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Open Access 01-12-2016 | Research article

Locomotive syndrome is associated with body composition and cardiometabolic disorders in elderly Japanese women

Authors: Misa Nakamura, Yosuke Kobashi, Hiroshi Hashizume, Hiroyuki Oka, Ryohei Kono, Sachiko Nomura, Akihiro Maeno, Munehito Yoshida, Hirotoshi Utsunomiya

Published in: BMC Geriatrics | Issue 1/2016

Abstract

Background

A concept referred to as locomotive syndrome (LS) was proposed by the Japanese Orthopaedic Association in order to help identify middle-aged and older adults who may be at high risk of requiring healthcare services because of problems associated with locomotion. Cardiometabolic disorders, including obesity, hypertension, diabetes, and dyslipidemia, have a high prevalence worldwide. The purpose of this study was to determine the associations between LS and both body composition and cardiometabolic disorders.

Methods

The study participants were 165 healthy adult Japanese women volunteers living in rural areas. LS was defined as a score ≥16 on the 25-question Geriatric Locomotive Function Scale (GLFS-25). Height, body weight, body fat percentage, body mass index (BMI), and bone status were measured. Bone status was evaluated by quantitative ultrasound (i.e., the speed of sound [SOS] of the calcaneus) and was expressed as the percent of Young Adult Mean of the SOS (%YAM). Comorbid conditions of hypertension, hyperlipidemia, and diabetes were assessed using self-report questionnaires.

Results

Twenty-nine participants (17.6 %) were classed as having LS. The LS group was older, shorter, and had a higher body fat percentage, a higher BMI, and lower bone status than the non-LS group. Multiple logistic regression analysis showed that participants with a BMI ≥23.5 kg/m² had a significantly higher risk for LS than those with a BMI <23.5 kg/m² (odds ratio [OR] = 3.78, p < 0.01). Furthermore, GLFS-25 scores were higher in participants with than those without hypertension, diabetes, or obesity, and significantly increased with the number of present disorders.

Conclusions

These findings suggest that BMI may be a useful screening tool for LS. Furthermore, because hypertension and diabetes were associated with LS, the prevention of these disorders accompanied by weight management may help protect against LS.

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Statistics Bureau. Population estimates (March 2015). http://www.e-stat.go.jp/SG1/estat/ListE.do?lid=000001131732. Accessed 22 Sept 2016.

Nakamura K. A “super-aged” society and the “locomotive syndrome”. J Orthop Sci. 2008;3(1):1–2. doi:10.1007/s00776-007-1202-6.CrossRef

Japanese Orthopaedic Association. Guidebook on locomotive syndrome. Tokyo: Bunkodo; 2010 (in Japanese).

Nakamura K. The concept and treatment of locomotive syndrome: its acceptance and spread in Japan. J Orthop Sci. 2011;16(5):489–91. doi:10.1007/s00776-007-1202-6.CrossRefPubMedPubMedCentral

Muramoto A, Imagama S, Ito Z, Hirano K, Ishiguro N, Hasegawa Y. Physical performance tests are useful for evaluating and monitoring the severity of locomotive syndrome. J Orthop Sci. 2012;17(6):782–8. doi:10.1007/s00776-013-0382-5.CrossRefPubMed

Sasaki E, Ishibashi Y, Tsuda E, Ono A, Yamamoto Y, Inoue R, et al. Evaluation of locomotive disability using loco-check: a cross-sectional study in the Japanese general population. J Orthop Sci. 2013;17(6):782–8. doi:10.1007/s00776-012-0329-2.

Seichi A, Hoshino Y, Doi T, Akai M, Tobimatsu Y, Iwaya T. Development of a screening tool for risk of locomotive syndrome in the elderly: the 25-question Geriatric Locomotive Function Scale. J Orthop Sci. 2012;17(6):782–8. doi:10.1007/s00776-011-0193-5.CrossRef

Japanese Orthopaedic Association 2013. Locomotive syndrome pamphlet. P.08. https://locomo-joa.jp/en/index.pdf. Accessed 22 Sept 2016.

Yoshimura N, Oka H, Muraki S, Akune T, Hirabayashi N, Matsuda S, et al. Reference values for hand grip strength, muscle mass, walking time, and one-leg standing time as indices for locomotive syndrome and associated disability: the second survey of the ROAD study. J Orthop Sci. 2011;16(6):768–77. doi:10.1007/s00776-011-0160-1.CrossRefPubMed

10.

Hirano K, Hasegawa Y, Imagama S, Wakao N, Muramoto A, Ishiguro N. Impact of spinal imbalance and back muscle strength on locomotive syndrome in community-living elderly people. J Orthop Sci. 2012;17(5):532–7. doi:10.1007/s00776-012-0266-0.CrossRefPubMed

11.

Seichi A, Hoshino Y, Doi T, Akai M, Tobimatsu Y, Kita K, et al. Determination of the optimal cutoff time to use when screening elderly people for locomotive syndrome using the one-leg standing test (with eyes open). J Orthop Sci. 2014;19(4):620–6. doi:10.1007/s00776-014-0581-8.CrossRefPubMed

12.

Fukumori N, Yamamoto Y, Takegami M, Yamazaki S, Onishi Y, Sekiguchi M, et al. Association between hand-grip strength and depressive symptoms: locomotive syndrome and health outcomes in Aizu cohort study (LOHAS). Age Ageing. 2015;44(4):592–8. doi:10.1093/ageing/afv013.CrossRefPubMed

13.

Nakamura M, Hashizume H, Oka H, Okada M, Takakura R, Hisari A, et al. Physical performance measures associated with locomotive syndrome in middle-aged and older Japanese women. J Geriatr Phys Ther. 2015;38(4):202–7. doi:10.1519/JPT.0000000000000033.CrossRefPubMed

14.

Muramoto A, Imagama S, Ito Z, Hirano K, Tauchi R, Ishiguro N, et al. Threshold values of physical performance tests for locomotive syndrome. J Orthop Sci. 2013;18(4):618–26. doi:10.1007/s00776-013-0382-5.CrossRefPubMed

15.

Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88. doi:10.1186/1471-2458-9-88.CrossRefPubMedPubMedCentral

16.

Bang E, Tanabe K, Yokoyama N, Chijiki S, Kuno S. Relationship between thigh intermuscular adipose tissue accumulation and number of metabolic syndrome risk factors in middle-aged and older Japanese adults. Exp Gerontol. 2016;16(79):26–30. doi:10.1016/j.exger.2016.03.010.CrossRef

17.

Hwang DK, Choi HJ. The relationship between low bone mass and metabolic syndrome in Korean women. Osteoporos Int. 2010;21:425–31. doi:10.1007/s00198-009-0990-2.CrossRefPubMed

18.

Kim HY, Choe JW, Kim HK, Bae SJ, Kim BJ, Lee SH, et al. Negative association between metabolic syndrome and bone mineral density in Koreans, especially in men. Calcif Tissue Int. 2010;86(5):350–8. doi:10.1007/s00223-010-9347-2.CrossRefPubMed

19.

Xue P, Gao P, Li Y. The association between metabolic syndrome and bone mineral density: a meta-analysis. Endocrine. 2012;42(3):546–54. doi:10.1007/s12020-012-9684-1.CrossRefPubMed

20.

Muka T, Trajanoska K, Kiefte-de Jong JC, Oei L, Uitterlinden AG, Hofman A, et al. The association between metabolic syndrome, bone mineral density, hip bone geometry and fracture risk: the Rotterdam study. PLoS One. 2015;10(6):e0129116. doi:10.1371/journal.pone.0129116.CrossRefPubMedPubMedCentral

21.

Ebron K, Andersen CJ, Aguilar D, Blesso CN, Barona J, Dugan CE, et al. A larger body mass index is associated with increased atherogenic dyslipidemia, insulin resistance, and low-grade inflammation in individuals with metabolic syndrome. Metab Syndr Relat Disord. 2015;13(10):458–64. doi:10.1089/met.2015.0053.CrossRefPubMed

22.

Muramoto A, Imagama S, Ito Z, Hirano K, Tauchi R, Ishiguro N, et al. Waist circumference is associated with locomotive syndrome in elderly females. J Orthop Sci. 2014;19(4):612–9. doi:10.1007/s00776-013-0382-5.CrossRefPubMed

23.

Alberti KG, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med. 2006;23:469–80.CrossRefPubMed

24.

Kaplan NM. The deadly quartet. Upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Arch Intern Med. 1989;149:1514–20.CrossRefPubMed

25.

Yoshimura N, Muraki S, Oka H, et al. Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab. 2009;27:620–8.CrossRefPubMed

26.

Ministry of Health Labour and Welfare. Measures for national health Promotion, Ref-70. http://www.mhlw.go.jp/english/wp/wp-hw2/part2/p3_0024.pdf. Accessed 22 Sept 2016.

27.

Examination Committee of Criteria for ‘Obesity Disease’ in Japan; Japan Society for the Study of Obesity. New criteria for ‘obesity disease’ in Japan. Circ J. 2002;66:987–92.CrossRef

28.

Kohri T, Kaba N, Murakami T, Narukawa T, Yamamoto S, Sakai T, Sasaki S. Search for promotion factors of ultrasound bone measurement in Japanese males and pre/post-menarcheal females aged 8–14 years. J Nutr Sci Vitaminol (Tokyo). 2012;58(4):263–71. 10.3177/jnsv.58.263.CrossRef

29.

Chin KY, Ima-Nirwana S. Calcaneal quantitative ultrasound as a determinant of bone health status: what properties of bone does it reflect? J Med Sci. 2013;10(12):1778–83. doi:10.7150/ijms.6765.

30.

Iizuka Y, Iizuka H, Mieda T, Tajika T, Yamamoto A, Takagishi K. Population-based study of the association of osteoporosis and chronic musculoskeletal pain and locomotive syndrome: the Katashina study. J Orthop Sci. 2015;20(6):1085–9. doi:10.1007/s00776-015-0774-9.CrossRefPubMed

31.

Zhang L, Lv H, Zheng H, Li M, Yin P, Peng Y, Gao Y, Zhang L, Tang P. Correlation between parameters of calcaneal quantitative ultrasound and hip structural analysis in osteoporotic fracture patients. PLoS One. 2015;10(12):e0145879. doi:10.1371/journal.pone.0145879.CrossRefPubMedPubMedCentral

32.

Nishimura A, Ikezoe T, Kitase S, et al. The factor influences fear of falling in elderly people. Phys Ther Kyoto. 2006;35:98–9 (in Japanese).

33.

Ogaya S, Ikezoe T, Tateuchi H, et al. The relationship of fear of falling and daily activity to postural control in the elderly. Phys Ther Sci. 2010;37:78–84 (in Japanese).

34.

Conde J, Scotece M, López V, Gómez R, Lago F, Pino J, et al. Adipokines: novel players in rheumatic diseases. Discov Med. 2013;15:73–83.PubMed

35.

Hofbauer LC, Schoppet M. Clinical implications of the osteoprotegerin/ RANKL/RANK system for bone and vascular diseases. JAMA. 2004;292:490–5.CrossRefPubMed

36.

Halade GV, El Jamali A, Williams PJ, Fajardo RJ, Fernandes G. Obesity-mediated inflammatory microenvironment stimulates osteoclastogenesis and bone loss in mice. Exp Gerontol. 2011;46(1):43–52. doi:10.1016/j.exger.2010.09.014.CrossRefPubMed

37.

Knutsson B, Sandén B, Sjödén G, Järvholm B, Michaëlsson K. Body mass index and risk for clinical lumbar spinal stenosis: a cohort study. Spine (Phila Pa 1976). 2015;40(18):1451–6. doi:10.1097/BRS.0000000000001038.CrossRef

38.

Ou CY, Lee TC, Lee TH, Huang YH. Impact of body mass index on adjacent segment disease after lumbar fusion for degenerative spine disease. Neurosurgery. 2015;76(4):396–401. doi:10.1227/NEU.0000000000000627.CrossRefPubMed

39.

Flamme CH. Obesity and low back pain--biology, biomechanics and epidemiology. Orthopade. 2005;34(7):652–7.CrossRefPubMed

40.

Musumeci G, Aiello FC, Szychlinska MA, Di Rosa M, Castrogiovanni P, Mobasheri A. Osteoarthritis in the XXIst century: risk factors and behaviours that influence disease onset and progression. Int J Mol Sci. 2015;16(3):6093–112. doi:10.3390/ijms16036093.CrossRefPubMedPubMedCentral

41.

Thijssen E, van Caam A, van der Kraan PM. Obesity and osteoarthritis, more than just wear and tear: Pivotal roles for inflamed adipose tissue and dyslipidaemia in obesity-induced osteoarthritis. Rheumatology (Oxford). 2014;54(4):588–600. doi:10.1093/rheumatology/keu464.CrossRef

42.

Zhuo Q, Yang W, Chen J, Wang Y. Metabolic syndrome meets osteoarthritis. Nat Rev Rheumatol. 2012;8:729–37. doi:10.1038/nrrheum.2012.135.CrossRefPubMed

43.

Verzijl N, DeGroot J, Ben ZC, Brau-Benjamin O, Maroudas A, Bank RA. Crosslinking by advanced glycation end products increases the stiffness of the collagen network in human articular cartilage: a possible mechanism through which age is a risk factor for osteoarthritis. Arthritis Rheum. 2002;46:114–23.CrossRefPubMed

44.

Yammani RR, Carlson CS, Bresnick AR, Loeser RF. Increase in production of matrix metalloproteinase 13 by human articular chondrocytes due to stimulation with S100A4: role of the receptor for advanced glycation end products. Arthritis Rheum. 2006;54:2901–11.CrossRefPubMed

45.

Cecil DL, Johnson K, Rediske J, Lotz M, Schmidt AM, Terkeltaub R. Inflammation-induced chondrocyte hypertrophy is driven by receptor for advanced glycation end products. J Immunol. 2005;175:8296–302.CrossRefPubMed

46.

Singh G, Miller JD, Lee FH, Pettitt D, Russell MW. Prevalence of cardiovascular disease risk factors among US adults with self-reported osteoarthritis: data from the Third National Health and Nutrition Examination Survey. Am J Manag Care. 2002;8(15 Suppl):S383–91.PubMed

47.

van den Berg WB. Osteoarthritis year 2010. In review: pathomechanisms. Osteoarthritis Cartilage. 2011;19(4):338–41. doi:10.1016/j.joca.2011.01.022.CrossRefPubMed

48.

Yoshimura N, Muraki S, Oka H, Tanaka S, Kawaguchi H, Nakamura K, et al. Mutual associations among musculoskeletal diseases and metabolic syndrome components: a 3-year follow-up of the ROAD study. Mod Rheumatol. 2015;25(3):438–48. doi:10.3109/14397595.2014.972607.CrossRefPubMed

49.

Yoshimura N, Muraki S, Oka H, Tanaka S, Kawaguchi H, Nakamura K, et al. Accumulation of metabolic risk factors such as overweight, hypertension, dyslipidaemia, and impaired glucose tolerance raises the risk of occurrence and progression of knee osteoarthritis: a 3-year follow-up of the ROAD study. Osteoarthritis Cartilage. 2012;20(11):1217–26. doi:10.1016/j.joca.2012.06.006.CrossRefPubMed

50.

Yoshimura N, Muraki S, Oka H, Tanaka S, Ogata T, Kawaguchi H, et al. Association of knee osteoarthritis with the accumulation of metabolic risk factors such as overweight, hypertension, dyslipidemia, and impaired glucose tolerance in Japanese men and women: the ROAD study. J Rheumatol. 2011;16(6):768–77. doi:10.1007/s00776-015-0741-5.

51.

Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766–81. doi:10.1016/S0140-6736(14)60460-8.CrossRefPubMedPubMedCentral

52.

Shah NR, Braverman ER. Measuring adiposity in patients: the utility of body mass index (BMI), percent body fat, and leptin. PLoS One. 2012;7(4):e33308. doi:10.1371/journal.pone.0033308.CrossRefPubMedPubMedCentral

Title: Locomotive syndrome is associated with body composition and cardiometabolic disorders in elderly Japanese women
Authors: Misa Nakamura
Yosuke Kobashi
Hiroshi Hashizume
Hiroyuki Oka
Ryohei Kono
Sachiko Nomura
Akihiro Maeno
Munehito Yoshida
Hirotoshi Utsunomiya
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Geriatrics / Issue 1/2016
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-016-0339-6

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