Jun-Il Yoo

Osteosarcopenia in Patients with Hip Fracture Is Related with High Mortality

Background This study evaluated the prevalence of osteosarcopenia, as well as the relationship between one-year mortality and osteosarcopenia, as defined by criteria of the Asian Working Group on Sarcopenia in patients age 60 or older with hip fracture. Methods A total of 324 patients age 60 years or older with hip fracture were enrolled in this retrospective observational study. The main outcome measure was the prevalence of osteosarcopenia, as well as the relationship between osteosarcopenia and 1-year mortality. The diagnosis of sarcopenia was carried out according to the Asian Working Group on Sarcopenia. Whole body densitometry analysis was used for skeletal muscle mass measurement and muscle strength were evaluated by handgrip testing. Mortality was assessed at the end of 1-year. Cox regression analysis was utilized to analyze the risk factor of osteosarcopenia. Results Of 324 patients with hip fracture, 93 (28.7%) were diagnosed with osteosarcopenia. In total, 9.0% died during the one-year follow-up. A one-year mortality of osteosarcopenia (15.1%) was higher than that of other groups (normal: 7.8%, osteoporosis only: 5.1%, sarcopenia only: 10.3%). Osteosarcopenia had a 1.8 times higher mortality rate than non-osteosarcopenia. Conclusion The present study demonstrates that the prevalence of osteosarcopenia is not rare, and has a higher mortality rate than the non-osteosarcopenia group at the 1-year follow-up period. This is the first study evaluating the relationship between mortality and osteosarcopenia in patients with hip fracture.

Relationship between water intake and skeletal muscle mass in elderly Koreans: A nationwide population-based study

OBJECTIVES The purposes of this study were to evaluate the correlation between sarcopenia and water intake and investigate lack of daily water intake in the presence of sarcopenia in an elderly population. METHODS Data from 3656 participants (1582 men and 2074 women) were analyzed using the Korea National Health and Nutrition Examination Survey. Sarcopenia was defined in accordance with the criteria of the Asia Working Group for Sarcopenia. Water intake was assessed using the dietary water adequacy ratio and was calculated by dividing the daily water intake from fluid by the recommended daily amount of 1000 mL in men and 900 mL in women. RESULTS Water intake from food (g/d and cup/d) and dietary water adequacy ratio (mL) were significantly lower in the sarcopenia group (757.8 g, 890.1 g, and 0.74 mL in men; 511.9 g, 757.8 g, and 0.70 mL in women, respectively) than in the non-sarcopenia group (878.4 g, 1015.1 g, and 0.81 mL in men; 581.3 g, 790.5 g, 0.74 mL in women, respectively). In elderly men, the odds ratio of sarcopenia in the lowest quartile increased to 1.47 (range, 1.13-1.91) in Model 2 compared with that in the highest quartile. In elderly women, the odds ratio of sarcopenia in the lowest quartile increased to 1.50 (range, 1.08-2.08) in Model 2 compared with that in the highest quartile. CONCLUSIONS The prevalence of sarcopenia in the elderly population was related to inadequate dietary water intake after adjusting for covariates. Adequate water intake in the elderly should be recommended to prevent dehydration-related complications, including sarcopenia.

Ultrasonographic Evaluation for the Effect of Extracorporeal Shock Wave Therapy on Gastrocnemius Muscle Spasticity in Patients With Chronic Stroke

Extracorporeal shock wave therapy (ESWT) has been suggested as a useful treatment for spasticity in patients with stroke. To date, most studies have used clinical or biomechanical assessments to determine the effects of treatment.

Relationship between endothelial function and skeletal muscle strength in community dwelling elderly women: Relationship between endothelial function and skeletal muscle strength

The aim of this study is to determine whether there is correlation between endothelial function and skeletal muscle function measured by hand grip strength in elderly women.

Review of Epidemiology, Diagnosis, and Treatment of Osteosarcopenia in Korea

Sarcopenia was listed in the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) as M62.84, on October 1, 2016. Sarcopenia is primarily associated with metabolic diseases, such as diabetes, obesity, and cachexia, as well as chronic renal failure, congestive heart failure, and chronic obstructive pulmonary disease. Sarcopenia is also significantly associated with osteoporosis in elderly populations and the combined disease is defined as osteosarcopenia. Several studies have confirmed that sarcopenia and osteoporosis (osteosarcopenia) share common risk factors and biological pathways. Osteosarcopenia is associated with significant physical disability, representing a significant threat to the loss of independence in later life. However, the pathophysiology and diagnosis of osteosarcopenia are not fully defined. Additionally, pharmacologic and hormonal treatments for sarcopenia are undergoing clinical trials. This review summarizes the epidemiology, pathophysiology, diagnosis, and treatment of osteosarcopenia, and includes Korean data.

Hand grip strength measurement in different epidemiologic studies using various methods for diagnosis of sarcopenia: a systematic review

BackgroundThe purpose of this systematic review was to compare various methods for measuring hand grip strength to provide data for the development of a standardized protocol for such a measurement based on epidemiologic studies of sarcopenia in older population.MethodsSystematic review and meta-analysis were performed using 34 available epidemiologic studies.ResultsThe choice of hand dynamometer and measurement protocols for measuring hand grip strength was not consistent among studies. Mean values of hand grip strength in older population were also different by study area (Europe, America, and Asia) and gender.ConclusionThis systematic review demonstrated that various grip strength measurement methods were used in different epidemiologic studies. A standardized method is needed to enable more consistent measurement of grip strength and better assessment of sarcopenia.

Measurement Uncertainty in Spine Bone Mineral Density by Dual Energy X-ray Absorptiometry

Background The purpose of this study was to calculate the measurement uncertainty of the process of bone mineral density (BMD) analysis using dual energy X-ray absorptiometry with traceability. Methods Between March 2015 and October 2016, among healthy participants in their 20s and 30s, the study included those who had not taken calcium, vitamin D supplements and steroids and were without a history of osteoporosis, osteopenia and diseases related to osteoporosis. Relational expression of the model was established based on Guide to the Expression of Uncertainty in Measurements and Eurachem and the uncertainty from each factor was evaluated. Results The combined standard uncertainty was 0.015, while the expanded uncertainty was 0.0298. The factor-specific standard uncertainties that occurred in the process of measuring BMD were 0.72% for the calibration curve, 0.9% for the internal quality control (IQC) using Aluminum Spine Phantom, 0.58% for European Spine Phantom (ESP), and 0.9% for the inspector precision (IP). Conclusions The combined standard uncertainty of the spine BMD corrected with ESP was 0.015 when measured at one time and targeting one participant. The uncertainties of the accuracy of the IQC and the IP were higher than that of the other factors. Therefore, there will be a need for establishment of protocols to lower these uncertainties.

Fracture Preventing Effects of Maxmarvil® Tablets (Alendronate 5 mg + Calcitriol 0.5 µg) in Patients with Osteoporosis

Background The purpose of this prospective, open-label, observational study was to assess the fracture preventing effect of Maxmarvil® tablets (alendronate 5 mg + calcitriol 0.5 µg) in patients with osteoporosis and to evaluate the change in bone mineral density (BMD) at the minimum 1-year follow-up. Methods In this multicenter observational study, 691 patients with osteoporosis (aged 50 years or older) were treated with alendronate 5 mg + calcitriol 0.5 µg/day during their normal course of care. Patients were assessed at baseline and at 6 and 12 months. Baseline characteristics (including age, gender, concomitant disease, and baseline fractures) were evaluated. Results From among the 848 participants, 149 individuals were lost to follow-up at the time of the study and 8 people had died. The 691 participants (54 men and 637 women) finished the follow-up study and completed the questionnaire. The mean age of the participants was 71.5 years (range, 50–92 years; mean age, 72.3 years for men and 71.4 years for women). Osteoporotic fracture occurred in 19 patients (2.7%). BMD of the lumbar spine and hip was improved by 5% and 1.5% at the latest follow-up. At the latest follow-up, 24 patients (3.5%) complained of drug-related complications such as dyspepsia, constipation, and nausea. Conclusions This prospective observational study demonstrated that alendronate 5 mg + calcitriol 0.5 µg/day had a preventive effect on osteoporotic fracture and it increased the BMD of the lumbar spine by 5% at the latest follow-up.