医学
肌萎缩
骨质疏松症
骨量减少
内科学
甲状旁腺激素
继发性甲状旁腺功能亢进
维生素D与神经学
体质指数
握力
物理疗法
骨矿物
内分泌学
钙
作者
Pushpa Suriyaarachchi,Fernando Gómez,Carmen Lucía Curcio,Derek Boersma,Lavanya Srinivasa Murthy,Vivian Grill,Gustavo Duque
出处
期刊:Maturitas
[Elsevier]
日期:2018-07-01
卷期号:113: 21-25
被引量:30
标识
DOI:10.1016/j.maturitas.2018.04.006
摘要
The combination of osteopenia/osteoporosis and sarcopenia (osteosarcopenia) defines a diagnostic subset of individuals at higher risk of falls, fractures and institutionalization. In this study we aimed to assess the potential role of high serum levels of parathyroid hormone (PTH) in osteosarcopenia. We hypothesized that a high PTH level is one of the major determinants of this syndrome.Cross-sectional study in 400 subjects (mean age = 79, 65% women) assessed between 2009 and 2014 at the Falls and Fractures Clinic, Nepean Hospital (Penrith, Australia).Medical history, physical examination, bone densitometry, body composition, posturography, grip strength, gait parameters, and blood tests for nutrition and secondary causes of sarcopenia and osteoporosis. Patients were assigned to one of four groups: 1) osteopenic/osteoporotic; 2) sarcopenic; 3) osteosarcopenic; or 4) non-sarcopenic/non-osteopenic. Patients with abnormal corrected calcium levels were excluded from analysis. Between-group differences were assessed using one-way analysis of variance and chi-squared tests. Multivariable linear regression was used to evaluate the association between the groups and PTH levels adjusted for age, vitamin D, renal function and albumin.24% of the subjects had a high serum PTH level with normal corrected calcium level. These subjects were older, reported more falls per year, and had lower grip strength, limits of stability, BMD, and gait velocity. Subjects with high PTH levels were more likely to be in the osteosarcopenia group than in the non-sarcopenic/non-osteopenic group (OR 6.88; CI: 1.9-9.2).We reported an independent association between high PTH levels and osteosarcopenia. Our results suggest an important role of PTH in osteosarcopenia that deserves further exploration.
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