肌少-骨质疏松症的研究进展

doi:10.3969/j.issn.1674-8115.2021.05.020

摘要/Abstract

摘要：

肌少-骨质疏松症是骨质疏松症和肌少症并存的一种老年综合征，在老年人群中广泛存在。骨质疏松症是以骨量降低、骨组织微结构破坏为特点的骨骼疾病；肌少症是指全身肌量减少、肌强度下降或肌肉生理功能的减退。肌少症和骨质疏松症是与年龄相关的退行性疾病，具有相似的病理生理基础，包括机械因素、遗传学、脂肪浸润和内分泌因素等。研究肌少-骨质疏松症的发病机制对预防和治疗该疾病，提高老年人生活质量和身心健康有重要的意义。该文就肌少-骨质疏松症的诊断、发病机制、干预及治疗进行综述。

关键词: 肌少-骨质疏松症, 肌少症, 骨质疏松症, 发病机制, 治疗

Abstract:

Osreosarcopenia is a geriatric syndrome that describes the co-existence of osteoporosis and sarcopenia, which is widespread in the elderly. Osteoporosis is a condition of low bone mass and micro-architectural of bone, and sarcopenia, the loss of muscle mass, strength and muscle physiological functions. Sarcopenia and osteoporosis are age-related degenerative diseases with similar pathophysiology, including mechanical factors, genetics, fatty infiltration and endocrine factors. Studying the pathogenesis of sarcopenia-osteoporosis is of great significance in preventing and treating the disease, improving the quality of life and physical and mental health of the elderly. This review introduces the diagnosis, pathogenesis, intervention and treatment of osteosarcopenia.

Key words: osteosarcopenia, sarcopenia, osteoporosis, pathogenesis, therapeutic

中图分类号:

R589.5

蔡苗苗, 高艳虹. 肌少-骨质疏松症的研究进展[J]. 上海交通大学学报(医学版), 2021, 41(5): 678-683.

Miao-miao CAI, Yan-hong GAO. Research progress of osteosarcopenia[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(5): 678-683.

参考文献 44

1	Fielding RA, Vellas B, Evans WJ, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International Working Group on sarcopenia[J]. J Am Med Dir Assoc, 2011, 12(4): 249-256.
2	中华医学会骨质疏松和骨矿盐疾病分会. 原发性骨质疏松症诊疗指南(2017)[J]. 中华骨质疏松和骨矿盐疾病杂志, 2017, 10(5): 413-444.
3	Paintin J, Cooper C, Dennison E. Osteosarcopenia[J]. Br J Hosp Med (Lond), 2018, 79(5): 253-258.
4	Kirk B, Al Saedi A, Duque G. Osteosarcopenia: a case of geroscience[J]. Aging Med (Milton), 2019, 2(3): 147-156.
5	di Monaco M, Castiglioni C, Bardesono F, et al. Sarcopenia, osteoporosis and the burden of prevalent vertebral fractures: a cross-sectional study of 350 women with hip fracture[J]. Eur J Phys Rehabilitation Med, 2020, 56(2): 184-190.
6	Binkley N, Buehring B. Beyond FRAX: it's time to consider "sarco-osteopenia"[J]. J Clin Densitom, 2009, 12(4): 413-416.
7	Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report[J]. Osteoporos Int, 1994, 4(6): 368-381.
8	Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis[J]. Age Ageing, 2019, 48(1): 16-31.
9	Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for sarcopenia[J]. J Am Med Dir Assoc, 2014, 15(2): 95-101.
10	Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on sarcopenia in older people[J]. Age Ageing, 2010, 39(4): 412-423.
11	Cawthon PM, Orwoll ES, Peters KE, et al. Strong relation between muscle mass determined by D3-creatine dilution, physical performance, and incidence of falls and mobility limitations in a prospective cohort of older men[J]. J Gerontol A Biol Sci Med Sci, 2019, 74(6): 844-852.
12	Wang YJ, Wang Y, Zhan JK, et al. Sarco-osteoporosis: prevalence and association with frailty in Chinese community-dwelling older adults[J]. Int J Endocrinol, 2015, 2015: 482940.
13	Urano T, Inoue S. Recent genetic discoveries in osteoporosis, sarcopenia and obesity[J]. Endocr J, 2015, 62(6): 475-484.
14	Hirschfeld HP, Kinsella R, Duque G. Osteosarcopenia: where bone, muscle, and fat collide[J]. Osteoporos Int, 2017, 28(10): 2781-2790.
15	Yang SY, Hoy M, Fuller B, et al. Pretreatment with insulin-like growth factor I protects skeletal muscle cells against oxidative damage via PI3K/Akt and ERK1/2 MAPK pathways[J]. Lab Invest, 2010, 90(3): 391-401.
16	Chen LY, Wu YH, Liu LK, et al. Association among serum insulin-like growth factor-1, frailty, muscle mass, bone mineral density, and physical performance among community-dwelling middle-aged and older adults in Taiwan[J]. Rejuvenation Res, 2018, 21(3): 270-277.
17	Tang BM, Eslick GD, Nowson C, et al. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis[J]. Lancet, 2007, 370(9588): 657-666.
18	Scimeca M, Centofanti F, Celi M, et al. Vitamin D receptor in muscle atrophy of elderly patients: a key element of osteoporosis-sarcopenia connection[J]. Aging Dis, 2018, 9(6): 952-964.
19	Carson JA, Manolagas SC. Effects of sex steroids on bones and muscles: similarities, parallels, and putative interactions in health and disease[J]. Bone, 2015, 80: 67-78.
20	Klein GL. The effect of glucocorticoids on bone and muscle[J]. Osteoporos Sarcopenia, 2015, 1(1): 39-45.
21	Stefanaki C, Pervanidou P, Boschiero D, et al. Chronic stress and body composition disorders: implications for health and disease[J]. Hormones (Athens), 2018, 17(1): 33-43.
22	Meex RCR, Blaak EE, van Loon LJC. Lipotoxicity plays a key role in the development of both insulin resistance and muscle atrophy in patients with type 2 diabetes[J]. Obes Rev, 2019, 20(9): 1205-1217.
23	JafariNasabian P, Inglis JE, Reilly W, et al. Aging human body: changes in bone, muscle and body fat with consequent changes in nutrient intake[J]. J Endocrinol, 2017, 234(1): R37-R51.
24	Mohsin S, Baniyas MM, AlDarmaki RS, et al. An update on therapies for the treatment of diabetes-induced osteoporosis[J]. Expert Opin Biol Ther, 2019, 19(9): 937-948.
25	Frost HM. Bone's mechanostat: a 2003 update[J]. Anat Rec A Discov Mol Cell Evol Biol, 2003, 275(2): 1081-1101.
26	Mera P, Laue K, Ferron M, et al. Osteocalcin signaling in myofibers is necessary and sufficient for optimum adaptation to exercise[J]. Cell Metab, 2017, 25(1): 218.
27	Bonewald L. Use it or lose it to age: a review of bone and muscle communication[J]. Bone, 2019, 120: 212-218.
28	Spichtig D, Zhang HB, Mohebbi N, et al. Renal expression of FGF23 and peripheral resistance to elevated FGF23 in rodent models of polycystic kidney disease[J]. Kidney Int, 2014, 85(6): 1340-1350.
29	Beben T, Ix JH, Shlipak MG, et al. Fibroblast growth factor-23 and frailty in elderly community-dwelling individuals: the cardiovascular health study[J]. J Am Geriatr Soc, 2016, 64(2): 270-276.
30	Hamrick MW. Increased bone mineral density in the femora of GDF8 knockout mice[J]. Anat Rec Part A: Discov Mol Cell Evol Biol, 2003, 272A(1): 388-391.
31	Park JH, Park KH, Cho S, et al. Concomitant increase in muscle strength and bone mineral density with decreasing IL-6 levels after combination therapy with alendronate and calcitriol in postmenopausal women[J]. Menopause N Y N Y, 2013, 20(7): 747-753.
32	Kawao N, Kaji H. Interactions between muscle tissues and bone metabolism[J]. J Cell Biochem, 2015, 116(5): 687-695.
33	Colaianni G, Mongelli T, Colucci S, et al. Crosstalk between muscle and bone via the muscle-myokine irisin[J]. Curr Osteoporos Rep, 2016, 14(4): 132-137.
34	Colaianni G, Mongelli T, Cuscito C, et al. Irisin prevents and restores bone loss and muscle atrophy in hind-limb suspended mice[J]. Sci Rep, 2017, 7(1): 2811.
35	Rudnicki MA, Williams BO. Wnt signaling in bone and muscle[J]. Bone, 2015, 80: 60-66.
36	陈小香, 邓伟民, 魏秋实, 等. 从GH/IGF-1轴与PI3K/Akt通路探讨老年骨质疏松症的发病机制[J]. 中国骨质疏松杂志, 2015, 21(11): 1412-1415.
37	Guttridge DC. Signaling pathways weigh in on decisions to make or break skeletal muscle[J]. Curr Opin Clin Nutr Metab Care, 2004, 7(4): 443-450.
38	Thoma A, Lightfoot AP. NF-κB and inflammatory cytokine signalling: role in skeletal muscle atrophy[J]. Adv Exp Med Biol, 2018, 1088: 267-279.
39	Becker C, Lord SR, Studenski SA, et al. Myostatin antibody (LY2495655) in older weak fallers: a proof-of-concept, randomised, phase 2 trial[J]. Lancet Diabetes Endocrinol, 2015, 3(12): 948-957.
40	Rudman D, Feller AG, Nagraj HS, et al. Effects of human growth hormone in men over 60 years old[J]. N Engl J Med, 1990, 323(1): 1-6.
41	Fatima M, Brennan-Olsen SL, Duque G. Therapeutic approaches to osteosarcopenia: insights for the clinician[J]. Ther Adv Musculoskelet Dis, 2019, 11: 1759720X19867009.
42	Bonnet N, Bourgoin L, Biver E, et al. RANKL inhibition improves muscle strength and insulin sensitivity and restores bone mass[J]. J Clin Invest, 2020, 130(6): 3329.
43	Phu S, Bani Hassan E, Vogrin S, et al. Effect of denosumab on falls, muscle strength, and function in community-dwelling older adults[J]. J Am Geriatr Soc, 2019, 67(12): 2660-2661.
44	Snyder PJ, Kopperdahl DL, Stephens-Shields AJ, et al. Effect of testosterone treatment on volumetric bone density and strength in older men with low testosterone: a controlled clinical trial[J]. JAMA Intern Med, 2017, 177(4): 471-479.

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