Association between sarcopenia, its components, and osteoporosis in the FRISBEE cohort.

Abstract

Abstract objective Bone and muscle diseases are both highly prevalent in aging adults but results from previous studies examining the relationship between sarcopenia and its components with osteoporosis are inconsistent. This study aimed to evaluate the association between sarcopenia and its components with osteoporosis in elderly postmenopausal women. Materials & Methods This study is based on cross-sectional data from the Fracture RISk Brussels Epidemiological Enquiry (FRISBEE), involving 3560 community-dwelling post-menopausal women initially included between 2007 and 2013. Randomly selected subjects were reassessed 10 years after inclusion with an evaluation of body composition by dual X-ray absorptiometry (DXA), with a medical questionnaire and a complete geriatric assessment. The diagnostic criteria for sarcopenia were low muscle mass < 5.5 kg/m2, low muscle strength < 16 kg, and low gait speed < 0.8 m/s according to the European Working Group on Sarcopenia in Older People (EWGSOP2). Osteoporosis was defined by the National Bone Health Alliance Working Group proposed extended criteria including a history of major osteoporotic fracture and high fracture risk. Results Among the 500 women included, with a median age of 77.4 (74.7–81.8) years, 178 (35.6%) were osteoporotic. Significant correlations were shown between sarcopenia components and bone mineral density (BMD) at all sites as well as trabecular bone score (TBS). The strongest correlations were between handgrip strength and distal forearm BMD (r = 0.27; p < 0.001), and between appendicular lean mass index (ALMI) and total hip BMD (r = 0.36; p < 0.001). Significant differences were observed between sub-groups of osteoporotic status: the handgrip strength, short physical performance battery (SPPB) test, gait speed, and ALMI were significantly lower in osteoporotic subjects (p < 0.001). After adjustment for all covariates, handgrip strength and gait speed were still significantly associated with osteoporosis with an odds ratio of 0.92 (0.88–0.97) and 0.33 (0.11–0.96), respectively. Handgrip strength under 16 kg showed a 2.2-fold higher risk of osteoporosis after adjustment for all covariates. Conclusion Sarcopenia, as defined by EWGSOP2, and its components, particularly handgrip strength and gait speed, were significantly associated with osteoporosis. The trabecular bone score, a surrogate for bone microarchitecture, was also significantly associated with all sarcopenia components. Therefore, it should be taken into consideration when evaluating bone health and fracture risk in routine geriatric clinical practice.