Background: Osteoporosis and sarcopenia are important aspects of motor neuron disease (MND). Individuals with amyotrophic lateral sclerosis (MND-ALS) have an increased risk of falls and fractures. Currently, the standard of care does not involve a routine assessment of bone mineral density (BMD) and body composition in these patients. We aimed to assess BMD, bone mineral parameters and body composition in men with MND and compared them with healthy controls. Methods: Consecutive males between 50 and 80 years of age diagnosed as MND-ALS by revised El Escorial criteria and able to walk unassisted attending Neurology outpatient clinic were recruited into the study. Age, gender and body mass index (BMI) matched healthy controls were recruited from the local community. BMD and body composition were assessed by dual-energy x-ray absorptiometry (DXA). Bone mineral parameters and bone turnover markers (BTMs) were also assessed in them. Results: A total of 30 subjects with MND-ALS and 33 controls were recruited. The mean age (years) was 59.2 in cases and 61.2 in controls. The mean BMD (g/cm²) between the two groups was similar; however, BTMs were significantly higher in the MND group (P < 0.05). Subjects with MND-ALS had significantly lower mean appendicular lean mass (ALM) (19.9 versus 22.4 kg; P = 0.007) and ALM corrected for BMI than the healthy control group (0.858 versus 0.934 kg/kg/m²; P = 0.034). Sarcopenic obesity (Percentage fat mass >27% + ALM/BMI <0.786 kg/kg/m²) was more prevalent in MND-ALS compared to controls (44.5% versus 16.7%; P = 0.03). Conclusion: Although BMD was not significantly different between subjects with MND-ALS and healthy controls, BTMs were significantly higher in the MND group indicating a high bone turnover state. Sarcopenia and sarcopenic obesity were also more in MND-ALS group than controls. Routine assessment for bone health parameters and body composition indices may be included in management of the patients with MND.


中文翻译：

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运动神经元疾病男性的骨矿物质密度和身体成分：印度南部教学医院的一项研究


背景：骨质疏松症和肌肉减少症是运动神经元病 (MND) 的重要方面。患有肌萎缩侧索硬化症 (MND-ALS) 的人跌倒和骨折的风险增加。目前，护理标准不涉及对这些患者的骨矿物质密度 (BMD) 和身体成分进行常规评估。我们旨在评估 MND 男性的 BMD、骨矿物质参数和身体成分，并将其与健康对照组进行比较。方法：研究招募了通过修订的 El Escorial 标准诊断为 MND-ALS 并且能够在没有帮助的情况下在神经科门诊就诊的 50 至 80 岁的连续男性参与研究。从当地社区招募年龄、性别和体重指数（BMI）匹配的健康对照。通过双能 X 射线吸收测定法 (DXA) 评估 BMD 和身体成分。还在其中评估了骨矿物质参数和骨转换标志物（BTM）。结果：共招募了 30 名 MND-ALS 受试者和 33 名对照。病例的平均年龄（岁）为 59.2，对照组为 61.2。平均骨密度 (g/cm ²) 两组之间相似；然而，MND 组的 BTM 显着升高（P < 0.05）。患有 MND-ALS 的受试者的平均四肢瘦体重 (ALM) 显着降低（19.9 对 22.4 kg；P = 0.007）和经 BMI 校正的 ALM 显着低于健康对照组（0.858 对 0.934 kg/kg/m ²；P = 0.034） . 与对照组相比，少肌性肥胖（脂肪量百分比 >27% + ALM/BMI <0.786 kg/kg/m ²）在 MND-ALS 中更为普遍（44.5% 对 16.7%；P = 0.03）。结论：尽管 MND-ALS 受试者和健康对照组的 BMD 没有显着差异，但 MND 组的 BTM 显着更高，表明骨转换状态高。MND-ALS 组的肌肉减少症和肌肉减少性肥胖症也多于对照组。骨骼健康参数和身体成分指数的常规评估可能包括在 MND 患者的管理中。