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        Association between Osteoporosis and Skeletal Muscle Mass in Men

        Mizutani Masaya,Eguchi Yawara,Toyoguchi Toru,Orita Sumihisa,Inage Kazuhide,Shiga Yasuhiro,Maki Satoshi,Nakamura Junichi,Hagiwara Shigeo,Aoki Yasuchika,Inoue Masahiro,Koda Masao,Takahashi Hiroshi,Akaza 대한척추외과학회 2024 Asian Spine Journal Vol.18 No.1

        Study Design: Cross-sectional study.Purpose: This cross-sectional study aimed to investigate the risk factors for osteoporosis in men by assessing bone mineral density (BMD), skeletal muscle mass, body fat mass, grip strength, and advanced glycation end products (AGEs).Overview of Literature: Fewer studies have reported the correlation between BMD and skeletal muscle mass in women. Moreover, a few studies have examined the relationship between osteoporosis and skeletal muscle mass.Methods: This study included 99 men (mean age, 74.9 years; range, 28–93 years) who visited Qiball Clinic for BMD and body composition examinations. The osteoporosis group consisted of 24 patients (mean age, 72.5 years; range, 44–92 years), and the control group consisted of 75 individuals (mean age, 74.9 years; range, 28–93 years). Whole-body skeletal muscle mass was measured using a bioelectrical impedance analyzer. BMD was measured by dual X-ray absorptiometry. Skin autofluorescence (SAF), a marker of dermal AGE accumulation, was measured using a spectroscope. Osteoporosis was defined as a bone density T score of –2.5 or less. Physical findings, skeletal muscle mass, BMD, grip strength, and SAF were compared between the osteoporosis and control groups.Results: The osteoporosis group had significantly lower trunk muscle mass (23.1 kg vs. 24.9 kg), lower leg muscle mass (14.4 kg vs. 13.0 kg), and skeletal mass index (7.1 kg/m<sup>2</sup> vs. 6.7 kg/m<sup>2</sup>) than the control group (all <i>p</i><0.05). Lower limb muscle mass was identified as a risk factor for osteoporosis in men (odds ratio, 0.64; <i>p</i>=0.03).Conclusions: Conservative treatment of osteoporosis in men will require an effective approach that facilitates the maintenance or strengthening of skeletal muscle mass, including exercise therapy with a focus on lower extremities and nutritional supplementation.

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        Risk factors for allogeneic red blood cell transfusion in adult spinal deformity surgery

        Iijima Yasushi,Kotani Toshiaki,Sakuma Tsuyoshi,Akazawa Tsutomu,Kishida Shunji,Ueno Keisuke,Ise Shohei,Ogata Yosuke,Mizutani Masaya,Shiga Yasuhiro,Minami Shohei,Ohtori Seiji 대한척추외과학회 2024 Asian Spine Journal Vol.18 No.4

        Study Design: Retrospective study.Purpose: To investigate the risk factors for allogeneic red blood cell (RBC) transfusion in adult spinal deformity (ASD) surgery.Overview of Literature: Studies have not thoroughly explored the roles of intraoperative hypothermia, autologous blood donation, and hemostatic agent administration, which would provide a better understanding of the risk for perioperative RBC transfusion in ASD surgery.Methods: The medical records of 151 patients with ASD who underwent correction surgery between 2012 and 2021 were retrospectively reviewed. Estimated blood loss and perioperative allogeneic transfusion were examined. Patients were categorized into two groups based on whether they received perioperative allogeneic blood transfusion. Logistic regression analysis was employed to investigate the effect of age, sex, blood type, body mass index, American Society of Anesthesiologists’ physical status, preoperative hemoglobin level, autologous blood donation, global spine alignment parameters, preoperative use of anticoagulants or antiplatelet medicine and nonsteroidal anti-inflammatory drugs, number of instrumented fusion levels, total operative duration, three-column osteotomy, lateral interbody fusion, pelvic fixation, intraoperative hypothermia, use of gelatin-thrombin based hemostatic agents, and intraoperative tranexamic acid (TXA) with simultaneous exposure by two attending surgeons.Results: The estimated blood loss was 994.2±754.5 mL, and 71 patients (47.0%) received allogeneic blood transfusion. In the logistic regression analysis, the absence of intraoperative TXA use and simultaneous exposure (odds ratio [OR], 26.3; 95% confidence interval [CI], 7.6–90.9; p<0.001), lack of autologous blood donation (OR, 21.2; 95% CI, 4.4–100.0; p<0.001), and prolonged operative duration (OR, 1.6; 95% CI, 1.3–1.9; p<0.001) were significant independent factors for perioperative allogeneic blood transfusion in ASD surgery.Conclusions: Autologous blood storage, intraoperative TXA administration, and simultaneous exposure should be considered to minimize perioperative allogeneic blood transfusion in ASD surgery, particularly in patients with anticipated lengthy surgeries.

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