Osteoporosis and Sarcopenia最新文献

英文中文

Associations between low muscle mass and clinical characteristics of health population in China 中国健康人群低肌肉质量与临床特征之间的关系

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-03-01 DOI: 10.1016/j.afos.2024.02.002

Yunfei Pan , Mengjie Hu , Feimin Zhao , Jingjing Ren

Objectives

The primary aim of this study is to discern the association between specific clinical parameters and low muscle mass (LMM). We endeavor to elucidate the determinants of LMM and the predictive potency of individual factors.

Methods

In this retrospective cross-sectional study, we encompassed 450 older adult Chinese participants (252 males and 198 females). Muscle mass quantifications were performed using bioelectrical impedance analysis. Comprehensive data encompassing demographic details (age, sex, height, and weight) and laboratory results (complete blood count, thyroid function, liver function, and renal function) were systematically recorded. Logistic regression models, coupled with receiver operating characteristic curve analytics, were employed to ascertain the variables influencing LMM and to evaluate the predictive validity of each parameter on LMM.

Results

Upon confounding adjustment for age, gender, body mass index (BMI), and free thyroxine (FT4) persisted as a determinant of LMM. Specifically, individuals with an FT4 exceeding 1.105 ng/dL exhibited a 1.803-fold increased propensity for LMM relative to those with FT4 values below the specified threshold. Incorporating age, gender, BMI, and FT4 in the diagnostic algorithm enhanced the precision of LMM. The results differ between men and women. In the male population, we can still observe that FT4 has a certain value in the diagnosis of LMM, but this phenomenon is not found in the female population.

Conclusions

Elevated FT4 concentrations, albeit within clinically accepted limits, are inversely associated with muscle mass. As such, FT4 could be postulated as a potential biomarker for LMM in geriatric individuals, especially in the male group.

本研究的主要目的是找出特定临床参数与低肌肉质量（LMM）之间的关联。方法在这项回顾性横断面研究中，我们纳入了 450 名中国老年参与者（男性 252 人，女性 198 人）。采用生物电阻抗分析法对肌肉质量进行量化。系统记录了包括人口统计学细节（年龄、性别、身高和体重）和实验室结果（全血细胞计数、甲状腺功能、肝功能和肾功能）在内的综合数据。结果在对年龄、性别、体重指数（BMI）和游离甲状腺素（FT4）进行混淆调整后，游离甲状腺素仍然是影响 LMM 的决定因素。具体而言，与游离甲状腺素（FT4）值低于规定阈值的人相比，游离甲状腺素（FT4）值超过1.105 ng/dL的人患LMM的几率增加了1.803倍。将年龄、性别、体重指数和 FT4 纳入诊断算法可提高 LMM 的精确度。男性和女性的结果有所不同。在男性人群中，我们仍然可以观察到 FT4 在 LMM 诊断中具有一定的价值，但在女性人群中却没有发现这种现象。因此，FT4可被推测为老年人，尤其是男性群体中LMM的潜在生物标志物。

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引用次数: 0

Temporal validation of a clinical prediction rule for distinguishing locomotive syndromes in community-dwelling older adults: A cross-sectional study from the DETECt-L study 用于区分社区老年人运动综合征的临床预测规则的时间验证：来自 DETECt-L 研究的横断面研究

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-03-01 DOI: 10.1016/j.afos.2024.02.003

Shigeharu Tanaka , Ryo Tanaka , Hungu Jung , Shunsuke Yamashina , Yu Inoue , Kazuhiko Hirata , Kai Ushio , Yasunari Ikuta , Yukio Mikami , Nobuo Adachi

Objectives

Clinical prediction rules are used to discriminate patients with locomotive syndrome and may enable early detection. This study aimed to validate the clinical predictive rules for locomotive syndrome in community-dwelling older adults.

Methods

We assessed the clinical prediction rules for locomotive syndrome in a cross-sectional setting. The age, sex, and body mass index of participants were recorded. Five physical function tests–grip strength, single-leg standing time, timed up-and-go test, and preferred and maximum walking speeds–were measured as predictive factors. Three previously developed clinical prediction models for determining the severity of locomotive syndrome were assessed using a decision tree analysis. To assess validity, the sensitivity, specificity, likelihood ratio, and post-test probability of the clinical prediction rules were calculated using receiver operating characteristic curve analysis for each model.

Results

Overall, 280 older adults were included (240 women; mean age, 74.8 ± 5.2 years), and 232 (82.9%), 68 (24.3%), and 28 (10.0%) participants had locomotive syndrome stages ≥ 1, ≥ 2, and = 3, respectively. The areas under the receiver operating characteristics curves were 0.701, 0.709, and 0.603, in models 1, 2, and 3, respectively. The accuracies of models 1 and 2 were moderate.

Conclusions

These findings indicate that the models are reliable for community-dwelling older adults.

目的临床预测规则用于鉴别运动综合征患者，可实现早期检测。本研究旨在对社区老年人的运动综合征临床预测规则进行验证。我们记录了参与者的年龄、性别和体重指数。作为预测因素，我们测量了五项身体功能测试--握力、单腿站立时间、定时起立行走测试、首选行走速度和最大行走速度。采用决策树分析法评估了之前开发的用于确定运动综合征严重程度的三个临床预测模型。为了评估有效性，使用接收器操作特征曲线分析法计算了每个模型的临床预测规则的灵敏度、特异性、似然比和测试后概率。结果总共纳入了 280 名老年人（240 名女性；平均年龄为 74.8 ± 5.2 岁），分别有 232 人（82.9%）、68 人（24.3%）和 28 人（10.0%）患有运动综合征≥1 期、≥2 期和 = 3 期。模型 1、2 和 3 的接收者操作特征曲线下面积分别为 0.701、0.709 和 0.603。结论这些研究结果表明，这些模型对于居住在社区的老年人来说是可靠的。

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引用次数: 0

Assessing the utility of osteoporosis self-assessment tool for Asians in patients undergoing hip surgery 评估髋关节手术患者骨质疏松症自我评估工具对亚洲人的实用性

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-03-01 DOI: 10.1016/j.afos.2024.01.003

Keisuke Uemura , Kazuma Takashima , Ryo Higuchi , Sotaro Kono , Hirokazu Mae , Makoto Iwasa , Hirohito Abe , Yuki Maeda , Takayuki Kyo , Takashi Imagama , Wataru Ando , Takashi Sakai , Seiji Okada , Hidetoshi Hamada

Objectives

Diagnosis and treatment of osteoporosis are instrumental in obtaining good outcomes of hip surgery. Measuring bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis. However, due to limited access to DXA, there is a need for a screening tool to identify patients at a higher risk of osteoporosis. We analyzed the potential utility of the Osteoporosis Self-assessment Tool for Asians (OSTA) as a screening tool for osteoporosis.

Methods

A total of 1378 female patients who underwent hip surgery at 8 institutions were analyzed. For each patient, the BMD of the proximal femoral region was measured by DXA (DXA-BMD), and the correlation with OSTA score (as a continuous variable) was assessed. Receiver operating characteristic (ROC) curve analysis was performed to assess the ability of OSTA score to predict osteoporosis. Lastly, the OSTA score was truncated to yield an integer (OSTA index) to clarify the percentage of patients with osteoporosis for each index.

Results

DXA-BMD showed a strong correlation with OSTA (r = 0.683; P < 0.001). On ROC curve analysis, the optimal OSTA score cut-off value of −5.4 was associated with 73.8% sensitivity and 80.9% specificity for diagnosis of osteoporosis (area under the curve: 0.842). A decrease in the OSTA index by 1 unit was associated with a 7.3% increase in the probability of osteoporosis.

Conclusions

OSTA is a potentially useful tool for screening osteoporosis in patients undergoing hip surgery. Our findings may help identify high-risk patients who require further investigation using DXA.

目的骨质疏松症的诊断和治疗有助于获得良好的髋关节手术效果。使用双能 X 射线吸收测量法（DXA）测量骨质密度（BMD）是诊断骨质疏松症的黄金标准。然而，由于使用 DXA 的机会有限，因此需要一种筛查工具来识别骨质疏松症风险较高的患者。我们分析了亚洲人骨质疏松症自我评估工具（OSTA）作为骨质疏松症筛查工具的潜在效用。通过 DXA 测量了每位患者股骨近端区域的 BMD（DXA-BMD），并评估了其与 OSTA 评分（连续变量）的相关性。为评估 OSTA 评分预测骨质疏松症的能力，还进行了接收者操作特征（ROC）曲线分析。最后，对 OSTA 评分进行截断，得出一个整数（OSTA 指数），以明确每个指数在骨质疏松症患者中所占的百分比。根据 ROC 曲线分析，最佳 OSTA 评分临界值为 -5.4，诊断骨质疏松症的灵敏度为 73.8%，特异度为 80.9%（曲线下面积：0.842）。OSTA 指数每降低一个单位，骨质疏松症的概率就会增加 7.3%。我们的研究结果可能有助于确定需要使用 DXA 进一步检查的高风险患者。

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引用次数: 0

The optimal cut-off values of FRAX without BMD for predicting osteoporosis fracture risk in the older adults at Nan, Thailand 预测泰国南部老年人骨质疏松症骨折风险的 FRAX（无 BMD）最佳临界值

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-03-01 DOI: 10.1016/j.afos.2023.12.004

Worapong Sucharitpongpan

Objectives

The World Health Organization developed the Fracture Risk Assessment Tool (FRAX) to assess the risk of having fragility fractures in the next 10 years. The FRAX tool is different by country, race, gender, and age. This study is a community-based study aiming to identify the optimal cut-off values of FRAX for the identification of older individuals who are at high risk of osteoporosis fractures in both genders.

Methods

This cross-sectional, analytic study was conducted by using health screening data of the older adults aged 60–90 living in the 3 biggest districts of Nan province, Thailand. Validity and optimal FRAX major osteoporotic fracture (MOF) and hip fracture (HF) cut-off values in both genders were determined.

Results

Of 36,042 older adults included in the study, 1624 older people had a history of fragility fractures. Older females were 3.2 and 2.5 times more likely to have fragility fractures and hip fractures than males, respectively. The optimal cut-off values of FRAX MOF for predicting fragility fractures were 3.0% for males and 6.3% for females. The optimal cut-off values of FRAX HF for predicting hip fractures were 1.1% for males and 3.3% for females.

Conclusions

A simple screening tool like the FRAX which is available in the annual health screening activities has the potential to be used to predict the risk of developing fragility fractures in rural areas of Thailand. Different cut-off values should be used in females and males because the risk of MOF and HF of both genders is significantly different.

目标世界卫生组织开发了骨折风险评估工具（FRAX），用于评估未来 10 年内发生脆性骨折的风险。FRAX工具因国家、种族、性别和年龄而异。本研究是一项以社区为基础的研究，旨在确定 FRAX 的最佳临界值，以识别出骨质疏松症骨折高风险的老年人（男女均有）。方法：本研究采用横断面分析法，通过对居住在泰国南部省 3 个最大地区的 60-90 岁老年人的健康检查数据进行分析。结果在纳入研究的 36042 名老年人中，1624 名老年人有脆性骨折史。老年女性发生脆性骨折和髋部骨折的几率分别是男性的 3.2 倍和 2.5 倍。FRAX MOF 预测脆性骨折的最佳临界值男性为 3.0%，女性为 6.3%。结论像 FRAX 这样简单的筛查工具可在每年的健康检查活动中使用，有潜力用于预测泰国农村地区发生脆性骨折的风险。由于女性和男性罹患脆性骨折和高频骨折的风险有显著差异，因此女性和男性应采用不同的临界值。

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引用次数: 0

Development of a shape-based algorithm for identification of asymptomatic vertebral compression fractures: A proof-of-principle study 开发基于形状的算法，用于识别无症状椎体压缩性骨折：原理验证研究

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-03-01 DOI: 10.1016/j.afos.2024.01.001

Huy G. Nguyen , Hoa T. Nguyen , Linh T.T. Nguyen , Thach S. Tran , Lan T. Ho-Pham , Sai H. Ling , Tuan V. Nguyen

Objectives

Vertebral fracture is both common and serious among adults, yet it often goes undiagnosed. This study aimed to develop a shape-based algorithm (SBA) for the automatic identification of vertebral fractures.

Methods

The study included 144 participants (50 individuals with a fracture and 94 without a fracture) whose plain thoracolumbar spine X-rays were taken. Clinical diagnosis of vertebral fracture (grade 0 to 3) was made by rheumatologists using Genant's semiquantitative method. The SBA algorithm was developed to determine the ratio of vertebral body height loss. Based on the ratio, SBA classifies a vertebra into 4 classes: 0 = normal, 1 = mild fracture, 2 = moderate fracture, 3 = severe fracture). The concordance between clinical diagnosis and SBA-based classification was assessed at both person and vertebra levels.

Results

At the person level, the SBA achieved a sensitivity of 100% and specificity of 62% (95% CI, 51%–72%). At the vertebra level, the SBA achieved a sensitivity of 84% (95% CI, 72%–93%), and a specificity of 88% (95% CI, 85%–90%). On average, the SBA took 0.3 s to assess each X-ray.

Conclusions

The SBA developed here is a fast and efficient tool that can be used to systematically screen for asymptomatic vertebral fractures and reduce the workload of healthcare professionals.

目的椎体骨折在成年人中既常见又严重，但往往得不到诊断。本研究旨在开发一种基于形状的算法（SBA），用于自动识别椎体骨折。方法本研究包括 144 名参与者（50 名骨折患者和 94 名无骨折患者），他们都拍摄了普通胸腰椎 X 光片。风湿病学家采用 Genant 半定量法对脊椎骨折（0 至 3 级）进行临床诊断。SBA 算法用于确定椎体高度损失的比率。根据该比率，SBA 将椎体分为 4 级：0 = 正常，1 = 轻度骨折，2 = 中度骨折，3 = 重度骨折）。结果在个人层面，SBA 的灵敏度为 100%，特异度为 62%（95% CI，51%-72%）。在椎骨水平，SBA 的灵敏度为 84%（95% CI，72%-93%），特异性为 88%（95% CI，85%-90%）。结论此处开发的 SBA 是一种快速高效的工具，可用于系统筛查无症状椎体骨折，减轻医护人员的工作量。

{"title":"Development of a shape-based algorithm for identification of asymptomatic vertebral compression fractures: A proof-of-principle study","authors":"Huy G. Nguyen , Hoa T. Nguyen , Linh T.T. Nguyen , Thach S. Tran , Lan T. Ho-Pham , Sai H. Ling , Tuan V. Nguyen","doi":"10.1016/j.afos.2024.01.001","DOIUrl":"10.1016/j.afos.2024.01.001","url":null,"abstract":"<div><h3>Objectives</h3><p>Vertebral fracture is both common and serious among adults, yet it often goes undiagnosed. This study aimed to develop a shape-based algorithm (SBA) for the automatic identification of vertebral fractures.</p></div><div><h3>Methods</h3><p>The study included 144 participants (50 individuals with a fracture and 94 without a fracture) whose plain thoracolumbar spine X-rays were taken. Clinical diagnosis of vertebral fracture (grade 0 to 3) was made by rheumatologists using Genant's semiquantitative method. The SBA algorithm was developed to determine the ratio of vertebral body height loss. Based on the ratio, SBA classifies a vertebra into 4 classes: 0 = normal, 1 = mild fracture, 2 = moderate fracture, 3 = severe fracture). The concordance between clinical diagnosis and SBA-based classification was assessed at both person and vertebra levels.</p></div><div><h3>Results</h3><p>At the person level, the SBA achieved a sensitivity of 100% and specificity of 62% (95% CI, 51%–72%). At the vertebra level, the SBA achieved a sensitivity of 84% (95% CI, 72%–93%), and a specificity of 88% (95% CI, 85%–90%). On average, the SBA took 0.3 s to assess each X-ray.</p></div><div><h3>Conclusions</h3><p>The SBA developed here is a fast and efficient tool that can be used to systematically screen for asymptomatic vertebral fractures and reduce the workload of healthcare professionals.</p></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"10 1","pages":"Pages 22-27"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405525524000025/pdfft?md5=63ec61beb3f370b70218acffa5705aba&pid=1-s2.0-S2405525524000025-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139825246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Asia-Pacific consensus on long-term and sequential therapy for osteoporosis 亚太地区就骨质疏松症的长期和连续治疗达成共识

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-03-01 DOI: 10.1016/j.afos.2024.02.001

Ta-Wei Tai , Hsuan-Yu Chen , Chien-An Shih , Chun-Feng Huang , Eugene McCloskey , Joon-Kiong Lee , Swan Sim Yeap , Ching-Lung Cheung , Natthinee Charatcharoenwitthaya , Unnop Jaisamrarn , Vilai Kuptniratsaikul , Rong-Sen Yang , Sung-Yen Lin , Akira Taguchi , Satoshi Mori , Julie Li-Yu , Seng Bin Ang , Ding-Cheng Chan , Wai Sin Chan , Hou Ng , Chih-Hsing Wu

Objectives

This study aimed to present the Asia-Pacific consensus on long-term and sequential therapy for osteoporosis, offering evidence-based recommendations for the effective management of this chronic condition. The primary focus is on achieving optimal fracture prevention through a comprehensive, individualized approach.

Methods

A panel of experts convened to develop consensus statements by synthesizing the current literature and leveraging clinical expertise. The review encompassed long-term anti-osteoporosis medication goals, first-line treatments for individuals at very high fracture risk, and the strategic integration of anabolic and antiresorptive agents in sequential therapy approaches.

Results

The panelists reached a consensus on 12 statements. Key recommendations included advocating for anabolic agents as the first-line treatment for individuals at very high fracture risk and transitioning to antiresorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for individuals experiencing new fractures or persistent high fracture risk despite antiresorptive treatment. In cases of inadequate response, the consensus recommended considering a switch to more potent medications. The consensus also addressed the management of medication-related complications, proposing alternatives instead of discontinuation of treatment.

Conclusions

This consensus provides a comprehensive, cost-effective strategy for fracture prevention with an emphasis on shared decision-making and the incorporation of country-specific case management systems, such as fracture liaison services. It serves as a valuable guide for healthcare professionals in the Asia-Pacific region, contributing to the ongoing evolution of osteoporosis management.

目的本研究旨在提出亚太地区关于骨质疏松症长期治疗和序贯治疗的共识，为有效管理这一慢性疾病提供循证建议。方法召集专家小组，通过综合现有文献和利用临床专业知识，制定共识声明。审查内容包括长期抗骨质疏松症药物治疗目标、针对骨折风险极高的个体的一线治疗方法，以及同化制剂和抗骨吸收制剂在序贯治疗方法中的战略整合。主要建议包括：主张将同化制剂作为骨折风险极高人群的一线治疗药物，并在完成同化制剂治疗后过渡到抗骨吸收制剂。对于出现新骨折或在接受抗骨吸收治疗后仍有持续高骨折风险的患者，仍可选择同化疗法。如果疗效不佳，共识建议考虑改用药效更强的药物。该共识还讨论了药物相关并发症的管理问题，提出了替代治疗而非终止治疗的方案。结论该共识为骨折预防提供了一个全面、具有成本效益的策略，强调共同决策，并纳入了针对具体国家的病例管理系统，如骨折联络服务。它为亚太地区的医护人员提供了宝贵的指南，有助于骨质疏松症管理的不断发展。

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引用次数: 0

Diagnosis and treatment of adult hypophosphatasia: Still a big challenge? 成人低磷血症的诊断和治疗：仍是一项巨大挑战？

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-03-01 DOI: 10.1016/j.afos.2024.03.002

Daisuke Inoue

引用次数: 0

Musculoskeletal and neurocognitive clinical significance of adult hypophosphatasia 成人低磷酸盐症的肌肉骨骼和神经认知临床意义

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2023-12-01 DOI: 10.1016/j.afos.2023.12.003

Se-Min Kim, Funda Korkmaz, S. Sims, Vitaly Ryu, T. Yuen, Mone Zaidi

引用次数: 0

Pain score as a predictor of subsequent fragility fracture in postmenopausal patients with rheumatoid arthritis: A retrospective case-control study 疼痛评分是绝经后类风湿性关节炎患者发生脆性骨折的预测因素：一项回顾性病例对照研究

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2023-12-01 DOI: 10.1016/j.afos.2023.12.001

I. Yoshii, N. Sawada, T. Chijiwa

引用次数: 0

Assessment of quality of life and its affecting factors in osteosarcopenic individuals in the Iranian older adult population: Bushehr Elderly Health (BEH) program 评估伊朗老年人群中骨质疏松患者的生活质量及其影响因素：布什尔老年人健康（BEH）计划

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2023-12-01 DOI: 10.1016/j.afos.2023.12.002

Amir Mohammad Vahdani, M. Sanjari, Noushin Fahimfar, M. Ebrahimpur, G. Shafiee, K. Khalagi, Mohammad Javad Mansourzadeh, I. Nabipour, B. Larijani, A. Ostovar

引用次数: 0

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