肌少-骨质疏松症:骨骼与肌肉的相互作用

Osteosarcopenia:muscle-bone interactions

背景:研究发现肌少-骨质疏松症降低了患者的生活质量,并且增加住院风险。与单独的骨质疏松症或者肌少症患者相比,肌少-骨质疏松症患者具有更高的跌倒和骨折风险。然而,既往研究对肌少-骨质疏松症的流行病学报道较少,骨骼和肌肉的相互联系不明确,相关预防及治疗措施较少。目的:阐述骨骼与肌肉之间的相互作用及肌少-骨质疏松症的预防治疗方法,呼吁建立早期的干预体系。方法:检索PubMed数据库及中国知网数据库1996-2020年发表的相关文章,检索词为“肌少-骨质疏松症,流行病学,骨骼和肌肉的相互作用,干预,治疗,osteosarcopenia,epidemiology,interaction between skeleton and muscle,intervention,treatment”。初检文章424篇,经过筛选、整理,最终纳入74篇文章进行分析、总结。结果与结论:①骨骼和肌肉具有相似的组织起源,在体内或体外因素下分化而来,相邻的解剖关系为力学信号及化学信号提供了基础条件,骨骼和肌肉之间的相互影响主要通过力学刺激与其分泌的生物活性因子实现的;②与大多数疾病类似,肌少-骨质疏松症的预防比治疗更重要,人体的骨骼和肌肉质量在年轻时期就达到峰值,之后开始随年龄增加逐渐下降;③肌少-骨质疏松症复杂的、多因素致病的特点要求多方面的预防和治疗策略,主要的防治措施包括:抗阻训练、营养饮食疗法、药物疗法等;④目前国内并没有给予肌少-骨质疏松症足够的重视,因此相应的早期干预体系建立也是滞后甚至是空白的。

BACKGROUND:Studies have found that there is a reduction in the quality of life of patients with osteosarcopenia and an increase in the risk of hospitalization.Compared to patients with osteoporosis or sarcopenia alone,patients with osteosarcopenia have a higher risk of falls and fractures.However,there are few epidemiological reports on osteosarcopenia,with the relationship between bones and muscles being unknown,and few treatment measures have developed.OBJECTIVE:To elucidate the interaction between bone and muscle and the prevention and treatment of osteosarcopenia,thereby calling for an early intervention system.METHODS:PubMed and CNKI were searched for relevant articles published from 1996 to 2020 using the keywords of“osteosarcopenia,epidemiology,interaction between skeleton and muscle,intervention,treatment.”A total of 424 articles were initially examined,and 74 articles were finally included for analysis and summary after screening and sorting.RESULTS AND CONCLUSION:Bone and muscle have similar tissue origin and are differentiated from each other under in vivo or in vitro factors.The adjacent anatomical relationship provides the basic conditions for mechanical signals and chemical signals.The interaction between bone and muscle is mainly realized through mechanical stimulation and its secreted bioactive factors.Like most diseases,the prevention of osteosarcopenia is more important than its treatment.Bone and muscle mass peaks at a young age and then begins to decline with age.The complex and multifactorial characteristics of osteosarcopenia require multifaceted prevention and treatment strategies.The main prevention and treatment measures include:resistance training,nutrition diet therapy,drug therapy,etc.Currently,no enough attention has been paid to osteosarcopenia in China.Therefore,establishing the corresponding early intervention system in China is lagging behind or even a gap in relevant fields.