Decline in Muscle Strength and Performance Predicts Fracture Risk in Elderly Women and Men
Decline in Muscle Strength and Performance Predicts Fracture Risk in Elderly Women and Men
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DOI：
10.1210/clinem/dgaa414
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发表时间：
2020-09-01
影响因子：
5.8
通讯作者：
Center, Jacqueline R.
中科院分区：
文献类型：
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作者：
Alajlouni, Dima;Bliuc, Dana;Center, Jacqueline R.
背景：肌肉力量和表现与骨折有关。然而，他们的下降率的贡献尚不清楚。目的：评估肌肉力量和性能下降率对骨折风险的独立贡献。设计，设置和参与者：社区居住女性（n = 811）和男性（n = 440）前瞻性杜博骨质疏松流行病学研究中年龄≥ 60岁的患者，随访时间为2000年至2018年，发生骨折。每两年测量一次临床数据、非典型瘦体重/身高2（ht）2、骨矿物质密度、四头肌强度/ht（QS）、定时起身行走（TGUG）、5次重复坐立（5xSTS）和步态速度（GS）。肌肉参数的下降率采用普通最小二乘回归和骨折风险进行了评估，使用考克斯models.Main结果：事件低创伤骨折确定的X射线report.Results：除了瘦体重的妇女，所有的肌肉参数随着时间的推移下降。体能下降率更高与女性骨折风险增加相关（风险比[HR]范围从GS的2.1（95% CI：1.5-2.9）至5xSTS的2.7（95% CI：1.9-3.6），而在男性中，仅GS下降与骨折风险相关（HR：3.4 [95% CI：1.8-6.3]）。基线性能和强度也与男性骨折风险增加（HR范围从1.8（95%CI：1.1-3.0）为QS到2.5（95%CI：1.5-4.1）为TGUG，但不是在women.Conclusion：率下降的身体表现在两种性别，基线强度和性能的男性，独立骨折风险。坐位站立和GS是与骨折最相关的测试。需要进一步的研究来确定肌肉力量和/或性能是否提高骨折预测模型的预测准确性。
Context: Muscle strength and performance are associated with fractures. However, the contribution of their rate of decline is unclear.Objective: To assess the independent contribution of the rate of decline in muscle strength and performance to fracture risk.Design, Setting, and Participants: Community-dwelling women (n = 811) and men (n = 440) aged 60 years or older from the prospective Dubbo Osteoporosis Epidemiology Study followed from 2000 to 2018 for incident fracture. Clinical data, appendicular lean mass/height2 (ht)2, bone mineral density, quadricep strength/ht (QS), timed get-up-and-go (TGUG), 5 times repeated sit-to-stand (5xSTS), and gait speed (GS) measured biennially. Rates of decline in muscle parameters were calculated using ordinary least squares regression and fracture risk was assessed using Cox's models.Main Outcome: Incident low-trauma fracture ascertained by x-ray report.Results: Apart from lean mass in women, all muscle parameters declined over time. Greater rates of decline in physical performance were associated with increased fracture risk in women (Hazard ratios [HRs] ranging from 2.1 (95% CI: 1.5-2.9) for GS to 2.7 (95% CI: 1.9-3.6) for 5xSTS, while in men only the decline in GS was associated with fracture risk (HR: 3.4 [95% CI: 1.8-6.3]). Baseline performance and strength were also associated with increased fracture risk in men (HRs ranging from 1.8 (95% CI: 1.1-3.0) for QS to 2.5 (95% CI: 1.5-4.1) for TGUG, but not in women.Conclusion: Rate of decline in physical performance in both genders, and baseline strength and performance in men, contributed independently to fracture risk. Sit-to-stand and GS were the tests most consistently associated with fractures. Further studies are required to determine whether muscle strength and/or performance improve the predictive accuracy of fracture prediction models.