Sarcopenia, osteoporosis and the burden of prevalent vertebral fractures: a cross-sectional study of 350 women with hip fracture.
Eur J Phys Rehabil Med. 2020 Feb 12;: Authors: Di Monaco M, Castiglioni C, Bardesono F, Milano E, Massazza G
BACKGROUND: The concurrent presence of sarcopenia and osteoporosis may enhance fracture risk. AIM: To evaluate the association between sarcopenia, osteoporosis, or the concurrent presence of both the conditions (osteosarcopenia) and the burden (number and severity) of vertebral fractures in women with hip fracture. DESIGN: Cross-sectional study. POPULATION: We studied 350 women with subacute hip fracture. METHODS: Lateral radiographs of the spine were taken 18.2±4.5 days after fracture occurrence and the spine deformity index (SDI) was calculated. Body composition was assessed by dual-energy x-ray absorptiometry. Low muscle mass was identified with appendicular lean mass <15.02 kg and low bone mineral density with a femoral T-score <-2.5. RESULTS: The presence of sarcopenia (P=0.033) and osteoporosis (P=0.032) was associated with the SDI scores independently of each other and independently of age, percentage of body fat and hip-fracture type. The 350 women were categorized into 3 groups according to the absence of both osteoporosis and sarcopenia (N=25), presence of either osteoporosis or sarcopenia (N=95) or presence of osteosarcopenia (N=230). We found a significant difference in SDI scores across the 3 groups: x² (2, N=350) = 15.29; P<0.001. The categorization of the 350 women into the 3 groups was associated with the SDI scores (P=0.001) independently of age, percentage of body fat and hip-fracture type. CONCLUSIONS: Both osteoporosis and sarcopenia were independently associated with the burden of prevalent vertebral fractures in women with hip fracture. The concurrent presence of sarcopenia and osteoporosis was associated with a higher SDI score than the presence of only one of the 2 conditions. CLINICAL REHABILITATION IMPACT: Subjects with both low bone mass and low muscle mass should be considered at particularly high risk for vertebral fractures. Interventions targeting both the components of the muscle-bone unit, including exercise, nutrition, and possibly new medications, should be investigated to optimize fracture prevention. PMID: 32052946 [PubMed - as supplied by publisher]