OSTEOPOROZLU HASTALARDA KEMİK KÜTLESİ İLE KAS KÜTLESİ VE FONKSİYONU ARASINDAKİ İLİŞKİNİN DEĞERLENDİRİLMESİ

Abstract

Assessment of Association Between Bone Mass and Muscle Mass with Functionality in Osteoporotic Patients Introduction: Musculoskeletal system disorders increase gradually in aging population worldwide. Bone and muscle mass decline noticeably with the fifth decade of life. This reduction could be synergistic. In this study, we aimed to assess the association between thigh muscle thickness derived from dual-energy X-ray absorptiometry (DXA) scans and ultrasound with muscle functionality measured using physical performance tests. Materials and Methods: We enrolled 175 perimenopausal and postmenopausal females age between 41-87 who had admission to our outpatient clinic in physical medicine and rehabilitation department. We collect demographic data, anthropometric measurements of subjects and bone mineral density (measured with DXA), plasma vitamin D, calcium and phosphate levels. We assessed muscle strength and physical performance via handgrip test, walking speed and chair-stand test (CST). Muscle thickness evaluated from bulk of lower limb using ultrasound-based measurements. Results: The subjects had a mean age of 57.92 (±0.66) years. In 51 (29.14%) patients were osteoporotic and 76 (43.43%) were obtained osteopenic. Subjects with normal BMD values had better measurements in muscle strength and performance tests compared to other patient groups. Osteoporotic group has a decreased muscle thickness (p=0.003) and sarcopenia observed more (p=0.043). In correlation analysis, we observed a positive relation between L1-4 KMD scores with body weight, length, lower limb muscle thickness, handgrip strength and walking speed. However, there is a negative correlation with age, smoking status and CST time. Similar correlations observed with femur neck BMD values, controversy femur neck BMD and hypertension and coronary artery disease has not positive relation. The association between BMD and sarcopenia parameters (lower limb muscle thickness, handgrip, CST and walking speed) evaluated according to multivariate linear and logistic regression analysis. Among functional and performances tests; Prolonged CST duration determined as predictive factor for femur neck and low walking speed determined as predictive factor for L1-L4 vertebrate osteopenia/osteoporosis respectively. Conclusion: Subjects with normal BMD values has improved performance compared to osteopenic and osteoporotic subjects during muscle strength and physical performance tests. Detection of muscle mass using US and tests, which are easy to apply and low cost in clinical conditions, can provide early diagnosis of osteoporotic or osteopenic individuals. Further, studies involving more subjects are needed to more obviously demonstrate the effects of muscle mass, and function on bone mass.