Abstract
BackgroundLocomotive syndrome (LS) is associated with weakness and loss of function in the musculoskeletal organs. We aimed to determine the association between LS components and blood parameters in middle-aged and elderly individuals.MethodsWe included 223 middle-aged and elderly individuals in this study (104 men and 119 women; age: 40–85 years). All participants were asked to fast for at least 3 h before the venous blood samples were obtained and the hemoglobin, total protein, glycated hemoglobin (HbA1c), growth hormone, albumin and lipid profile were measured. Three functional tests, the stand-up test, the two-step test, and the 25-question geriatric locomotive function scale (GLFS) were used to assess the risk of LS. Walking speed was assessed by the 10-m walking test. Maximal isometric muscle strengths of the knee extensors were examined, and the weight bearing index (knee extension strength/body weight) was calculated. To assess an independent association between blood parameters and LS, the area under the receiver operating characteristic curve analysis (area under the curve, sensitivity, and specificity) and a binary logistic regression analysis were performed with adjustment for age.ResultsOf the 223 subjects, 119 (53.3%) fulfilled the diagnostic criteria for LS (including a two-step test score < 1.3, difficulty with one-leg standing from 40 cm in the stand-up test, and a 25-question GLFS score ≥ 7). Increased levels of HbA1c were significant risk factors for LS with an OR of 2.62 (OR95%CI = 1.43–4.80), as determined by a logistic regression analysis. Additionally, dehydroepiandrosterone-sulfate (DHEA-S) levels were significant only in the male subjects (OR = 0.992 [OR95%CI = 0.986–0.998]), at a threshold of 88 (AUC; 0.70, sensitivity; 79.6%, specificity; 49.1%). Moreover, 101 of 223 participants (41 men, 60 women) were analyzed for serum albumin levels, with a prevalence of LS at 55.4%, indicating that low levels of albumin were significant risk factors for LS (OR = 0.148 [OR95%CI = 0.023–0.954], p = 0.0445).ConclusionsThese results suggest that higher HbA1c and lower albumin are associated with the prevalence of LS in Japanese middle-aged and elderly individuals. Furthermore, low DHEA-S levels may be useful screening tools for LS in men.
Highlights
Locomotive syndrome (LS) is associated with weakness and loss of function in the musculoskeletal organs
We focused on the stage 1 of Japanese Orthopedic Association (JOA) definition of LS considered as LS group, and the independent values were compared between the LS and non-LS groups
53.3% (119 of 223 participants: 55 men, 64 women) of participants fulfilled the diagnostic criteria for LS
Summary
Locomotive syndrome (LS) is associated with weakness and loss of function in the musculoskeletal organs. LS leads to difficulties in the ability to stand, walk, run, climb stairs, and perform other physical functions essential to daily living and mobility [1] This syndrome is caused by weakness and fragility of the function of musculoskeletal organs, such as bone, joint, and muscle. Ogata et al [5] determined whether these risk tests were beneficial as predictive screening programs for evaluating motor function and quality of life across a wide range of ages. Their findings suggest that this short battery of tests is a feasible tool for screening the adult population at risk of LS. Despite advances in screening methods of LS, the development of other predictive indicators of LS have not been established
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