2012年5月9日水曜日

大腿骨頸部骨折女性のサルコペニア有病割合

大腿骨頸部骨折の女性のサルコペニア有病割合と骨粗鬆症との関連をみた論文を紹介します。

Di Monaco M, Vallero F, Di Monaco R, Tappero R. Prevalence of sarcopenia and its association with osteoporosis in 313 older women following a hip fracture. Arch Gerontol Geriatr. 2011 Jan-Feb;52(1):71-4.

筋肉量の評価はDEXAで行っています。大腿骨頸部骨折の女性313人中、180人(58%)にサルコペニアを認めました。骨粗鬆症は230人(74%)に認めました。サルコペニアを認める女性では、骨粗鬆症のオッズ比が1.8倍と有意な関連がありました。

私が知る限り、大腿骨頸部骨折でサルコペニアの有無をきちんと報告した論文は、他にはありません。脳卒中、大腿骨頸部骨折、廃用症候群などリハ栄養の主な疾患で、サルコペニアの診断基準を決めたうえで、その有病割合を日本で調べることが当面は重要だと考えます。

Abstract
Changes in body composition, including a decrease in muscle and bone mass, accompany aging. Our aim was to assess the prevalence of sarcopenia and its association with osteoporosis in hip-fracture women. We performed a Dual-Energy X-Ray Absorptiometry (DXA) scan in 313 of 340 women, 20.9 ± 6.5 (mean ± S.D.) days after hip-fracture occurrence. To adjust appendicular lean mass for body size we divided it by height squared in each woman. A total of 180 of the 313 women (58%) were sarcopenic, whereas 230 (74%) were osteoporotic. After adjustment for age and interval between fracture and DXA scan we found a significant association between sarcopenia and osteoporosis (p=0.026). For a sarcopenic woman the adjusted odds ratio (OR) for osteoporosis was 1.80 (95%CI=1.07-3.02). Our data shows the high prevalence of sarcopenia and its significant association with osteoporosis in a large sample of hip-fracture women. Data supports a research approach on preventive and treatment strategies for osteoporosis and sarcopenia targeting both bone and muscle tissue. Furthermore, data should be considered when the economic burden of sarcopenia is estimated, given the high proportion of sarcopenic women with bone fragility.

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