Osteoporosis liaison service in Japan

Hiroshi Hagino,Takashi Wada 대한골다공증학회 2019 Osteoporosis and Sarcopenia Vol.5 No.3

A fracture liaison service (FLS) is a secondary fracture prevention program that is led by a coordinator. A program called the osteoporosis liaison service (OLS), which includes FLS, was first implemented in Japan and has become popular for solving problems related to osteoporosis treatment. OLS and FLS have the same purpose, namely preventing fragility fractures, but while FLS focuses mainly on secondary fracture prevention in fracture patients, OLS addresses this issue as well as primary fracture prevention at clinics and in communities.

Locomotive syndrome presents a risk for falls and fractures in the elderly Japanese population

Hiromi Matsumoto,Hiroshi Hagino,Takashi Wada,Eri Kobayashi 대한골다공증학회 2016 Osteoporosis and Sarcopenia Vol.2 No.3

“Locomotive syndrome” is used to designate the condition of individuals with musculoskeletal disease who are highly likely to require nursing care. This article reviews screening, prevalence, causal and related factors, and the relationship between locomotive syndrome and falls and fractures in older adults with this syndrome. A few self-administered questionnaire tools are available to assess individuals for locomotive syndrome. Additionally, screening methods, including a physical functioning assessment, are appropriate for detailed discrimination of locomotive syndrome. The prevalence of locomotive syndrome is significantly higher in women than in men, and tends to increase markedly from 70 years of age. More severe locomotive syndrome is related to knee pain, osteoporosis, sarcopenia, and lumbar disease. The incidence of falling in locomotive syndrome is higher than the incidence for the older population in general. Locomotive training including squats and a unipedal standing exercise has been recommending to prevent locomotive syndrome. This training improves muscle strength and balance function for older people who have a risk for locomotive syndrome.

Relationship among Osteoporosis, Sarcopenia, Locomotive Syndrome, and Spinal Kyphosis in Older Individuals Living in a Local Mountain Area

Tanishima Shinji,Hagino Hiroshi,Matsumoto Hiromi,Tanimura Chika,Nagashima Hideki 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.6

Study Design: Cross-sectional cohort study.Purpose: This study investigated the relationship among osteoporosis, sarcopenia, locomotive syndrome, and spinal kyphosis in older individuals living in a mountain area.Overview of Literature: Kyphosis greatly reduces the quality of life of older individuals. Osteoporosis and sarcopenia are kyphosiscausing factors.Methods: This cross-sectional study included 361 individuals aged ≥65 years (mean age, 75.0 years) living in a local mountain area and underwent medical check-ups from 2014 to 2018. The survey items included kyphosis index, body mass index, back pain prevalence, back pain Visual Analog Scale score, Oswestry Disability Index, walking speed, grip strength, skeletal mass index, osteoporosis (% young adult mean [YAM]), LOCOMO 5 score, and presence of sarcopenia (Asian Working Group for Sarcopenia). The participants were divided into the N (kyphosis index: <12; n=229, 63.4%), M (kyphosis index: 12–15; n=99, 27.4%), and K (kyphosis index: ≥15; n=33, 9.2%) groups. <i>p</i> -values of <0.05 were considered statistically significant. An association factor of kyphosis (kyphosis index: ≥15) was investigated with logistic regression analysis.Results: Age and LOCOMO 5 scores were significantly higher (<i>p</i> <0.05) and %YAM and walking speed were significantly lower (<i>p</i> <0.05) in the K group than in the M and N groups. Other survey items showed significant differences. Only %YAM (odds ratio, 0.20; 95% confidence interval, 0.04–0.96) was an independent factor associated with a kyphosis index of ≥15.Conclusions: Decreased muscle mass and muscle strength would be related to kyphosis; however, no such relations were noted. Bone loss was significantly related to kyphosis. Osteoporosis-induced decrease in vertebral body height is present in the background. Sarcopenia and locomotive syndrome were not related to kyphosis, whereas decreased bone density was independently associated with kyphosis in older individuals living in a mountain area.

Response to the Editor

Hiromi Matsumoto,Hiroshi Hagino,Takashi Wada 대한골다공증학회 2016 Osteoporosis and Sarcopenia Vol.2 No.4

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Diagnosis of knee osteoarthritis and gait variability increases risk of falling for osteoporotic older adults: The GAINA study

Hiromi Matsumoto,Hiroshi Hagino,Hirofumi Sageshima,Mari Osaki,Shinji Tanishima,Chika Tanimura 대한골다공증학회 2015 Osteoporosis and Sarcopenia Vol.1 No.1

Objectives: To examine the relationship between history of falling, and musculoskeletal disease, bone mass, muscle strength, muscle mass, kyphosis, and gait speed and variability in osteoporotic older adults. Methods: The GAINA study, which began in 2014, is a population-based prospective study of subject cohorts from the town of Hino, Tottori Prefecture, Japan. Participants were recruited from among individuals who had an annual town-sponsored medical check-up in 2014, between May and June. A total 223 of residents were screened for our study. Inclusion criteria were osteoporotic older adults who had: (1) a ?70% young adult mean (YAM) bone mass as assessed using quantitative ultrasound (QUS) methods, (2) a prior hip fracture or vertebral fracture, (3) fragility fractures other than hip and vertebral fractures and <80% YAM of bone mass. From the total screened, 91 residents (mean age, 76.0 ± 8.0 years; 22 men and 69 women) met the eligibility criteria. History of falling, diagnosis of musculoskeletal disease, bone mass, grip strength, muscle mass, kyphosis, and gait speed were assessed. Gait variability analysis was based on acceleration in three directions: mediolateral (ML), vertical (VT), and anteroposterior (AP) using a wireless triaxial accelerometer. Subjects were classified as belonging to a nonfall group or fall group based on their history of falling. Results: During the previous 12 months, 26 falls were reported by 16 subjects (5 men and 11 women). Sixteen of the 91 included patients (17.6%) fell (22% men and 15% women), and 8 of the 16 subjects reported multiple falls. In a multivariable analysis, diagnosis of knee osteoarthritis and higher gait variability had a significant independent relationship with falling in these osteoporotic adults. Conclusions: Diagnosis of knee osteoarthritis and gait variability are associated with previous falls in osteoporotic older adults. Accelerometrybased gait analysis may be a useful tool with which to assess the risk of falling in this population.

Chemokine expression in human 3-dimensional cultured epidermis exposed to PM2.5 collected by cyclonic separation

Kono Maori,Okuda Tomoaki,Ishihara Nami,Hagino Hiroyuki,Tani Yuto,Okochi Hiroshi,Tokoro Chiharu,Takaishi Masayuki,Ikeda Hidefumi,Ishihara Yasuhiro 한국독성학회 2023 Toxicological Research Vol.39 No.1

Fine particulate matter (PM2.5) exposure has a risk of inducing several health problems, especially in the respiratory tract. The skin is the largest organ of the human body and is therefore the primary target of PM2.5. In this study, we examined the effects of PM2.5 on the skin using a human 3-dimensional cultured epidermis model. PM2.5 was collected by cyclonic separation in Yokohama, Japan. Global analysis of 34 proteins released from the epidermis revealed that the chemokines, chemokine C-X-C motif ligand 1 (CXCL1) and interleukin 8 (IL-8), were significantly increased in response to PM2.5 exposure. These chemokines stimulated neutrophil chemotaxis in a C-X-C motif chemokine receptor 2-dependent manner. The oxidative stress and signal transducer and activator of transcription 3 pathways may be involved in the increased expression of CXCL1 and IL-8 in the human epidermis model. Interestingly, in the HaCaT human keratinocyte cell line, PM2.5 did not affect chemokine expression but did induce IL-6 expression, suggesting a different effect of PM2.5 between the epidermis model and HaCaT cells. Overall, PM2.5 could induce the epidermis to release chemokines, followed by neutrophil activation, which might cause an unregulated inflammatory reaction in the skin.

Effectiveness of ultrasonographic skeletal muscle assessment in patients after total knee arthroplasty

Yuki Kitsuda,Chika Tanimura,Kazuoki Inoue,Daeho Park,Mari Osaki,Hiroshi Hagino 대한골다공증학회 2019 Osteoporosis and Sarcopenia Vol.5 No.3

Objectives: This study aimed to characterize the skeletal muscles of patients who underwent total knee arthroplasty (TKA) using ultrasonography in order to investigate the effectiveness of ultrasonographic skeletal muscle assessment after TKA. Methods: This study included 50 TKA patients (TKA group) and 41 residents with osteoarthritis who have not received TKA (non-TKA group). Ultrasonography was used to assess the characteristics of several different muscles. Various postoperative outcomes were evaluated. Muscle thickness (MT) and echo intensity (EI) results were compared among operated knees in the TKA group, nonoperated knees in the TKA group, and more severely affected knees in the non-TKA group. For the TKA group, multiple regression was conducted to examine the association between skeletal muscle characteristics of operated knees and postoperative outcomes. Results: The MTs of the vastus medialis, vastus intermedius, and rectus femoris (RF) were significantly smaller and the RF-EI was significantly greater for both operated and nonoperated knees in the TKA group compared with the non-TKA group (P < 0.017). Several parameters of physical function were significantly poorer in the TKA group than in the non-TKA group (P < 0.05). Multiple regression demonstrated that RF-MT was associated with knee range of motion, knee strength, and physical functional performance in the TKA group (P < 0.05). Conclusions: The quantity and quality of skeletal muscles were lower in the TKA group than in the non- TKA group. Ultrasonography may be useful for assessing skeletal muscles in TKA patients because MT assessed with ultrasonography was associated with various parameters of physical function.

Relationship between sarcopenia and pain catastrophizing in patients with lumbar spinal stenosis: A cross-sectional study

Takashi Wada,Shinji Tanishima,Mari Osaki,Hideki Nagashima,Hiroshi Hagino 대한골다공증학회 2019 Osteoporosis and Sarcopenia Vol.5 No.4

Objectives: The purpose of this study is to clarify the psychological factors related to sarcopenia in patients with lumbar spinal stenosis (LSS). Methods: This cross-sectional study included 72 patients with LSS (38 males and 34 females; mean age, 70.4 ± 6.9 years). Demographic data, lower extremity pain, back pain, Japanese Orthopaedic Association score, Pain Catastrophizing Scale (PCS) score, Hospital Anxiety and Depression Scale (HADS) score, Fear- Avoidance Beliefs Questionnaire score, walking velocity, grip strength, walking distance, and appendicular muscle mass were assessed. Muscle mass was measured using bioelectrical impedance analysis. Patients were grouped based on sarcopenia status according to skeletal muscle mass index. Results: The prevalence of sarcopenia was 13.9% (10 of 72 patients). Sarcopenia was significantly more common in females. The incidence of dyslipidemia and cardiovascular disease were significantly higher in the sarcopenia group. The sarcopenia group had lower body weight, body mass index, grip strength, and walking distance than the control group. The sarcopenia group had higher PCS scores and HADSanxiety scores. Multivariate analysis identified body weight, dyslipidemia, walking distance, and PCS score as significantly related to sarcopenia. Conclusions: Pain catastrophizing might be the most relevant psychological factor in sarcopenia. Evaluation of both physical function and pain catastrophizing is needed when investigating sarcopenia in LSS.