肌少–骨质疏松症的国内外研究进展

Research Progress on Osteosarcopenia at Home and Abroad

摘要: 肌少–骨质疏松症是老年人肌肉衰减与骨量丢失并存的代谢综合征，因其显著增加跌倒、骨折和死亡风险，已成为老龄化背景下备受关注的健康问题。本文从流行病学、病因机制、诊断评估、防治策略等方面，系统综述了肌少–骨质疏松症的国内外研究进展，重点分析了肌肉–骨生化串扰通路(Wnt/β-catenin、PI3K/AKT、NF-κB等)、肌因子/骨因子介导的内分泌对话、以及铁死亡和线粒体自噬等新兴机制在该病发生发展中的作用。同时，从中医“脾肾相关”、“骨肉不相亲”等理论出发，阐释了中医药(健脾补肾、益气活血)干预该病的理论依据与临床应用进展，并结合当前诊疗共识与食养指南探讨了综合防治策略。研究认为，揭示肌肉与骨骼的共同调控机制是实现“肌骨同治”的关键突破方向，中医药在这一交叉领域具有显著的理论优势和实践潜力。

Abstract: Osteosarcopenia is a metabolic syndrome characterized by concurrent muscle atrophy and bone mass loss in the elderly. Due to its significant increase in the risk of falls, fractures, and mortality, it has become a health issue of great concern in the context of an aging population. This article systematically reviews the research progress of Osteosarcopenia at home and abroad from the aspects of epidemiology, etiology and mechanism, diagnosis and evaluation, prevention and treatment strategies, and focuses on analyzing the roles of emerging mechanisms such as muscle-bone biochemical crosstalk pathways (Wnt/β-catenin, PI3K/AKT, NF-κB, etc.), endocrine dialogue mediated by myokines/bone factors, and ferroptosis and mitophagy in the occurrence and development of this disease. At the same time, based on the theories of “spleen-kidney correlation” and “bone-muscle disconnection” in traditional Chinese medicine, it explains the theoretical basis and clinical application progress of traditional Chinese medicine (tonifying the spleen and kidney, benefiting qi and promoting blood circulation) in the intervention of this disease, and discusses the comprehensive prevention and treatment strategies in combination with current diagnosis and treatment consensus and dietary guidelines. The study suggests that revealing the common regulatory mechanisms of muscle and bone is the key breakthrough direction for achieving “muscle-bone co-treatment”, and traditional Chinese medicine has significant theoretical advantages and practical potential in this cross-disciplinary field.