臨床整形外科52巻12号

2017年12月発行

誌上シンポジウム 慢性腰痛のサイエンス

—高齢者の腰痛—骨粗鬆症とサルコペニア

著者： 藤本和輝¹² 稲毛一秀² 豊口透³ 折田純久² 江口和⁴ 鈴木都² 西能健⁵ 寺門淳⁶ 大鳥精司²

所属機関： ¹千葉県済生会習志野病院整形外科・千葉脊椎外科センター ²千葉大学大学院医学研究院整形外科学 ³千葉きぼーるクリニック整形外科 ⁴国立病院機構下志津病院整形外科 ⁵西能病院 ⁶北千葉整形外科

ページ範囲：P.1167 - P.1173

　腰痛患者65名を対象にしてdual energy X-ray absorptiometry(DXA)法とbioelectrical impedance analysis(BIA)法の四肢筋量の相関関係と実際の測定値の差異について調査した．四肢筋量測定において，DXA法とBIA法の測定値は強い正の相関関係を認めたが，BIA法の測定値が有意に高値であった．また，四肢筋量と骨密度も正の相関関係を認めた．骨粗鬆症患者130例において，骨粗鬆症薬の筋量に対する効果について調べた．骨粗鬆症がなく経過観察を行ったコントロール群に比し投与後6カ月で骨密度は有意に増加したが，下肢筋量は有意に減少した．ビタミンD併用患者では下肢筋量の減少量が有意に少なかった．

参考文献

1）Tanaka M, Nagai K, Koshiba H, et al. Sarcopenia and its relationship with falling among outpatients attending a geriatric and memory clinic at Kyorin University Hospital. Nihon Ronen Igakkai Zasshi 2017;54:63-74.

2）Miyakoshi N, Hongo M, Mizutani Y, et al. Prevalence of sarcopenia in Japanese women with osteopenia and osteoporosis. J Bone Miner Metab 2013;31:556-61.

3）Sjöblom S, Suuronen J, Rikkonen T, et al. Relationship between postmenopausal osteoporosis and the components of clinical sarcopenia. Maturitas 2013;75:175-80.

4）Rosenberg IH. Sarcopenia:origins and clinical relevance. J Nutr 1997;127:990S-991S.

5）Baumgartner RN, Koehler KM, Gallagher D, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 1998;147:755-63.

6）真田樹義，宮地元彦，山元健太・他．日本人成人男女を対象としたサルコペニア簡易評価法の開発．体力科学2010；59：291-302．

7）Verney J, Schwartz C, Amiche S, et al. Comparisons of a multi-frequency bioelectrical impedance analysis to the dual-energy x-ray absorptiometry scan in healthy young adults depending on their physical activity level. J Hum Kinet 2015;47:73-80.

8）Huang AC, Chen YY, Chuang CL, et al. Cross-mode bioelectrical impedance analysis in a standing position for estimating fat-free mass validated against dual-energy x-ray absorptiometry. Nutr Res 2015;35:982-9.

9）Esco MR, Snarr RL, Leatherwood MD, et al. Comparison of total and segmental body composition using DXA and multi frequency bioimpedance in collegiate female athletes. J Strength Cond Res 2015;29:918-25.

10）Velazquez-Alva Mdel C, Irigoyen-Camacho ME, Huerta-Huerta R, et al. A comparison of dual energy x-ray absorptiometry and two bioelectrical impedance analyzers to measure body fat percentage and fat-free mass index in a group of Mexican young women. Nutr Hosp 2014;29:1038-46.

11）Wang JG, Zhang Y, Chen HE, et al. Comparison of two bioelectrical impedance analysis devices with dual energy X-ray absorptiometry and magnetic resonance imaging in the estimation of body composition. J Strength Cond Res 2013;27:236-43.

12）Buckinx F, Reginster JY, Dardenne N, et al. Concordance between muscle mass assessed by bioelectrical impedance analysis and by dual energy X-ray absorptiometry:a cross-sectional study. BMC Musculoskelet Disord 2015;16:60. doi:10.1186/s12891-015-0510-9.

13）厚生労働科学研究補助金(長寿科学総合研究事業)高齢者における加齢性筋肉減弱現象(サルコペニア)に関する予防対策確立のための包括的研究研究班．サルコペニア：定義と診断に関する欧州関連学会のコンセンサス−高齢者のサルコペニアに関する欧州ワーキンググループの報告−の監訳．日老医誌2012；49．788-805．

14）Chien MY, Huang TY, Wu YT, et al. Prevalence of sarcopenia estimated using a bioelectrical impedance analysis prediction equation in community-dwelling elderly people in Taiwan. J Am Geriatr Soc 2008;56:1710-5.

15）Fujimoto K, Inage K, Toyoguchi T, et al. The effects of minodronate and activated vitamin D on bone mineral density and muscle mass in postmenopausal women with osteoporosis, Spine Surgery and Related Research (SSRR). 2017 (in press).

16）Tanimoto Y, Watanabe M, Kono R, et al. Aging changes in muscle mass of Japanese. Nihon Ronen Igakkai Zasshi 2010;47:52-7. [Article in Japanese]

17）Shiomi K, Nagata Y, Kiyono T, et al. Differential impact of the bisphosphonate alendronate on undifferentiated and terminally differentiated human myogenic cells. J Pharm Pharmacol 2014;66:418-27.

18）Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, et al. Fall prevention with supplemental and active forms of vitamin D:a meta-analysis of randomised controlled trials. BMJ 2009;339:b3692.

19）Ito S, Harada A, Kasai T, et al. Use of alfacalcidol in osteoporotic patients with low muscle mass might increase muscle mass:an investigation using a patient database. Geriatr Gerotol Int 2014;14 (Suppl. 1):122-8.