Fat Infiltration of Muscle, Diabetes, and Clinical Fracture Risk in Older Adults
Fat Infiltration of Muscle, Diabetes, and Clinical Fracture Risk in Older Adults
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DOI：
10.1210/jc.2010-0780
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发表时间：
2010-11-01
影响因子：
5.8
通讯作者：
Schwartz, Ann V.
中科院分区：
文献类型：
--
作者：
Schafer, Anne L.;Vittinghoff, Eric;Schwartz, Ann V.
内容：2型糖尿病老年人与非糖尿病成年人相比，在调整其较高的骨密度后，骨折的风险更高。脂肪浸润肌肉预示髋部骨折风险增加目的：我们研究了脂肪浸润肌肉（糖尿病成人中脂肪浸润更大）是否与所有临床骨折相关，以及它是否导致糖尿病患者骨折风险增加。设计、设置和参与者：数据分析来自健康、老龄化和身体成分研究，这是一个年龄在70-79岁之间的社区居住成年人队列。2762名参与者的基线葡萄糖代谢状态和大腿肌肉的X线衰减进行了测定。主要结果测量：在平均8.2 +/- 2.3年的随访中，331名参与者报告了至少一次临床fracture.Results：糖尿病或糖代谢受损患者的肌肉脂肪浸润高于糖代谢正常的患者（P < 0.001）。肌肉脂肪浸润与临床骨折风险增加19%独立相关（多变量风险比= 1.19; 95%置信区间= 1.04-1.36）;这种相关性在葡萄糖代谢组之间没有差异（相互作用P = 0.65）。如前所述，调整骨密度后，与正常葡萄糖代谢相比，糖尿病与更大的骨折风险相关（风险比= 1.42; 95%置信区间= 1.07-1.89），但进一步调整肌肉脂肪浸润并没有减弱这种关联。结论：肌肉脂肪浸润预测老年人临床骨折。虽然糖尿病患者肌肉的脂肪浸润更高，但这并不能解释他们骨折风险的增加。（临床内分泌代谢杂志95：E368-E372，2010）
Context: Older adults with type 2 diabetes are at higher risk for fracture compared with nondiabetic adults after adjustment for their higher bone mineral density. Infiltration of muscle by fat predicts increased risk of hip fracture.Objective: We investigated whether fat infiltration of muscle, which is greater in diabetic adults, is associated with all clinical fracture and whether it accounts for the increased fracture risk in those with diabetes.Design, Setting, and Participants: Data were analyzed from the Health, Aging, and Body Composition Study, a cohort of community-dwelling adults aged 70-79 yr. Glucose metabolism status and x-ray attenuation of thigh muscle were determined at baseline for 2762 participants.Main Outcome Measures: During a mean 8.2 +/- 2.3 yr follow-up, 331 participants reported at least one clinical fracture.Results: Fat infiltration of muscle was higher in those with diabetes or impaired glucose metabolism than in those with normal glucose metabolism (P < 0.001). Fat infiltration of muscle was independently associated with a 19% increased risk of incident clinical fracture (multivariate hazard ratio = 1.19; 95% confidence interval = 1.04-1.36); this association did not differ across glucose metabolism groups (P for interaction = 0.65). As previously reported, diabetes was associated with a greater fracture risk compared with normal glucose metabolism (hazard ratio = 1.42; 95% confidence interval = 1.07-1.89) after adjustment for bone mineral density, but further adjustment for fat infiltration of muscle did not attenuate this association.Conclusions: Fat infiltration of muscle predicts clinical fracture in older adults. Although fat infiltration of muscle is higher among those with diabetes, it does not account for their increased fracture risk. (J Clin Endocrinol Metab 95: E368-E372, 2010)