David Scott1, Catherine Shore-Lorenti2, Lachlan McMillan2, Jakub Mesinovic2, Ross A Clark3, Alan Hayes4, Kerrie M Sanders5, Gustavo Duque6, Peter R Ebeling7. 1. Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Australia. Electronic address: david.scott@monash.edu. 2. Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia. 3. School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Australia. 4. Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Australia; Institute of Sport, Exercise and Active Living, College of Health and Biomedicine, Victoria University, Melbourne, Australia. 5. Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Australia; Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia. 6. Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Australia. 7. Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Australia.
Abstract
OBJECTIVES: To determine characteristics of sarcopenic obesity that are independently associated with bone health and balance in older adults. STUDY DESIGN: Cross-sectional study of 168 community-dwelling older adults (mean age 67.7 ± 8.4 years; 55% women). MAIN OUTCOME MEASURES: Appendicular lean mass (ALM), whole-body areal BMD (aBMD) and body fat percentage were assessed by dual-energy X-ray absorptiometry. Peripheral quantitative computed tomography assessed muscle density and cortical volumetric BMD (vBMD), area, thickness, and strength-strain index (SSI) at 66% tibial length. Hand grip strength (dynamometry) and balance path length (computerised posturography) were assessed. Obesity was defined as high body fat percentage. RESULTS: Greater lower-leg muscle density was associated with lower balance path length in men (r = -0.36; P < .01) and women (r = -0.40; P = < .01). Obese participants by body fat percentage did not differ to non-obese on bone indices, although a trend towards lower cortical vBMD was observed in obese compared with non-obese men (1041.4 ± 39.8 vs 1058.8 ± 36.1 mg/cm3; P = .051). In multivariable models, ALM was positively associated with all bone parameters in obese women, and with whole-body aBMD, proximal tibial cortical area and SSI in non-obese women, and both non-obese and obese men (all P < .05). Lower-leg muscle density was also positively associated with cortical vBMD (B = 2.91; 95% CI 0.02, 5.80) and area (2.70; 0.06, 5.33) in obese women. CONCLUSIONS: Amongst components of sarcopenic obesity, higher ALM is a consistent independent predictor of better bone health. Low muscle density may also compromise bone health and balance. Interventions which improve muscle mass and composition may lower fracture risk in sarcopenic obesity.
OBJECTIVES: To determine characteristics of sarcopenic obesity that are independently associated with bone health and balance in older adults. STUDY DESIGN: Cross-sectional study of 168 community-dwelling older adults (mean age 67.7 ± 8.4 years; 55% women). MAIN OUTCOME MEASURES: Appendicular lean mass (ALM), whole-body areal BMD (aBMD) and body fat percentage were assessed by dual-energy X-ray absorptiometry. Peripheral quantitative computed tomography assessed muscle density and cortical volumetric BMD (vBMD), area, thickness, and strength-strain index (SSI) at 66% tibial length. Hand grip strength (dynamometry) and balance path length (computerised posturography) were assessed. Obesity was defined as high body fat percentage. RESULTS: Greater lower-leg muscle density was associated with lower balance path length in men (r = -0.36; P < .01) and women (r = -0.40; P = < .01). Obeseparticipants by body fat percentage did not differ to non-obese on bone indices, although a trend towards lower cortical vBMD was observed in obese compared with non-obesemen (1041.4 ± 39.8 vs 1058.8 ± 36.1 mg/cm3; P = .051). In multivariable models, ALM was positively associated with all bone parameters in obesewomen, and with whole-body aBMD, proximal tibial cortical area and SSI in non-obesewomen, and both non-obese and obesemen (all P < .05). Lower-leg muscle density was also positively associated with cortical vBMD (B = 2.91; 95% CI 0.02, 5.80) and area (2.70; 0.06, 5.33) in obesewomen. CONCLUSIONS: Amongst components of sarcopenic obesity, higher ALM is a consistent independent predictor of better bone health. Low muscle density may also compromise bone health and balance. Interventions which improve muscle mass and composition may lower fracture risk in sarcopenic obesity.
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