Muscle Strength and Physical Performance Are Associated With Risk of Postfracture Mortality But Not Subsequent Fracture in Men.
Muscle Strength and Physical Performance Are Associated With Risk of Postfracture Mortality But Not Subsequent Fracture in Men.
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DOI：
10.1002/jbmr.4619
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发表时间：
2022-08
影响因子：
6.2
通讯作者：
Center, Jacqueline R.
中科院分区：
文献类型：
--
作者：
Alajlouni, Dima A.;Bliuc, Dana;Tran, Thach S.;Blank, Robert D.;Cawthon, Peggy M.;Ensrud, Kristine E.;Lane, Nancy E.;Orwoll, Eric S.;Cauley, Jane A.;Center, Jacqueline R.
关键词：
肌肉力量和体能与骨折和死亡率相关。然而，其在随后骨折风险和骨折后死亡率中的作用尚不清楚。我们评估了830名低创伤指数骨折男性的肌肉力量（握力）和性能（步态速度和椅子站立时间）与后续骨折风险和死亡率之间的相关性，这些男性参与了美国男性骨质疏松性骨折（MrOS）研究，并在指数骨折前5年内评估了他们的指数测量值。使用线性混合效应回归估计的指数骨折后肌肉力量和性能的年度下降与死亡率的关系也进行了检查。采用校正了年龄、股骨颈骨密度（FN BMD）、既往骨折、福尔斯、体重指数（BMI）、指数骨折部位、生活方式因素和合并症的考克斯比例风险模型评估相关性。从首次骨折到后续骨折的中位随访时间为3.7年（四分位距[IQR]，1.3-8.1），201例（24%）男性发生后续骨折，死亡时间超过5.1年（IQR，1.8-9.6），536例（65%）男性死亡。指数测量与随后的骨折无关（风险比[HR]范围为0.97至1.07）。然而，它们与骨折后死亡率相关。HR（95%置信区间[CI]）每1个标准差（1-SD）下降的握力：HR 1.12（95% CI，1.01-1.25）和步态速度：HR 1.14（95% CI，1.02-1.27），椅子站立时间的1-SD增量：HR 1.08（95% CI，0.97-1.21）。这些指标的年下降幅度越大，死亡风险越高，与指数值和其他协变量无关。HR（95% CI）：握力变化每1-SD年递减：HR 1.15（95% CI，1.01-1.33），步态速度变化每1-SD年递减：HR 1.38（95% CI，1.13-1.68），椅子站立时间每1-SD年递增：HR 1.28（95% CI，1.07-1.54）。无法完成一项或多项测试的男性与完成所有测试的男性相比，骨折后死亡的风险更大（24%-109%）。这些可变因素的改善是否能降低骨折后死亡率还有待观察。版权所有© 2022作者。《骨与矿物质研究杂志》由Wiley Periodicals LLC代表美国骨与矿物质研究学会（ASBMR）出版。
Muscle strength and physical performance are associated with incident fractures and mortality. However, their role in the risk of subsequent fracture and postfracture mortality is not clear. We assessed the association between muscle strength (grip strength) and performance (gait speed and chair stands time) and the risk of subsequent fracture and mortality in 830 men with low‐trauma index fracture, who participated in the Osteoporotic Fractures in Men (MrOS) USA Study and had their index measurements assessed within 5 years prior to the index fracture. The annual decline in muscle strength and performance following index fracture, estimated using linear mixed‐effects regression, was also examined in relation to mortality. The associations were assessed using Cox proportional hazards models adjusted for age, femoral neck bone mineral density (FN BMD), prior fractures, falls, body mass index (BMI), index fracture site, lifestyle factors, and comorbidities. Over a median follow‐up of 3.7 (interquartile range [IQR], 1.3–8.1) years from index fracture to subsequent fracture, 201 (24%) men had a subsequent fracture and over 5.1 (IQR, 1.8–9.6) years to death, and 536 (65%) men died. Index measurements were not associated with subsequent fracture (hazard ratios [HRs] ranging from 0.97 to 1.07). However, they were associated with postfracture mortality. HR (95% confidence interval [CI]) per 1 standard deviation (1‐SD) decrement in grip strength: HR 1.12 (95% CI, 1.01–1.25) and gait speed: HR 1.14 (95% CI, 1.02–1.27), and 1‐SD increment in chair stands time: HR 1.08 (95% CI, 0.97–1.21). Greater annual declines in these measurements were associated with higher mortality risk, independent of the index values and other covariates. HR (95% CI) per 1‐SD annual decrement in change in grip strength: HR 1.15 (95% CI, 1.01–1.33) and in gait speed: HR 1.38 (95% CI, 1.13–1.68), and 1‐SD annual increment in chair stands time: HR 1.28 (95% CI, 1.07–1.54). Men who were unable to complete one or multiple tests had greater risk of postfracture mortality (24%–109%) compared to those performed all tests. It remains to be seen whether improvement in these modifiable factors can reduce postfracture mortality. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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