Comparing the Fracture Profile of Osteosarcopenic Older Adults with Osteopenia/Osteoporosis Alone

Ben Kirk; Simon Zhang; Sara Vogrin; Christel Harijanto; Myrla Sales; Gustavo Duque

doi:10.1007/s00223-022-01044-1

Comparing the Fracture Profile of Osteosarcopenic Older Adults with Osteopenia/Osteoporosis Alone

Calcif Tissue Int. 2023 Mar;112(3):297-307. doi: 10.1007/s00223-022-01044-1. Epub 2022 Nov 27.

Authors

Ben Kirk^#^{1

2}, Simon Zhang^#^{1

2}, Sara Vogrin^{1

2}, Christel Harijanto^{1

2}, Myrla Sales^{1

2}, Gustavo Duque^{3

4

5}

Affiliations

¹ Department of Medicine, Melbourne Medical School, University of Melbourne, Western Health, St Albans, Melbourne, VIC, Australia.
² Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia.
³ Department of Medicine, Melbourne Medical School, University of Melbourne, Western Health, St Albans, Melbourne, VIC, Australia. gustavo.duque@mcgill.ca.
⁴ Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia. gustavo.duque@mcgill.ca.
⁵ Department of Medicine and Research Institute, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, QC, H4A 3J1, Canada. gustavo.duque@mcgill.ca.

^# Contributed equally.

PMID: 36436030
DOI: 10.1007/s00223-022-01044-1

Abstract

Purpose: To determine whether osteosarcopenia is associated with a greater likelihood of recurrent fractures, as well as type of fracture, than osteopenia/osteoporosis or sarcopenia alone.

Methods: Anthropometry (height/weight; scales and stadiometer), body composition (bone mineral density [BMD] and appendicular lean mass; dual-energy x-ray absorptiometry), grip strength (hydraulic dynamometer), and gait speed (4 m) were measured in an outpatient clinic. WHO definition for osteopenia/osteoporosis (BMD T-score below -1 SDs) while sarcopenia was defined by SDOC or EWGSOP2. Number and location of fractures within the past 5 years were self-reported and verified by medical records (unverified fractures excluded). Univariable and multivariable regressions were used to examine the association between the exposure and outcome while adjusting for confounders.

Results: 481 community-dwelling older adults (median age: 78, IQR: 72, 83; 75.9% women) were included. Prevalence of osteosarcopenia depended on the definition (SDOC: 179 (37.2%); EWGSOP2: 123 (25.6%)). In multivariable analysis adjusting for age, sex, alcohol, smoking, BMI, lowest BMD T-score, physical activity, and comorbidities, the likelihood of recurrent fractures (≥ 2 vs 0-1) was significantly higher in those with osteosarcopenia versus osteopenia/osteoporosis irrespective of the definition (SDOC: odds ratio [OR]: 1.63, 95% CI: 1.03, 2.59, p = 0.037; EWGSOP2: OR: 1.83, 95% CI: 1.12, 3.01, p = 0.016]. Associations with sarcopenia alone (SDOC: 10; EWGSOP2: 7) were not possible due to the extremely low prevalence of this condition in those with normal BMD.

Conclusion: Our data suggest osteosarcopenia is associated with a greater likelihood of recurrent fractures versus osteopenia/osteoporosis alone. Further studies are needed to evaluate the relationship with sarcopenia alone.

Keywords: Aging; Bone; Crosstalk; Fractures; Musculoskeletal; Skeletal Muscle.

MeSH terms

Absorptiometry, Photon
Aged
Bone Density
Comorbidity
Female
Fractures, Bone* / epidemiology
Hand Strength
Humans
Male
Osteoporosis* / complications
Sarcopenia* / complications

Grants and funding

Seed Grant/Australian Institute for Musculoskeletal Science