Yıl: 2020 Cilt: 26 Sayı: 2 Sayfa Aralığı: 47 - 57 Metin Dili: Türkçe DOI: 10.4274/tod.galenos.2020.65477 İndeks Tarihi: 25-11-2020

Osteosarkopeni: Klinik Perspektif

Öz:
Osteosarkopeni yaşlanma ile ilişkili iki kronik kas iskelet sistemi sorunu olan osteoporoz ve sarkopeninin birlikteliğini tanımlayan bir geriatrik sendromdur. Bu sendrom düşmelere ve kırıklara, morbidite, mortalite ve yeti yitiminde artışa ve yaşam kalitesinde azalmaya yol açabilir. Osteosarkopenin etiyopatogenezi multifaktöriyeldir; mekanik, biyokimyasal, genetik ve yaşam tarzı ile ilişkili faktörler ortaya çıkmasında önemli rollere sahiptir. Prevalansı %5 ile %37 arasında bildirilmiştir. Prevalanstaki bu değişkenlik, muhtemelen çalışma popülasyonlarındaki heterojeniteye veya farklı tanı kriterlerin kullanılmasına bağlıdır. Osteosarkopeni tanısı detaylı klinik değerlendirme (örneğin; tarama ve risk hesaplama araçları, kavrama kuvveti ölçümü, fiziksel performans testleri), laboratuvar testleri ve görüntüleme yöntemleri ile konulabilir. Osteoporoz tanısına yönelik olarak kemik mineral yoğunluğunu ölçmek için en sık kullanılan dual enerjili X-ışını absorbsiyometri yöntemidir. Sarkopenide meydana gelen iskelet kas kütlesindeki kaybı saptamak amacıyla kullanılan görüntüleme teknikleri ise dual enerjili X-ışını absorbsiyometri, bilgisayarlı tomografi, ultrasonografi ve manyetik rezonans görüntülemedir. Osteosarkopeninin tedavi seçenekleri arasında egzersiz, besin takviyeleri (protein, D vitamini, kalsiyum ve kreatin), yaşam tarzı değişiklikleri ve farmakolojik tedaviler yer almaktadır. Osteosarkopeni gelişiminin altında yatan mekanizmalar daha iyi anlaşıldıkça hem kası hem de kemiği hedef alan terapötik ajanların geliştirilmesi, yeni bir araştırma alanı haline gelmiştir. Bu derlemede, konuyla ilgili güncel literatür ışığında, osteosarkopenin epidemiyolojisi, patogenezi, tanı ve tedavisi özetlenmiştir.
Anahtar Kelime:

Osteosarcopenia: Clinical Perspective

Öz:
Osteosarcopenia is a geriatric syndrome characterised by the co-existence of osteoporosis and sarcopenia, two chronic musculoskeletal conditions associated with ageing. This syndrome may lead to falls and fractures, increased morbidity, mortality and disability, and reduced quality of life. The etiopathogenesis of osteosarcopenia is multifactorial; mechanical, biochemical, genetic and lifestyle factors all play important roles. Its prevalence has been reported between 5% and 37%. The varied prevalence is likely due to the heterogeneous populations or non-unified diagnostic criteria for this syndrome. Osteosarcopenia can be diagnosed by detailed clinical assessment (e.g. screening and risk calculation tools, grip strength, physical performance tests), laboratory tests and imaging methods. Dual-energy X-ray absorptiometry is the most common method used in measuring bone mineral density for the diagnosis of osteoporosis. The imaging techniques used to detect loss of skeletal muscle mass in sarcopenia are dual-energy X-ray absorptiometry, computed tomography, ultrasonography and magnetic resonance imaging. Treatment options for osteosarcopenia include exercise, nutritional supplements (protein, vitamin D, calcium and creatine), life style modifications and pharmacological therapy. With increasing understanding of the underlying mechanisms of osteosarcopenia, the development of therapeutic agents targeting both muscle and bone has become a new area of investigation. This review summarises the epidemiology, pathophysiology, diagnosis and treatment of osteosarcopenia in the light of the relevant literature.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
  • 1. Gökçe Kutsal Y. Geriatric syndromes. International Journal of Ageing in Developing Countries 2019;4:41-56.
  • 2. Rodriguez-Manas L, Fried LP. Frailty in the clinical scenario. Lancet 2015;385:e7-e9.
  • 3. NIH consensus development panel on osteoporosis prevention, diagnosis, and therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA 2001;285:785-95.
  • 4. Cruz Jentoft AJ, Sayer AA. Sarcopenia. Lancet 2019;393:2636-46.
  • 5. Eyigör S, Gökçe Kutsal Y. Sarcopenia: again and updated. Turk J Geriatr 2020;23:1-7.
  • 6. Kirk B, Zanker J, Duque G. Osteosarcopenia: epidemiology, diagnosis, and treatment- facts and numbers. J Cachexia Sarcopenia Muscle 2020;11:609-18.
  • 7. Paintin J, Cooper C, Dennison E. Osteosarcopenia. Br J Hosp Med (Lond) 2018;79:253-8.
  • 8. Reiss J, Iglseder B, Alzner R, Mayr-Pirker B, Pirich C, Kässmann H, et al. Sarcopenia and osteoporosis are interrelated in geriatric inpatients. Z Gerontol Geriat 2019;52:688-93.
  • 9. Kirk B, Al Saedi A, Duque G. Osteosarcopenia: A case of geroscience. Aging Med (Milton) 2019;2:147-56.
  • 10. Reginster JY, Beaudart C, Buckinx F, Bruyère O. Osteoporosis and sarcopenia: two diseases or one? Curr Opin Clin Nutr Metab Care 2016;19:31-6.
  • 11. Frisoli A, Chaves P, Inghan S, Carvalho A. Osteosarcopenia has stronger association with impaired physical function than sarcopenia only. Innov Aging 2018;2(Suppl 1):304.
  • 12. Fahimfar N, Zahedi Tajrishi F, Gharibzadeh S, Shafiee G, Tanha K, Heshmat R, et al. Prevalence of osteosarcopenia and its association with cardiovascular risk factors in Iranian older people: Bushehr Elderly Health (BEH) Program. Calcif Tissue Int 2020;106:364-70.
  • 13. Sjöblom S, Suuronen J, Rikkonen T, Honkanen R, Kröger H, Sirola J. Relationship between postmenopausal osteoporosis and the components of clinical sarcopenia. Maturitas 2013;75:175-80.
  • 14. Scott D, Johansson J, McMillan LB, Ebeling PR, Nordstrom P, Nordstrom A. Associations of sarcopenia and its components with bone structure and incident falls in Swedish older adults. Calcif Tissue Int 2019;105:26-36.
  • 15. Huo YR, Suriyaarachchi P, Gomez F, Curcio CL, Boersma D, Muir SW, et al. Phenotype of osteosarcopenia in older individuals with a history of falling. J Am Med Dir Assoc 2015;16:290-5.
  • 16. Yoo JI, Kim H, Ha YC, Kwon HB, Koo KH. Osteosarcopenia in patients with hip fracture is related with high mortality. J Korean Med Sci 2018;33:e27.
  • 17. Wang YJ, Wang Y, Zhan JK, Tang ZY, He JY, Tan P, et al. Sarco-osteoporosis: Prevalence and association with frailty in Chinese community-dwelling older adults. Int J Endocrinol 2015;2015:482940.
  • 18. Daly RM. Exercise and nutritional approaches to prevent frail bones, falls and fractures: an update. Climacteric 2017;20:119-24.
  • 19. Lombardi G, Sanchis-Gomar F, Perego S, Sansoni V, Banfi G. Implications of exercise-induced adipo-myokines in bone metabolism. Endocrine 2016;54:284-305.
  • 20. Schaap LA, Pluijm SMF, Deeg DJH, Visser M. Inflammatory markers and loss of muscle mass (sarcopenia) and strength. Am J Med 2006;119:526.e9-17.
  • 21. Kaji H. Interaction between muscle and bone. J Bone Metab 2014;21:29-40.
  • 22. Kawao N, Kaji H. Interactions between muscle tissues and bone metabolism. J Cell Biochem 2015;116:687-95.
  • 23. Houston DK, Nicklas BJ, Ding J, Harris TB, Tylavsky FA, Newman AB, et al. Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 2008;87:150-5.
  • 24. Bruyère O, Cavalier E, Reginster JY. Vitamin D and osteosarcopenia: an update from epidemiological studies. Curr Opin Clin Nutr Metab Care 2017;20:498-503.
  • 25. Girgis CM, Cha KM, So B, Tsang M, Chen J, Houweling PJ, et al. Mice with myocyte deletion of vitamin D receptor have sarcopenia and impaired muscle function. J Cachexia Sarcopenia Muscle 2019;10:1228-40.
  • 26. Kanis JA, Cooper C, Rizzoli R, Reginster JY; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2019;30:3-44.
  • 27. Kanis JA, Harvey NC, Johansson H, Liu E, Vandenput L, Lorentzon M, et al. A decade of FRAX: how has it changed the management of osteoporosis? Aging Clin Exp Res 2020;32:187-96.
  • 28. Dent E, Morley JE, Cruz-Jentoft AJ, Arai H, Kritchevsky SB, Guralnik J, et al. International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, diagnosis and management. J Nutr Health Aging 2018;22:1148-61.
  • 29. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019;48:16-31.
  • 30. Bahat G, Yilmaz O, Kılıç C, Oren MM, Karan MA. Performance of SARC-F in regard to sarcopenia definitions, muscle mass and functional measures. J Nutr Health Aging 2018;22:898-903.
  • 31. Hirschfeld HP, Kinsella R, Duque G. Osteosarcopenia: where bone, muscle, and fat collide. Osteoporos Int 2017;28:2781-90.
  • 32. Messina C, Maffi G, Vitale JA, Ulivieri FM, Guglielmi G, Sconfienza LM. Diagnostic imaging of osteoporosis and sarcopenia: a narrative review. Quant Imaging Med Surg 2018;8:86-99.
  • 33. Petak S, Barbu CG, Yu EW, Fielding R, Mulligan K, Sabowitz B, et al. The official positions of the International Society for Clinical Densitometry: body composition analysis reporting. J Clin Densitom 2013;16:508-19.
  • 34. Suetta C, Haddock B, Alcazar J, Noerst T, HansenOM, Ludvig H, et al. The Copenhagen Sarcopenia Study: lean mass, strength, power, and physical function in a Danish cohort aged 20-93 years. J Cachexia Sarcopenia Muscle 2019;10:1316-29.
  • 35. Compston J, Mc Clung MR, Leslie WD. Osteoporosis. Lancet 2019;393:364-76.
  • 36. Tannenbaum C, Clark J, Schwartzman K, Wallenstein S, Lapinski R, Meier D, et al. Yield of labora-tory testing to identify secondary contributors to osteoporosis in otherwise healthy women. J Clin Endocrinol Metab 2002;87:4431-7.
  • 37. Vasikaran S, Eastell R, Bruyere O, Foldes AJ, Garnero P, Griesmacher A, et al. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int 2011;22:391-420.
  • 38. Curcio F, Ferro G, Basile C, Liguori I, Parrella P, Pirozzi F, et al. Biomarkers in sarcopenia: a multifactorial approach. Exp Gerontol 2016;85:1-8.
  • 39. Calvani R, Marini F, Cesari M, Tosato M, Picca A, Anker SD, et al. Biomarkers for physical frailty and sarcopenia. Aging Clin Exp Res 2017;29:29-34.
  • 40. Poggiogalle E, Cherry KE, Su LJ, Kim S, Myers L, Welsh DA, et al. Body Composition, IGF1 status, and physical functionality in nonagenarians: Implications for osteosarcopenia. J Am Med Dir Assoc 2019;20:70-5.e2.
  • 41. Shankaran M, Czerwieniec G, Fessler C, Wong PA, Killion S, Turner SM, et al. Dilution of oral D3-creatine to measure creatine pool size and estimate skeletal muscle mass: development of a correction algorithm. J Cachexia Sarcopenia Muscle 2018;9:540-6.
  • 42. Clark RV, Walker AC, Miller RR, O’Connor-Semmes RL, Ravussin E, Cefalu WT. Creatine (methyl-d3) dilution in urine for estimation of total body skeletal muscle mass: accuracy and variability vs. MRI and DXA. J Appl Physiol (1985) 2018;124:1-9.
  • 43. Buehring B, Siglinsky E, Krueger D, Evans W, Hellerstein M, Yamada Y, et al. Comparison of muscle/ lean mass measurement methods: correlation with functional and biochemical testing. Osteoporos Int 2018;29:675-83.
  • 44. Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 2009;361:756-65.
  • 45. Bonnet N, Bourgoin L, Biver E, Douni E, Ferrari S. RANKL inhibition improves muscle strength and insulin sensitivity and restores bone mass. J Clin Invest 2019;129:3214-23.
  • 46. Morley JE. Pharmacologic options for the treatment of sarcopenia. Calcif Tissue Int 2016;98:319-33.
  • 47. Fatima M, Brennan-Olsen SL, Duque G. Therapeutic approaches to osteosarcoperia: insights for the clinical. Ther Adv Musculoskelet Dis 2019;11:1759720X19867009.
  • 48. Liu H, Bravata DM, Olkin I, Nayak S, Roberts B, Am Garber, et al. Systematic review: the safety and efficacy of growth hormone in the healthy elderly. Ann Intern Med 2007;146:104-15.
  • 49. Barake M, Arabi A, Nakhoul N, El-Hajj Fuleihan G, El Ghandour S, Klibanski A, et al. Effects of growth hormone therapy on bone density and fracture risk in age-related osteoporosis in the absence of growth hormone deficiency: a systematic review and meta-analysis. Endocrine 2018;59:39-49.
  • 50. Girgis CM, Mokbel N, Digirolamo DJ. Therapies for musculoskeletal disease: can we treat two birds with one stone? Curr Osteoporos Rep 2014;12:142-53.
  • 51. Camporez JP, Petersen MC, Abudukadier A, Moreira GV, Jurczak MJ, Friedman G, et al. Anti-myostatin antibody increases muscle mass and strength and improves insulin sensitivity in old mice. Proc Natl Acad Sci U S A 2016;113:2212-7.
  • 52. Becker C, Lord SR, Studenski SA, Warden SJ, Fielding RA, Recknor CP, et al. Myostatin antibody (LY2495655) in older weak fallers: A proof-of-concept, randomised, phase 2 trial. Lancet Diabetes Endocrinol 2015;3:948-57.
  • 53. Moreira LD, Oliveira ML, Lirani-Galvão AP, Marin-Mio RV, Santos RN, Lazaretti-Castro M. Physial exercise and osteoporosis: effects of different types of exercises on bone and physical function of postmenopausal women. Arq Brass Endocrinol Metabol 2014;58:514-22.
  • 54. Pellikaan P, Giarmatzis G, Vander Sloten J, Verschueren S, Jonkers I. Ranking of osteojenic potential of physical excerises in postmenausal women based on femoral neck strains. PLoS One 2018;13:eO195463.
  • 55. Daly RM, Via JD, Duckham RL, Fraser SF, Helge EW. Exercise for the prevention of osteoporosis in postmenopausal women: an evidence-based guide to the optimal prescription. Braz J Phys Ther 2019;23:170-80.
  • 56. Xu J, Lombardi G, Jiao W, Banfi G. Effects of exercise on bone status in female subject, from young girls to postmenopausal women: an overview of systematic reviews and meta-analyses. Sports Med 2016;46:1165-82.
  • 57. Daly RM, Gianoudis J, Kersh ME, Bailey CA, Ebeling PR, Krug R, et al. Effects of a12-month supervised, community-based, multimodal excercise program followed by a 6-month research to practice transition on bone mineral density, trabecular microarchitecture and physical function in older adults: a randomized controlled trial. J Bone Miner Res 2020;35:419-29.
  • 58. Sardelli AV, Komatsu TR, Mori MA, Gáspari AF, Chacon-Mikahil MPT. Resistance training prevents muscle loss induced by caloric restriction in obese elderly individuals: a systematic review and meta analysis. Nutrients 2018;10:423.
  • 59. Wilhem M, Roskovensky G, Emery K, Manno C, Valek K, Cook C. Effect of resistance exercises on functon in older adults with osteoporosis or osteopenia: a systematic review. Physioyher Can 2012;64:386-94.
  • 60. Marin-Cascales E, Alcarez PE, Ramos-Campo DJ, Martinez-Rodriguez A, Chung LH, Rubio-Arias JÁ. Whole-body vibration training and bone health in postmenopausal women: a systematic review and meta-analysis. Medicine (Baltimore) 2018;97:e11918.
  • 61. Rabe KG, Matsuse H, Jackson A, Segal NA. Evaluation of the combined application of neuromuscular electrical stimulation and volitional contractions on thigh muscle strength, knee pain, and physical performance in women at risk for knee osteoarthritis: A randomized controlled trial. PM R 2018;10:1301-10.
  • 62. Mangano KM, Sahni S, Kerstetter JE. Dietary protein is beneficial to bone health under conditions of adequate calcium intake: an update on clinical research. Curr Opin Clin Nutr Metab Care 2014;17:69-74.
  • 63. Wilkinson DJ, Hassain T, Hill DS, Phillips BE, Crossland H, Williams J, et al. Effect of leucine and its metabolite β-hydroxy-β-methylbutyrate on human skeletal muscle protein metabolism. J Physiol 2013;591:2911-23.
  • 64. Rizzoli R, Stevenson JC, Bauer JM, van Loon LJ, Walrand S, Kanis JA, et al. The role of dietary protein and vitanin D in maintaining musculoskeletal health in postmenopausal women: a consensus statement from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Maturitas 2014;79:122-32.
  • 65. Anagnostis P, Dimopoulou C, Karras S, Lambrinoudaki I, Goulis DG. Sarcopenia in post-menopausal women: Is there any role for vitamin D? Maturitas 2015;82:56-64.
  • 66. Gunton JE, Girtis JM, Baldock RA, Lips P. Bone muscle interactions and vitamin D. Bone 2015;80:89-94.
  • 67. Hirani V, Cumming RG, Naganathan V, Blyth F, Le Couteur DG, Hsu B, et al. Longitidual associations between vitamin D metabolities and sorcopenia in older Australian men: the Concord health and aging in men project. J Gerontol A Biol Med Sci 2017;73:131-8.
  • 68. De Spiegeleer A, Beckwee D, Bautmans I, Petrovic M; Sarcopenia Guidelines Development group of the Belgian Society of Gerontology and Geriatrics (BSGG). Pharmacological interventions to improve muscle mass, muscle strength physical performance in older people: an umbrella review of systematic reviews and meta-analysis. Drugs Aging 2018;35:719-34.
  • 69. Tankeu AT, Ndip Agbor V, Noubiap JJ. Calcium supplementation and cardiovascular risk: a rising concern. J Clin Hypertens 2017;19:640-6.
APA Gokce Kutsal F, Özdemir O, Saridogan M, günendi z, Küçükdeveci A, Kirazlı Y, Meray J (2020). Osteosarkopeni: Klinik Perspektif. , 47 - 57. 10.4274/tod.galenos.2020.65477
Chicago Gokce Kutsal F. Yesim,Özdemir Oya,Saridogan Merih,günendi zafer,Küçükdeveci Ayşe A.,Kirazlı Yeşim,Meray Jale Osteosarkopeni: Klinik Perspektif. (2020): 47 - 57. 10.4274/tod.galenos.2020.65477
MLA Gokce Kutsal F. Yesim,Özdemir Oya,Saridogan Merih,günendi zafer,Küçükdeveci Ayşe A.,Kirazlı Yeşim,Meray Jale Osteosarkopeni: Klinik Perspektif. , 2020, ss.47 - 57. 10.4274/tod.galenos.2020.65477
AMA Gokce Kutsal F,Özdemir O,Saridogan M,günendi z,Küçükdeveci A,Kirazlı Y,Meray J Osteosarkopeni: Klinik Perspektif. . 2020; 47 - 57. 10.4274/tod.galenos.2020.65477
Vancouver Gokce Kutsal F,Özdemir O,Saridogan M,günendi z,Küçükdeveci A,Kirazlı Y,Meray J Osteosarkopeni: Klinik Perspektif. . 2020; 47 - 57. 10.4274/tod.galenos.2020.65477
IEEE Gokce Kutsal F,Özdemir O,Saridogan M,günendi z,Küçükdeveci A,Kirazlı Y,Meray J "Osteosarkopeni: Klinik Perspektif." , ss.47 - 57, 2020. 10.4274/tod.galenos.2020.65477
ISNAD Gokce Kutsal, F. Yesim vd. "Osteosarkopeni: Klinik Perspektif". (2020), 47-57. https://doi.org/10.4274/tod.galenos.2020.65477
APA Gokce Kutsal F, Özdemir O, Saridogan M, günendi z, Küçükdeveci A, Kirazlı Y, Meray J (2020). Osteosarkopeni: Klinik Perspektif. Türk Osteoporoz Dergisi, 26(2), 47 - 57. 10.4274/tod.galenos.2020.65477
Chicago Gokce Kutsal F. Yesim,Özdemir Oya,Saridogan Merih,günendi zafer,Küçükdeveci Ayşe A.,Kirazlı Yeşim,Meray Jale Osteosarkopeni: Klinik Perspektif. Türk Osteoporoz Dergisi 26, no.2 (2020): 47 - 57. 10.4274/tod.galenos.2020.65477
MLA Gokce Kutsal F. Yesim,Özdemir Oya,Saridogan Merih,günendi zafer,Küçükdeveci Ayşe A.,Kirazlı Yeşim,Meray Jale Osteosarkopeni: Klinik Perspektif. Türk Osteoporoz Dergisi, vol.26, no.2, 2020, ss.47 - 57. 10.4274/tod.galenos.2020.65477
AMA Gokce Kutsal F,Özdemir O,Saridogan M,günendi z,Küçükdeveci A,Kirazlı Y,Meray J Osteosarkopeni: Klinik Perspektif. Türk Osteoporoz Dergisi. 2020; 26(2): 47 - 57. 10.4274/tod.galenos.2020.65477
Vancouver Gokce Kutsal F,Özdemir O,Saridogan M,günendi z,Küçükdeveci A,Kirazlı Y,Meray J Osteosarkopeni: Klinik Perspektif. Türk Osteoporoz Dergisi. 2020; 26(2): 47 - 57. 10.4274/tod.galenos.2020.65477
IEEE Gokce Kutsal F,Özdemir O,Saridogan M,günendi z,Küçükdeveci A,Kirazlı Y,Meray J "Osteosarkopeni: Klinik Perspektif." Türk Osteoporoz Dergisi, 26, ss.47 - 57, 2020. 10.4274/tod.galenos.2020.65477
ISNAD Gokce Kutsal, F. Yesim vd. "Osteosarkopeni: Klinik Perspektif". Türk Osteoporoz Dergisi 26/2 (2020), 47-57. https://doi.org/10.4274/tod.galenos.2020.65477