Risk factors predicting osteosarcopenia in postmenopausal women with osteoporosis: A retrospective study
Risk factors predicting osteosarcopenia in postmenopausal women with osteoporosis: A retrospective study
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DOI：
10.1371/journal.pone.0237454
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发表时间：
2020-08-07
期刊：
影响因子：
3.7
通讯作者：
Inagaki, Katsunori
中科院分区：
文献类型：
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作者：
Okamura, Hiroki;Ishikawa, Koji;Inagaki, Katsunori
随着骨质疏松症和肌肉减少症的共存加剧了不良后果，对“骨减少症”的兴趣越来越大。然而，关于骨质疏松症患者发生骨质疏松症的危险因素的信息有限。因此，我们回顾性分析了276例绝经后骨质疏松症患者定期访问昭和大学医院。如果患者年龄≥ 65岁，并接受双能X线吸收测定法、血液采样和体能评估，则符合研究条件。根据亚洲少肌症工作组的诊断标准，将患者分为少肌症组和单纯骨质疏松组。在276例骨质疏松症患者中，54例（19.6%）有骨质疏松症。骨质疏松组患者比单纯骨质疏松组患者有更大的虚弱风险（比值比2.33; 95%可信区间，1.13-4.80，P = 0.028）。低体重指数似乎是与骨质疏松症发展相关的最强因素，骨质疏松症组中没有患者肥胖（BMI >= 27.5 kg/m2）。多项logistic分析显示，患有肾功能不全和HbA 1c水平高等合并症的65-74岁患者有发生骨质疏松症的风险。因此，我们强烈建议在骨质疏松症门诊中对低体重指数患者进行骨减少症诊断的关键组成部分的评估。此外，适当的评估，包括合并症，将有助于确定患者发生骨质疏松症的风险更大。
There is growing interest in "osteosarcopenia" as the coexistence of osteoporosis and sarcopenia exacerbates negative outcomes. However, limited information is available regarding the risk factors of osteosarcopenia development in patients with osteoporosis. Therefore, we retrospectively reviewed 276 consecutive patients with postmenopausal osteoporosis who regularly visited Showa University Hospital. Patients were eligible for the study if they were >= 65 years of age and underwent dual-energy X-ray absorptiometry, blood sampling, and physical performance assessment. Patients were divided into the osteosarcopenia and osteoporosis alone groups according to the diagnostic criteria of the Asian Working Group for Sarcopenia. Of the 276 patients with osteoporosis, 54 patients (19.6%) had osteosarcopenia. Patients in the osteosarcopenia group had a greater risk of frailty than did those in the osteoporosis alone group (odds ratio 2.33; 95% confidence interval, 1.13-4.80, P = 0.028). Low body mass index seemed to be the strongest factor related to the development of osteosarcopenia, and none of the patients in the osteosarcopenia group were obese (BMI >= 27.5 kg/m(2)). Multiple logistic analyses revealed that patients aged 65-74 years who had comorbidities such as kidney dysfunction and high levels of HbA1c were at risk of developing osteosarcopenia. Thus, we strongly recommend the assessment of the key components of the diagnosis of osteosarcopenia in an osteoporosis clinic for patients with low body mass index. Furthermore, appropriate assessments, including comorbidities, will help in identifying patients at greater risk of developing osteosarcopenia.