March 09, 2018
2 min read

No increased fracture risk identified with sarcopenia

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Adults with pre-sarcopenia or sarcopenia are no more likely to sustain a fracture than adults with osteoporosis without sarcopenia, according to findings published in the Journal of Bone and Mineral Research.

“Sarcopenia has been associated with increased fracture risk,” Fernando Rivadeneira, MD, PhD, a genetic epidemiologist in the department of internal medicine at Erasmus University Medical Center in Rotterdam, the Netherlands, and colleagues wrote in the study background. “However, sarcopenia may co-occur with osteoporosis, a condition referred to as osteosarcopenia, and it is not clear if the effect of sarcopenia is independent of the bone mineral density status.”

Rivadeneira and colleagues analyzed data from 5,911 older adults (mean age, 69 years; 55.8% women) with data on sarcopenia participating in the population-based Rotterdam Study. Participants underwent DXA measurements to assess femoral neck BMD, as well as lean mass, appendicular lean mass and skeletal muscle index, with low muscle index defined as skeletal muscle index up to 7.25 kg/m² for men and 5.67 kg/m² for women. The researchers used criteria from the European Working Group on Sarcopenia in Older People to define sarcopenia as the presence of low muscle mass plus low muscle strength or low physical performance. Pre-sarcopenia was defined as having only low muscle mass. Muscle strength was assessed using a hydraulic hand dynamometer. Researchers used logistic regression analysis to calculate ORs for fracture risk, stratified by osteopenia, osteoporosis and sarcopenia status.

Within the cohort, 5.9% of adults had pre-sarcopenia and 4.4% of adults had sarcopenia, whereas 80.4% of those with sarcopenia also had low BMD. However, only 15% of adults with osteoporosis had sarcopenia.

Compared with adults without sarcopenia, those with sarcopenia had a lower BMD and a higher prevalence of fractures (23.5% vs. 15.5%); however, the difference in fracture prevalence was attenuated after adjustment for age and sex, according to researchers.

Researchers did not observe any between-group differences in the prevalence of chronic diseases, apart from a higher prevalence of chronic obstructive pulmonary disease in adults with pre-sarcopenia (29.1%) and sarcopenia (26.9 %) vs. those without sarcopenia (13.4%). The association with sarcopenia and chronic obstructive pulmonary disease persisted after adjustment for smoking status, physical activity and number of prescribed corticosteroids.

Researchers also found that adults with osteoporosis only had a higher prevalence of fracture (34.5%) vs. those with sarcopenia only (17%). Adults with osteoporosis were just as likely to sustain a fracture regardless of sarcopenia status, with an OR of 2.59 for those with osteoporosis and sarcopenia (95% CI, 1.41-4.45) and 2.75 for those with osteoporosis without sarcopenia (95% CI, 2.01-3.75), according to researchers.

“Overall, our findings suggest that sarcopenia does not add additional risk for fracture,” the researchers wrote. “The majority of individuals with sarcopenia have low BMD, suggesting that co-occurrence of both conditions may follow similar pathways and be responsive to similar interventions.” – by Regina Schaffer

Disclosures: Two of the study authors work in Erasmus AGE, a center for aging research across the life course funded by Nestle Nutrition.