Osteoporosis and Sarcopenia最新文献

英文中文

Foot and knee deformities in relation to functional limitations and incident osteoarthritis: A prospective cohort study 足部和膝部畸形与功能限制和骨关节炎的关系：前瞻性队列研究

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-09-01 DOI: 10.1016/j.afos.2024.08.002

Objectives

This study aimed to investigate the relationships of foot and leg symptoms, structure, and function with functional limitations and osteoarthritis (OA).

Methods

We included 1253 participants (mean age 58.1 years) from the Hong Kong Osteoporosis Study who completed an examination on foot posture, function, pain, and presence of deformities such as hallux valgus and varus knee. Using logistic regression, we estimated cross-sectional associations of each foot and knee problem with functional outcomes (slow walking speed, self-reported falls, and functional limitations) and OA. Through linkage to electronic health records, we further examined their associations with incident OA over 8 years using Cox models. All models were adjusted for age, sex, and body mass index.

Results

The prevalence of hallux valgus, foot pain, and varus knee were 33.1%, 35.1%, and 25.8%, respectively. Planus foot posture was associated with varus knee, and pronated foot function was associated with hallux valgus. Of the assessed foot problems, only foot pain showed significant associations with functional outcomes, including functional limitations and recurrent falls. Foot pain was also associated with prevalent OA at baseline but not incident OA. Meanwhile, we observed a 3-times increased risk of incident OA associated with varus knee (95% CI = 1.48–6.10), and this association was particularly seen in older adults, women, and obese individuals.

Conclusions

In community-dwelling Chinese adults, foot pain, but not the reported foot deformities, is associated with functional limitations and falls, while varus knee is associated with incident OA.

方法我们纳入了香港骨质疏松症研究的 1253 名参与者（平均年龄 58.1 岁），他们完成了关于足部姿势、功能、疼痛以及是否存在畸形（如足外翻和膝内翻等）的检查。我们使用逻辑回归法估算了每种足部和膝部问题与功能结果（行走速度慢、自我报告的跌倒和功能限制）和 OA 的横截面关联。通过与电子健康记录的联系，我们使用 Cox 模型进一步研究了这些问题与 8 年内发生的 OA 之间的关系。所有模型均根据年龄、性别和体重指数进行了调整。结果足外翻、足痛和膝关节屈曲的患病率分别为 33.1%、35.1% 和 25.8%。扁平足姿势与膝关节屈曲有关，代偿足功能与足外翻有关。在所评估的足部问题中，只有足部疼痛与功能性结果（包括功能限制和反复跌倒）有显著关联。足部疼痛还与基线时普遍存在的 OA 有关，但与发生的 OA 无关。结论在社区居住的中国成年人中，足部疼痛（而非足部畸形）与功能受限和跌倒有关，而膝关节外翻与OA事件有关。

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引用次数: 0

Corrigendum to “Is ankle fracture related to low bone mineral density and subsequent fracture? A systematic review” [Osteoporos Sarcopenia 2020 6:151–159] 踝关节骨折与低骨矿密度和后续骨折有关吗？系统综述》 [Osteoporos Sarcopenia 2020 6:151-159] 的更正

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-09-01 DOI: 10.1016/j.afos.2024.09.003

引用次数: 0

TOC 技术选择委员会

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-09-01 DOI: 10.1016/S2405-5255(24)00104-3

引用次数: 0

Verification of grip strength as an evaluation tool for locomotive syndrome in rheumatoid arthritis 将握力验证作为类风湿性关节炎运动综合征的评估工具

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-09-01 DOI: 10.1016/j.afos.2024.07.001

Objectives

Locomotive syndrome (LS) leads to reduced physical function and a high risk of becoming bedridden. Grip strength serves as an indicator of upper limb and overall physical function. Rheumatoid arthritis (RA) patients with reduced grip strength frequently show finger and wrist joint inflammation. The purpose of this study was to verify grip strength as an evaluation tool for physical function and LS in RA patients.

Methods

As part of an ongoing multicenter observational study, 591 consecutive RA patients whose background information was available, including data for the 25-question Geriatric Locomotive Function Scale (GLFS-25) and grip strength, were examined. LS was defined as a GLFS-25 score ≥ 16 points. Finger and wrist joint inflammation were defined as tender or swollen joints.

Results

Among the 591 patients, 244 (41.3%) patients had LS, and 167 (28.3%) were male. Receiver operating characteristic curve analysis yielded cut-off values of grip strength for LS of 24 kg (specificity 72.2%; sensitivity 62.7%) for males and 17 kg (specificity 65.7%; sensitivity 67.6%) for females. Multivariable logistic regression analysis revealed a significant association of grip strength with LS, even after adjusting for finger and wrist joint inflammation.

Conclusions

LS was significantly associated with grip strength, even after adjusting for the presence of finger and wrist joint inflammation. We recommend adopting grip strength measurement as a screening tool for evaluating LS and guiding interventions.

目的肌张力综合征（LS）会导致身体功能下降，卧床不起的风险很高。握力是上肢和整体身体功能的一个指标。握力减弱的类风湿性关节炎（RA）患者经常出现手指和手腕关节炎症。本研究的目的是验证握力作为 RA 患者身体功能和 LS 的评估工具的作用。方法作为一项正在进行的多中心观察研究的一部分，研究人员对 591 名连续的 RA 患者进行了背景资料检查，包括 25 个问题的老年运动功能量表（GLFS-25）和握力的数据。GLFS-25评分≥16分定义为LS。结果在591名患者中，244人（41.3%）患有LS，167人（28.3%）为男性。根据接收者操作特征曲线分析，男性 LS 患者握力的临界值为 24 千克（特异性 72.2%；灵敏度 62.7%），女性为 17 千克（特异性 65.7%；灵敏度 67.6%）。多变量逻辑回归分析显示，即使在调整了手指和腕关节炎症后，握力仍与 LS 有显著关联。我们建议将握力测量作为评估 LS 和指导干预措施的筛选工具。

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引用次数: 0

Surgery for spinal deformity with osteoporosis: Achieving successful fusion 骨质疏松症脊柱畸形手术：成功实现融合

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-09-01 DOI: 10.1016/j.afos.2024.06.002

The objectives of fusion surgery for spinal deformities include decompressing neural elements and achieving balanced spinal alignment. Particularly, in cases where spinal deformities coexist with osteoporosis, successful surgery requires careful consideration due to the susceptibility to fixation failure and non-union. Various efforts are being made to restore spinal alignment through surgery in osteoporotic patients. The administration of osteoporosis medications before and after surgery is effective for bony union. Additionally, appropriate selection of fusion range, rigid internal fixation, and utilization of bone substitutes play significant roles in successful fusion surgery. Although surgical treatment for spinal deformities accompanied by osteoporosis remains still challenging, we can anticipate successful outcomes with effective strategies and ongoing advancements in the future.

脊柱畸形融合手术的目的包括为神经元减压和实现脊柱的平衡排列。特别是在脊柱畸形与骨质疏松症并存的情况下，由于容易发生固定失败和不愈合，成功的手术需要慎重考虑。为了通过手术恢复骨质疏松症患者的脊柱排列，人们正在做出各种努力。手术前后服用骨质疏松症药物可有效促进骨结合。此外，融合范围的适当选择、严格的内固定以及骨替代物的使用对融合手术的成功起着重要作用。虽然骨质疏松症脊柱畸形的手术治疗仍具有挑战性，但我们可以预见，通过有效的策略和不断的进步，未来的手术治疗一定会取得成功。

引用次数: 0

Reply on “Choice of cemented or uncemented stems for displaced femoral neck fractures” 关于 "治疗移位性股骨颈骨折选择骨水泥或非骨水泥柄 "的答复

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-09-01 DOI: 10.1016/j.afos.2024.09.002

引用次数: 0

Does intradiscal steroid injection accelerate the histological degeneration of the human disc? 椎间盘内注射类固醇是否会加速人体椎间盘的组织学退化？

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-09-01 DOI: 10.1016/j.afos.2024.06.001

Objectives

Intradiscal steroid injection (ISI) use has been proven as a low-risk and rapid treatment for disc degeneration disease (DDD). However, the histological effects of steroids on human discs remain poorly understood. The purpose of this study is to investigate whether ISI induces histologic degeneration of the disc.

Methods

In this study, a histological analysis was carried out on the nucleus pulposus obtained from 150 patients who underwent posterior lumbar interbody fusion. Among these individuals, 59 received ISI before the surgery, while 91 did not. After staining with hematoxylin and eosin, the histological classification was performed based on chondrocyte proliferation (C1, C2, and C3) and granular matrix change (M1 and M2). Logistic regression analysis was used to identify the main factors influencing chondrocyte proliferation and granular matrix change. Additionally, histological differences between the ISI group and the non-ISI group were analyzed.

Results

Chondrocyte proliferation and granular matrix changes were not significantly different between the ISI and non-ISI groups. The logistic regression analysis indicated that age is the most significant risk factor for both chondrocyte proliferation (P = 0.02) and granular matrix changes (P < 0.01).

Conclusions

The most crucial factor in disc degeneration is age. ISI does not accelerate the histological degeneration of chondrocyte proliferation and granular matrix. Therefore, the ISI could be considered as a histologically safe alternative in patients with DDD.

目标椎间盘类固醇注射（ISI）已被证明是一种低风险、快速治疗椎间盘退行性疾病（DDD）的方法。然而，类固醇对人体椎间盘的组织学影响仍鲜为人知。本研究的目的是调查 ISI 是否会诱发椎间盘的组织学退变。其中，59 人在手术前接受了 ISI 治疗，91 人未接受治疗。苏木精和伊红染色后，根据软骨细胞增殖（C1、C2 和 C3）和颗粒基质变化（M1 和 M2）进行组织学分类。利用逻辑回归分析确定了影响软骨细胞增殖和颗粒基质变化的主要因素。结果软骨细胞增殖和颗粒基质变化在 ISI 组和非 ISI 组之间无显著差异。逻辑回归分析表明，年龄是软骨细胞增殖（P = 0.02）和颗粒基质变化（P < 0.01）的最重要风险因素。ISI不会加速软骨细胞增殖和颗粒基质的组织学退化。因此，对于椎间盘突出症患者来说，ISI 可被视为一种组织学上安全的替代方法。

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引用次数: 0

Choice of cemented or uncemented stems for displaced femoral neck fractures 治疗股骨颈移位骨折的骨水泥或非骨水泥柄的选择

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-09-01 DOI: 10.1016/j.afos.2024.09.001

引用次数: 0

Effects of whole-body vibration on bone properties in type 2 diabetes model rats 全身振动对 2 型糖尿病模型大鼠骨骼特性的影响

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-09-01 DOI: 10.1016/j.afos.2024.08.001

Objectives

We examined the effects of whole-body vibration (WBV) on bone properties in type 2 diabetes (T2DM) model rats.

Methods

Twenty male Hos:ZFDM-Lepr^fa, fa/fa rats (divided into DM and WBV groups, N = 10 each) and 10 Hos:ZFDM-Lepr^fa, fa/+ rats (as the control (CON) group) were used. The WBV group underwent WBV at 45 Hz frequency, with 0.5 g acceleration (15 min/day, 5 days/week) for 8 weeks. Trabecular and cortical bone mass, trabecular bone microstructure (TBMS), and cortical bone geometry (CBG) were analyzed via micro-computed tomography. Bone mechanical strength (maximum load, break point, and stiffness) was also measured. Additionally, bone metabolic and DM-related markers were determined.

Results

The bone mechanical strength of the femur improved in the WBV group, although muscle atrophy and bone deterioration were observed in the DM and WBV groups. The serum levels of bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase-5b were significantly higher in the DM and WBV groups than in the CON group. Serum glucose and blood urea nitrogen levels were significantly lower in the WBV group than in the DM group.

Conclusions

This study suggests that WBV potentially improves the decrease in the bone mechanical strength of the femur, although it does not prevent the deterioration of bone mineral content, TBMS, and CBG parameters. Further studies are needed to investigate the effective timing and duration of WBV and the conditions that prevent T2DM and deterioration of bone properties and clarify the mechanism underlying WBV effects on bone properties in DM animals.

方法20只雄性Hos:ZFDM-Leprfa, fa/fa大鼠（分为DM组和WBV组，每组10只）和10只Hos:ZFDM-Leprfa, fa/+大鼠（作为对照（CON）组）。WBV 组接受频率为 45 Hz、加速度为 0.5 g 的 WBV（15 分钟/天，5 天/周），为期 8 周。通过微型计算机断层扫描分析了骨小梁和皮质骨质量、骨小梁微结构（TBMS）和皮质骨几何形状（CBG）。还测量了骨机械强度（最大负荷、断裂点和刚度）。结果尽管在 DM 组和 WBV 组都观察到肌肉萎缩和骨质退化，但 WBV 组的股骨机械强度有所改善。DM 组和 WBV 组血清中骨特异性碱性磷酸酶和酒石酸磷酸酶-5b 的水平明显高于 CON 组。结论本研究表明，WBV 有可能改善股骨骨机械强度的下降，但不能阻止骨矿物质含量、TBMS 和 CBG 参数的恶化。还需要进一步研究WBV的有效时间和持续时间，以及防止T2DM和骨特性恶化的条件，并阐明WBV对DM动物骨特性影响的机制。

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引用次数: 0

Monoclonal antibodies in patients with osteoporosis and renal insufficiency: An updated systematic review and meta-analysis 骨质疏松症和肾功能不全患者的单克隆抗体：最新系统综述和荟萃分析

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-06-01 DOI: 10.1016/j.afos.2024.05.004

Maria L.R. Defante , Victoria Alzogaray , Davi Said Gonçalves Celso , Lucas Antônio Torres , Mayara Bearse , Ana Claudia Frota Machado de Melo Lopes

Objectives

There are challenges for the treatment of osteoporosis in patients with kidney failure and monoclonal antibodies (MAb) might be a suitable therapy. However, the efficacy and safety of MAb among patients with osteoporosis and renal insufficiency remains unclear.

Methods

We systematically searched PubMed, Embase, and Cochrane Central for studies evaluating the efficacy and safety of the use of MAb in patients with osteoporosis and renal insufficiency. We pooled risk ratios (RR) and 95% confidence intervals (CI) for binary outcomes. Mean difference (MD) was used for continuous outcomes.

Results

We included 5 studies with 33,550 patients. MAb therapy decreased the risk of vertebral fractures (RR 0.32; 95% CI 0.26–0.40; P < 0.01) when compared to placebo and no statistical difference was found when comparing to bisphosphonate (RR 0.71; 95% CI 0.49–1.03; P = 0.07). MAb therapy also decreased the risk of nonvertebral fractures (RR 0.79; 95% CI 0.69–0.91; P = 0.0009). Lumbar spine bone mineral density (BMD) was higher in the MAb therapy when compared to both placebo (MD 10.90; 95% CI 8.00–13.80; P < 0.01) and bisphosphonate (MD 7.66; 95% CI 6.19–9.14; P < 0.01). There was no statistically significant difference in the change of estimated glomerular filtration rate and in the incidence of hypocalcemia and serious adverse events between groups.

Conclusions

There were reductions in both vertebral and nonvertebral fracture risks, alongside improvements in BMD among patients with renal insufficiency treated with MAb.

目的肾功能不全患者骨质疏松症的治疗面临挑战，而单克隆抗体（MAb）可能是一种合适的疗法。方法我们系统地检索了 PubMed、Embase 和 Cochrane Central，以寻找评估骨质疏松症和肾功能不全患者使用 MAb 的疗效和安全性的研究。我们对二元结果的风险比 (RR) 和 95% 置信区间 (CI) 进行了汇总。结果我们纳入了 5 项研究，共 33,550 名患者。与安慰剂相比，MAb疗法降低了椎体骨折的风险（RR 0.32; 95% CI 0.26-0.40; P < 0.01），与双膦酸盐相比则无统计学差异（RR 0.71; 95% CI 0.49-1.03; P = 0.07）。MAb疗法还能降低非椎体骨折的风险（RR 0.79；95% CI 0.69-0.91；P = 0.0009）。与安慰剂（MD 10.90; 95% CI 8.00-13.80; P <0.01）和双磷酸盐（MD 7.66; 95% CI 6.19-9.14; P <0.01）相比，MAb疗法的腰椎骨矿物质密度（BMD）更高。结论接受MAb治疗的肾功能不全患者的椎体和非椎体骨折风险均有所降低，同时BMD也有所改善。

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