Sarcopenia và loãng xương ở người cao tuổi: một phân tích tổng hợp và đánh giá hệ thống

European Geriatric Medicine - Tập 9 - Trang 419-434 - 2018
Barbara Rubek Nielsen1, Jawdat Abdulla1, Hanne Elkjær Andersen1, Peter Schwarz2, Charlotte Suetta3
1Medical Department M, Amager and Hvidovre Hospital, Glostrup, Denmark
2Department of Endocrinology, Rigshospitalet and Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
3Department of Geriatric Medicine, Frederiksberg and Bispebjerg Hospital and Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark

Tóm tắt

Mất cơ và xương liên quan đến tuổi tác (sarcopenia và loãng xương) làm tăng nguy cơ té ngã và gãy xương, từ đó dẫn đến gánh nặng kinh tế đáng kể cho xã hội. Tình trạng kết hợp, gọi là osteosarcopenia, có thể giúp xác định những bệnh nhân có nguy cơ cao hơn đối với những hậu quả này và có thể có liên quan đến việc đánh giá và điều trị trong thực hành lâm sàng. Mục tiêu nghiên cứu là đánh giá kiến thức hiện tại về tầm quan trọng của osteosarcopenia và nguy cơ gãy xương ở người cao tuổi. Một đánh giá tài liệu hệ thống đã được thực hiện đến ngày 10 tháng 3 năm 2018. Tổng cộng có 1105 tài liệu được phát hiện, trong đó 1049 và 29 tài liệu bị loại bỏ dựa trên tiêu đề/tóm tắt và đánh giá toàn văn, tương ứng. Hai mươi bảy tài liệu gốc đã được đưa vào đánh giá hệ thống, trong đó 17 tài liệu phù hợp cho phân tích tổng hợp. Tỷ lệ osteosarcopenia có sự thay đổi (5–37%) tùy thuộc vào phân loại sarcopenia và việc phân loại người tham gia ban đầu theo sarcopenia hay loãng xương. Ở những bệnh nhân có gãy xương loãng xương do năng lượng thấp, sarcopenia có mặt trong 7.8–58% và 1.3–96.3% trường hợp, ở phụ nữ và nam giới, tương ứng. Phân tích meta về tỷ lệ sarcopenia ở bệnh nhân với gãy xương do năng lượng thấp (n = 9) là 46% (95% CI 44, 48; p < 0.001). Nguy cơ tương đối của gãy xương (sarkopenic so với không sarkopenic) trong phân tích tổng hợp của bốn nghiên cứu là 1.37 (95% CI 1.18, 1.59; p < 0.001). Mật độ khoáng xương trung bình (n = 5) và điểm T (n = 3) của cổ xương đùi thấp hơn đáng kể ở những người tham gia có sarcopenia [− 0.07 g/cm2 (95% CI 0.08, 0.06) và − 0.34 (95% CI − 0.46, − 0.23), tương ứng]. Osteosarcopenia là tình trạng phổ biến và nguy cơ tương đối của gãy xương cao hơn ở những bệnh nhân có sarcopenia. Cần có một phân loại chính xác và nghiêm ngặt về sarcopenia để đánh giá đúng mối quan hệ và hậu quả của nó.

Từ khóa

#sarcopenia #loãng xương #người cao tuổi #osteosarcopenia #nguy cơ gãy xương #phân tích tổng hợp

Tài liệu tham khảo

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