Skip to main content

Advertisement

Log in

Racial and gender differences in the relationship between sarcopenia and bone mineral density among older adults

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

Both sarcopenia and low bone mineral density (BMD) have become public health concerns. We found that presarcopenic and/or sarcopenic individuals were more likely to have lower BMD. And this relationship has race and sex-specific discrepancy.

Purpose

The purpose of the study was to investigate the racial and gender differences in the relationship between sarcopenia and BMD among older adults.

Methods

Totally, 5476 subjects (mean age = 65.7 ± 6.4) of non-Hispanic White (n = 3297), non-Hispanic Black (n = 1265), and non-Hispanic Asian (n = 914) were analyzed. Sarcopenia was defined according to the revised European consensus on definition and diagnosis of sarcopenia (EWGSOP2). General linear model and multivariable linear regression model were used to examine the relationship between sarcopenia and regional/whole body BMD stratified by race and sex. Adjustments were conducted for physiological, behavioral, and disease factors.

Results

Comparing with normal older participants, presarcopenic and sarcopenic elderly were more likely to have lower BMD. Although the difference was not statistically significant in a few sub-groups, among the three racial groups, the strongest association between sarcopenia and BMD was found in non-Hispanic Black people, followed by non-Hispanic White people and non-Hispanic Asian people. In addition, significant differences of BMD across sarcopenia stages were found in more sub-groups in women than in men after adjusting for covariates.

Conclusions

In this older cohort, sarcopenia is significantly related to low regional/whole-body BMD, and these associations vary by race and sex. Consideration in race and sex is warranted when developing strategies to maintain or minimize BMD loss.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, Garry PJ, Lindeman RD (1998) Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 147:755–763

    CAS  PubMed  Google Scholar 

  2. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M, Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48(1):16–31

    PubMed  Google Scholar 

  3. Shafiee G, Keshtkar A, Soltani A, Ahadi Z, Larijani B, Heshmat R (2017) Prevalence of sarcopenia in the world: a systematic review and meta-analysis of general population studies. J Diabetes Metab Disord 16:21

    PubMed  PubMed Central  Google Scholar 

  4. Goates S, Du K, Arensberg MB, Gaillard T, Guralnik J, Pereira SL (2019) Economic impact of hospitalizations in US adults with sarcopenia. J Frailty Aging 8:93–99

    CAS  PubMed  Google Scholar 

  5. Compston J (2010) Osteoporosis: social and economic impact. Radiol Clin N Am 48:477–482

    PubMed  Google Scholar 

  6. Mariconda M, Costa GG, Cerbasi S, Recano P, Orabona G, Gambacorta M, Misasi M (2016) Factors predicting mobility and the change in activities of daily living after hip fracture: a 1-year prospective cohort study. J Orthop Trauma 30:71–77

    PubMed  Google Scholar 

  7. Drake MT, Murad MH, Mauck KF et al (2012) Clinical review. Risk factors for low bone mass-related fractures in men: a systematic review and meta-analysis. J Clin Endocrinol Metab 97:1861–1870

    CAS  PubMed  Google Scholar 

  8. Kanis JA, Burlet N, Cooper C, Delmas PD, Reginster JY, Borgstrom F, Rizzoli R (2008) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 19:399–428

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Lee JJ, Aghdassi E, Cheung AM et al (2012) Ten-year absolute fracture risk and hip bone strength in Canadian women with systemic lupus erythematosus. J Rheumatol 39:1378–1384

    PubMed  Google Scholar 

  10. Nelson HD, Haney EM, Dana T, Bougatsos C, Chou R (2010) Screening for osteoporosis: an update for the U.S. Preventive Services Task Force. Ann Intern Med 152(2):99–111

    Google Scholar 

  11. Schurman L, Bagur A, Claus-Hermberg H, Messina OD, Negri AL, Sánchez A, González C, Diehl M, Rey P, Gamba J, Chiarpenello J, Moggia MS, Mastaglia S (2013) Guidelines for the diagnosis, prevention and treatment of osteoporosis, 2012. Medicina 73:55–74

    PubMed  Google Scholar 

  12. Kanis JA (2007) WHO Technical Report. University of Sheffield, UK, p 66

    Google Scholar 

  13. Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res 22:465–475

    PubMed  Google Scholar 

  14. Edwards MH, Dennison EM, Aihie Sayer A, Fielding R, Cooper C (2015) Osteoporosis and sarcopenia in older age. Bone 80:126–130

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Pisani P, Renna MD, Conversano F, Casciaro E, Di Paola M, Quarta E, Muratore M, Casciaro S (2016) Major osteoporotic fragility fractures: risk factor updates and societal impact. World J Orthop 7:171–181

    PubMed  PubMed Central  Google Scholar 

  16. Curtis E, Litwic A, Cooper C, Dennison E (2015) Determinants of muscle and bone aging. J Cell Physiol 230:2618–2625

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Looker AC, Melton LJ, Harris T, Borrud L, Shepherd J, McGowan J (2009) Age, gender, and race/ethnic differences in total body and subregional bone density. Osteoporos Int 20:1141–1149

    CAS  PubMed  Google Scholar 

  18. Verschueren S, Gielen E, O’Neill TW, Pye SR, Adams JE, Ward KA, Wu FC, Szulc P, Laurent M, Claessens F, Vanderschueren D, Boonen S (2013) Sarcopenia and its relationship with bone mineral density in middle-aged and elderly European men. Osteoporos Int 24:87–98

    CAS  PubMed  Google Scholar 

  19. Blain H, Vuillemin A, Teissier A, Hanesse B, Guillemin F, Jeandel C (2001) Influence of muscle strength and body weight and composition on regional bone mineral density in healthy women aged 60 years and over. Gerontology 47:207–212

    CAS  PubMed  Google Scholar 

  20. Deng HW, Shen H, Xu FH, Deng HY, Conway T, Zhang HT, Recker RR (2002) Tests of linkage and/or association of genes for vitamin D receptor, osteocalcin, and parathyroid hormone with bone mineral density. J Bone Miner Res Off J Am Soc Bone Miner Res 17(4):678–686. https://doi.org/10.1359/jbmr.2002.17.4.678

    Article  CAS  Google Scholar 

  21. Du Y, Zhao LJ, Xu Q, Wu KH, Deng HW (2017) Socioeconomic status and bone mineral density in adults by race and gender: the Louisiana osteoporosis study. Osteoporos Int 28:1699–1709

    CAS  PubMed  Google Scholar 

  22. Kim J, Wang Z, Heymsfield SB, Baumgartner RN, Gallagher D (2002) Total-body skeletal muscle mass: estimation by a new dual-energy X-ray absorptiometry method. Am J Clin Nutr 76:378–383

    CAS  PubMed  Google Scholar 

  23. Carey G (2013) Chapter 9 The General Linear Model (GLM): A gentle introduction. In: Quantitative Methods In Neuroscience. http://psych.colorado.edu/~carey/qmin/QMIN_2013_03_17.pdf. Accessed 05 May2019

  24. He H, Liu Y, Tian Q, Papasian CJ, Hu T, Deng HW (2016) Relationship of sarcopenia and body composition with osteoporosis. Osteoporos Int 27:473–482

    CAS  PubMed  Google Scholar 

  25. Cheng Q, Zhu X, Zhang X, Li H, Du Y, Hong W, Xue S, Zhu H (2014) A cross-sectional study of loss of muscle mass corresponding to sarcopenia in healthy Chinese men and women: reference values, prevalence, and association with bone mass [J]. J Bone Miner Metab 32(1):78–88

    PubMed  Google Scholar 

  26. Taaffe DR, Cauley JA, Danielson M, Nevitt MC, Lang TF, Bauer DC, Harris TB (2001) Race and sex effects on the association between muscle strength, soft tissue, and bone mineral density in healthy elders: the Health, Aging, and Body Composition Study. J Bone Miner Res 16:1343–1352

    CAS  PubMed  Google Scholar 

  27. Farber CR (2012) Systems genetics: a novel approach to dissect the genetic basis of osteoporosis [J]. Curr Osteoporos Rep 10(3):228–235

    PubMed  PubMed Central  Google Scholar 

  28. Travison TG, Chiu GR, McKinlay JB, Araujo AB (2011) Accounting for racial/ethnic variation in bone mineral content and density: the competing influences of socioeconomic factors, body composition, health and lifestyle, and circulating androgens and estrogens [J]. Osteoporos Int 22(10):2645–2654

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Megyesi MS, Hunt LM, Brody H (2011) A critical review of racial/ethnic variables in osteoporosis and bone density research [J]. Osteoporos Int 22(6):1669–1679

    CAS  PubMed  Google Scholar 

  30. Lima RM, de Oliveira RJ, Raposo R, Neri SGR, Gadelha AB (2019) Stages of sarcopenia, bone mineral density, and the prevalence of osteoporosis in older women [J]. Arch Osteoporos 14(1):38

    PubMed  Google Scholar 

  31. Blain H, Vuillemin A, Teissier A (2001) Influence of muscle strength and body weight and composition on regional bone mineral density in healthy women aged 60 years and over [J]. Gerontology 47(4):207–212

    CAS  PubMed  Google Scholar 

  32. Kim KM, Lee EY, Lim S, Jang HC, Kim CO (2017) Favorable effects of skeletal muscle on bone are distinguished according to gender and skeletal sites [J]. Osteoporos Sarcopenia 3(1):32–36

    PubMed  Google Scholar 

  33. Silva MJ (2007) Biomechanics of osteoporotic fractures [J]. Injury 38(Suppl 3):S69–S76

    PubMed  Google Scholar 

  34. Ribom E, Ljunggren O, Piehl-Aulin K, Ljunghall S, Bratteby LE, Samuelson G, Mallmin H (2004) Muscle strength correlates with total body bone mineral density in young women but not in men [J]. Scand J Med Sci Sports 14(1):24–29

    CAS  PubMed  Google Scholar 

  35. Bevier WC, Wiswell RA, Pyka G, Kozak KC, Newhall KM, Marcus R (1989) Relationship of body composition, muscle strength, and aerobic capacity to bone mineral density in older men and women [J]. J Bone Miner Res 4(3):421–432

    CAS  PubMed  Google Scholar 

  36. Philippou A, Maridaki M, Halapas A, Koutsilieris M (2007) The role of the insulin-like growth factor 1 (IGF-1) in skeletal muscle physiology [J]. In Vivo 21(1):45–54

    CAS  PubMed  Google Scholar 

  37. Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S, Dawson-Hughes B (2014) The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine [J]. J Bone Miner Res 29(11):2520–2526

    PubMed  Google Scholar 

  38. Reginster JY, Burlet N (2006) Osteoporosis: a still increasing prevalence [J]. Bone 38(2 Suppl 1):S4–S9

    PubMed  Google Scholar 

  39. Janssen I, Heymsfield SB, Ross R (2002) Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 50(5):889–896

    PubMed  Google Scholar 

  40. Travison T, Chiu G, McKinlay J, Araujo A (2011) Accounting for racial/ethnic variation in bone mineral content and density: the competing influences of socioeconomic factors, body composition, health and lifestyle, and circulating androgens and estrogens. Osteoporos Int 22:2645–2654

    CAS  PubMed  PubMed Central  Google Scholar 

  41. Navarro MC, Saavedra P, Jódar E, Gómez DT, Mirallave A, Sosa M (2013) Osteoporosis and metabolic syndrome according to socioeconomic status, contribution of PTH, vitamin D and bodyweight: the Canarian osteoporosis poverty study (COPS). Clin Endocrinol 78:681–686

    CAS  Google Scholar 

  42. Lips P, van Schoor NM (2011) The effect of vitamin D on bone and osteoporosis. Best Pract Res Clin Endocrinol Metab 25(4):585–591

    CAS  PubMed  Google Scholar 

  43. Girgis CM, Clifton-Bligh RJ, Hamrick MW, Holick MF, Gunton JE (2013) The roles of vitamin D in skeletal muscle: form, function, and metabolism. Endocr Rev 34(1):33–83

    CAS  PubMed  Google Scholar 

  44. Gunton JE, Girgis CM (2018) Vitamin D and muscle. Bone Rep 8:163–167

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to H.-W. Deng.

Ethics declarations

Conflicts of interest

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

ESM 1

(DOCX 677 kb).

Appendix

Appendix

Table 4 Adjusted regression coefficient of sarcopenia stages and regional/whole body BMD by race and sex in model 1
Table 5 Adjusted regression coefficient of sarcopenia stages and regional/whole body BMD by race and sex in model 2

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ning, HT., Du, Y., Zhao, LJ. et al. Racial and gender differences in the relationship between sarcopenia and bone mineral density among older adults. Osteoporos Int 32, 841–851 (2021). https://doi.org/10.1007/s00198-020-05744-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-020-05744-y

Keywords

Navigation