
- University of Rochester School of Medicine, Rochester, NY, USA
| | | | - D. R. Sinacore
- Washington University School of Medicine, St. Louis, MO, USA
| | - C. Qualls
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - D. T. Villareal
- New Mexico VA Health Care System, Albuquerque, NM, USA,
- University of New Mexico School of Medicine, Albuquerque, NM, USA
- Washington University School of Medicine, St. Louis, MO, USA
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Shah K, Majeed Z, Jonason J, O'Keefe RJ. The role of muscle in bone repair: the cells, signals, and tissue responses to injury. Curr Osteoporos Rep 2013; 11:130-5. [PMID: 23591779 PMCID: PMC3698863 DOI: 10.1007/s11914-013-0146-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Bone repair is a complicated process that includes many types of cells, signaling molecules, and growth factors. Fracture healing involves a temporally and spatially regulated biologic process that involves recruitment of stem cells to the injury site, tissue specific differentiation, angiogenesis, and remodeling. In light of its proximity to bone and abundant vascularity, muscle is an important potential source of cells and signals for bone healing. More complete understanding of the role of muscle in bone formation and repair will provide new therapeutic approaches to enhance fracture healing. Recent studies establish that muscle-derived stem cells are able to differentiate into cartilage and bone and can directly participate in fracture healing. The role of muscle-derived stem cells is particularly important in fractures associated with more severe injury to the periosteum. Sarcopenia is a serious consequence of aging, and studies show a strong association between bone mass and lean muscle mass. Muscle anabolic agents may improve function and reduce the incidence of fracture with aging.
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Affiliation(s)
- Krupa Shah
- Department of Orthopedics and Rehabilitation, University of Rochester Medical Center, Box 665, 601 Elmwood Avenue, Rochester, NY 14692, USA
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Liu JM, Zhao HY, Zhao L, Chen Y, Zhang LZ, Tao B, Sun LH, Zhao YJ, Wang WQ, Xu MY, Chen JL, Ning G. An independent positive relationship between the serum total osteocalcin level and fat-free mass in healthy premenopausal women. J Clin Endocrinol Metab 2013; 98:2146-52. [PMID: 23553865 DOI: 10.1210/jc.2013-1112] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
CONTEXT It is widely reported that osteocalcin is negatively associated with fat mass. However, there are few reports describing its correlation with fat-free mass, particularly in women. OBJECTIVES The objective of the current study was to investigate the possible relationship between osteocalcin and fat-free mass in healthy, nonobese women. DESIGN AND SETTING This study was performed in a tertiary university teaching hospital. SUBJECTS A total of 504 healthy women aged 20-75 years were enrolled. MAIN OUTCOME MEASURES Body composition was measured using a bioelectronics impedance analyzer. The serum concentrations of total osteocalcin, estradiol, leptin, osteoprotegerin, the receptor activator of nuclear factor-κB ligand, IGF-I, fasting plasma glucose, and urinary N-terminal telopeptide of type I collagen were tested. The bone mineral densities (BMDs) at the lumbar spine and proximal femoral neck were measured by dual-energy X-ray absorptiometry. RESULTS The serum total osteocalcin level had a significant positive association with fat-free mass (r = 0.168, P = .007) after adjusting for age, fat mass, menopausal status, estradiol, fasting glucose, leptin, osteoprotegerin, receptor activator of nuclear factor-κB ligand, IGF-I, N-terminal telopeptide of type I collagen, BMDs, and waist and hip circumference. Analysis in pre- and postmenopausal women demonstrated that this association was only present in premenopausal women (r = 0.190, P = .005). The multiple stepwise regression analysis revealed that hip circumference, femoral neck-BMD, fat mass, leptin, osteocalcin, and age are the contributors to the changes in fat-free mass in premenopausal women (adjusted R(2) = 0.521, P < .001). CONCLUSION The serum level of total osteocalcin was positively associated with fat-free mass independent of age, fat mass, leptin, and other confounders in premenopausal women.
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Affiliation(s)
- Jian-min Liu
- Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-tong University School of Medicine, 197 Rui-jin Er Road, Shanghai, China 200025
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