Saliu Balogun1, Tania Winzenberg2, Karen Wills3, David Scott4, Michele Callisaya5, Flavia Cicuttini6, Graeme Jones7, Dawn Aitken8. 1. Menzies Institute for Medical Research, University of Tasmania, Australia. Electronic address: Saliu.Balogun@utas.edu.au. 2. Menzies Institute for Medical Research, University of Tasmania, Australia; Faculty of Health, University of Tasmania, Australia. Electronic address: Tania.Winzenberg@utas.edu.au. 3. Menzies Institute for Medical Research, University of Tasmania, Australia. Electronic address: Karen.Wills@utas.edu.au. 4. Menzies Institute for Medical Research, University of Tasmania, Australia; Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, & Peninsula Clinical School, Central Clinical School, Monash University, Clayton, Victoria, 3168, Australia; Australian Institute for Musculoskeletal Science, Melbourne Medical School (Western Campus), the University of Melbourne, St Albans, Victoria, 3021, Australia. Electronic address: d.scott@unimelb.edu.au. 5. Menzies Institute for Medical Research, University of Tasmania, Australia; Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, & Peninsula Clinical School, Central Clinical School, Monash University, Clayton, Victoria, 3168, Australia. Electronic address: Michele.Callisaya@utas.edu.au. 6. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Electronic address: Flavia.Cicuttini@monash.edu. 7. Menzies Institute for Medical Research, University of Tasmania, Australia. Electronic address: Graeme.Jones@utas.edu.au. 8. Menzies Institute for Medical Research, University of Tasmania, Australia. Electronic address: Dawn.Aitken@utas.edu.au.
Abstract
AIM: To determine whether older adults with low muscle mass (sarcopenia) and strength (dynapenia), in the presence of osteoporosis/osteopenia, have an increased risk of fracture and mortality over 10 years, compared to those with low muscle or low bone mass alone or with neither condition. METHODS: 1032 participants (52% women; mean age 62.9 ± 7.4 years) were prospectively followed for 10 years. Mortality was ascertained from the death registry and fractures were self-reported. Baseline appendicular lean mass (ALM) was assessed using dual-energy X-ray absorptiometry and normalised to body mass index (BMI). Hand grip strength (HGS) was assessed by dynamometer. Osteosarcopenia and osteodynapenia were defined as having T-scores of the total hip and/or lumbar spine bone mineral density (BMD) < -1 combined with being in the lowest 20% of the sex-specific distribution for ALM/BMI or HGS respectively. RESULTS: Incident fracture risk was significantly higher in participants who were osteodynapenic (RR = 2.07, 95% CI: 1.26-3.39), dynapenic alone (RR = 1.74, 95% CI: 1.05-2.87), and osteopenic alone (RR = 1.63, 95% CI: 1.15-2.31), compared to those without dynapenia or osteopenia. Mortality risk was significantly higher only in participants with osteosarcopenia (RR = 1.49, 95% CI: 1.01-2.21) compared to those without sarcopenia or osteopenia. However, osteosarcopenia and osteodynapenia did not lead to a significantly greater fracture or mortality risk compared to having these conditions on their own. CONCLUSION: These findings suggest that the combined effect of osteopenia and sarcopenia or dynapenia on fracture and mortality risk, respectively, may not be greater than that of each individual condition.
AIM: To determine whether older adults with low muscle mass (sarcopenia) and strength (dynapenia), in the presence of osteoporosis/osteopenia, have an increased risk of fracture and mortality over 10 years, compared to those with low muscle or low bone mass alone or with neither condition. METHODS: 1032 participants (52% women; mean age 62.9 ± 7.4 years) were prospectively followed for 10 years. Mortality was ascertained from the death registry and fractures were self-reported. Baseline appendicular lean mass (ALM) was assessed using dual-energy X-ray absorptiometry and normalised to body mass index (BMI). Hand grip strength (HGS) was assessed by dynamometer. Osteosarcopenia and osteodynapenia were defined as having T-scores of the total hip and/or lumbar spine bone mineral density (BMD) < -1 combined with being in the lowest 20% of the sex-specific distribution for ALM/BMI or HGS respectively. RESULTS: Incident fracture risk was significantly higher in participants who were osteodynapenic (RR = 2.07, 95% CI: 1.26-3.39), dynapenic alone (RR = 1.74, 95% CI: 1.05-2.87), and osteopenic alone (RR = 1.63, 95% CI: 1.15-2.31), compared to those without dynapenia or osteopenia. Mortality risk was significantly higher only in participants with osteosarcopenia (RR = 1.49, 95% CI: 1.01-2.21) compared to those without sarcopenia or osteopenia. However, osteosarcopenia and osteodynapenia did not lead to a significantly greater fracture or mortality risk compared to having these conditions on their own. CONCLUSION: These findings suggest that the combined effect of osteopenia and sarcopenia or dynapenia on fracture and mortality risk, respectively, may not be greater than that of each individual condition.
Authors: Marta M Rey-Rodriguez; M A Vazquez-Gamez; Mercè Giner; Fernando Garrachón-Vallo; Luis Fernández-López; Miguel Angel Colmenero; María-José Montoya-García Journal: BMJ Open Date: 2020-09-24 Impact factor: 2.692