Low handgrip strength is associated with reduced functional recovery and longer hospital stay in patients with osteoporotic vertebral compression fractures: a prospective cohort study.

AIM: Despite the growing interest in sarcopenia in clinical medicine, there is little evidence to support the association between muscle strength and functional prognosis in patients with osteoporotic vertebral fractures. The aim of this study was to evaluate the impact of low handgrip strength (HGS) on functional outcomes in older patients with osteoporotic vertebral fractures. METHODS: A prospective cohort study was performed between 2017 and 2019 on consecutive patients with conservatively treated vertebral compression fractures who were newly admitted for post-acute rehabilitation. HGS was measured on admission. Outcomes included the Functional Independence Measure-motor (FIM-motor) score at discharge and length of hospital stay. Multivariate linear regression analyses were utilized to determine whether HGS at baseline was significantly associated with these outcomes after adjustment for potential confounders. RESULTS: Of the 207 patients admitted, 159 patients (mean age 83 years; 78% women) were enrolled in the analysis. The mean (standard deviation: SD) HGS was 15.9 (7.7) kg. Multivariate analysis showed that HGS at admission was independently associated with the FIM-motor score at discharge (ß = 0.107, p = 0.006) and length of stay (ß = - 0.118, p = 0.030). CONCLUSION: Low HGS is commonly found and is associated with reduced functional recovery and prolonged hospital stay in older patients with osteoporotic vertebral fractures. Early detection and interventions for low HGS could help achieve improved outcomes. However, further studies are needed to validate our findings.

Serum alanine aminotransferase concentration as a predictive factor for the development or regression of fatty liver.

Serum alanine aminotransferase (ALT) concentration is the most commonly used marker for hepatocellular injury. We investigated the suitable cutoff value of serum ALT for the diagnosis or prediction of fatty liver. In 1578 Japanese adults (1208 men, 370 women; 35-69 years of age) who visited our center both in 2000 and between April 2007 and March 2008 (2007-2008), serum ALT concentration was an independent predictor of fatty liver in men in 2000 and in both sexes in 2007-2008. A significant increase in the frequency of fatty liver was detected in participants with elevated serum ALT concentrations, and serum levels of ALT in 2000 were associated with fatty liver in 2007-2008 when the cutoff value was set at 30 IU/L in men and 19 IU/L in women. The frequency of fatty liver in 2007-2008 was significantly lower in participants without fatty liver in 2000 whose serum ALT decreased between 2000 and 2007-2008. Our results suggest that serum ALT might be not only an indicator of fatty liver but also a predictor of the regression of fatty liver, and cutoff values of serum ALT of 30 IU/L in men and 19 IU/L in women are suitable for the screening of fatty liver.

Predictive factors for the development or regression of Fatty liver in Japanese adults.

Fatty liver is commonly associated with alcohol or metabolic syndrome. We aimed to examine the longitudinal aspects of fatty liver, and clarify the independent predictors for the development or regression of fatty liver. In the present study, the clinical features of 1578 Japanese adults (1208 men and 370 women; 35 to 69 years of age) who visited our center both in 2000 and 2007-2008 were recorded and compared, including liver status diagnosed by ultrasonography. Of the 1578 participants, 217 (13.8%) showed fatty liver development, and 74 (4.7%) showed fatty liver regression. Logistic regression analysis revealed that body mass index and percentage body fat were strongly associated with the development or regression of fatty liver. Metabolic syndrome-related disorders such as serum levels of total cholesterol, triglyceride, uric acid, and fasting blood glucose were also associated with clinical course to some degree. However, the history of alcohol intake, the presence of metabolic syndrome, blood pressure, and habitual physical exercise were not independent predictors for the development or regression of fatty liver. Our present data suggest that control of body weight in men and the percentage body fat in women are particularly important for the prevention or treatment of fatty liver.