Osteoporosis and sarcopenia in older age.
Osteoporosis and sarcopenia in older age.
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DOI：
10.1016/j.bone.2015.04.016
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发表时间：
2015-11
期刊：
影响因子：
4.1
通讯作者：
Cooper C
中科院分区：
文献类型：
--
作者：
Edwards MH;Dennison EM;Aihie Sayer A;Fielding R;Cooper C
骨质疏松症和骨质疏松症在老年人中很常见，并与显著的发病率和死亡率有关。因此，它们都面临着相当大的社会经济负担。世界卫生组织(WHO)于1994年将骨质疏松症定义为骨密度低于特定性别年轻人平均水平的2.5标准差，这一特征已在全球范围内采用。随后，当骨密度被纳入骨折风险预测算法时，又向前迈进了一步，例如也由世界卫生组织开发的骨折风险评估工具(FRAX®)。相比之下，对于骨质疏松症提出了几个诊断标准，最初只与低肌肉质量有关，最近又与低肌肉质量和肌肉功能有关。然而，这些都没有被普遍接受。这导致了在准确描述疾病负担、探索地理差异以及招募合适的受试者进行临床试验方面的困难。在药物试验中，石棺减少的改善应该如何衡量，也存在不确定性。这些困难的原因包括可获得的肌肉健康方面的数量，例如质量、力量、功能和表现，以及与骨质疏松症相关的各种临床结果，如跌倒、骨折、残疾和过早死亡。当务之急是尽快达成对石棺减少的普遍定义，以促进对这一令人衰弱的疾病的研究取得更大进展。
Osteoporosis and sarcopenia are common in older age and associated with significant morbidity and mortality. Consequently, they are both attended by a considerable socioeconomic burden. Osteoporosis was defined by the World Health Organisation (WHO) in 1994 as a bone mineral density of less than 2.5 standard deviations below the sex-specific young adult mean and this characterisation has been adopted globally. Subsequently, a further step forward was taken when bone mineral density was incorporated into fracture risk prediction algorithms, such as the Fracture Risk Assessment Tool (FRAX®) also developed by the WHO. In contrast, for sarcopenia there have been several diagnostic criteria suggested, initially relating to low muscle mass alone and more recently low muscle mass and muscle function. However, none of these have been universally accepted. This has led to difficulties in accurately delineating the burden of disease, exploring geographic differences, and recruiting appropriate subjects to clinical trials. There is also uncertainty about how improvement in sarcopenia should be measured in pharmaceutical trials. Reasons for these difficulties including the number of facets of muscle health available, e.g. mass, strength, function, and performance, and the various clinical outcomes to which sarcopenia can be related such as falls, fracture, disability and premature mortality. It is imperative that a universal definition of sarcopenia is reached soon to facilitate greater progress in research into this debilitating condition.