Osteoporosis International

, Volume 17, Issue 1, pp 61–67 | Cite as

Sarcopenia in premenopausal and postmenopausal women with osteopenia, osteoporosis and normal bone mineral density

  • Marianne C. Walsh
  • Gary R. Hunter
  • Margaret Barbara Livingstone
Original Article


Sarcopenia, the decline of muscle mass with age, causes impaired gait, disability and falls. It may therefore increase the risk of fracture for osteoporotic women. The aims of this study were to determine the prevalence of sarcopenia in osteopenic and osteoporotic women, and to determine if hormone replacement therapy (HRT), diet, or physical activity (PA) has a role in the prevention of sarcopenia. One hundred and thirty-one premenopausal and 82 postmenopausal (54 taking HRT) healthy women (17–77 years) volunteered for the study. Body composition was measured by dual X-ray absorptiometry (DXA). Sarcopenia was defined as a relative skeletal muscle index (RSMI) (appendicular skeletal muscle mass divided by height) below 5.45 kg/m2. Osteopenia was defined by a densitometric t -score for bone mineral density (BMD) (g/cm2) below −1.0 and osteoporosis by a t -score below −2.5. Nutrient intake was assessed using 3-day food records and physical activity (PA) was measured using the Baecke Physical Activity Questionnaire. Pearson chi-squared, independent t -tests, simple correlation and multiple regression were used to analyze the data. In premenopausal osteopenic women the prevalence of sarcopenia was 12.5%. In postmenopausal women it was 25% for those with osteopenia, and 50% for those with osteoporosis. PA was independently related to RSMI (β=0.222, p =0.0001), but diet and HRT were not. After adjusting for PA, RSMI was not significantly related to BMD. These data suggest that the relationship between RSMI, BMD and risk of osteoporosis may largely be mediated through participation in PA. Sarcopenia screening simultaneous to BMD examinations by DXA, may be of value in identifying osteoporotic women with sarcopenia, a group that may be most in need of exercise interventions to increase muscle and BMD.


Fracture risk HRT Osteopenia Osteoporosis Sarcopenia 



Body fat


Bone mineral content


Bone mineral density


Dual X-ray absorptiometry


Fat free mass


Fat mass


Lean mass


Hormone replacement therapy


Physical activity


Relative skeletal muscle index


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2005

Authors and Affiliations

  • Marianne C. Walsh
    • 1
  • Gary R. Hunter
    • 2
    • 3
  • Margaret Barbara Livingstone
    • 1
  1. 1.Northern Ireland Centre for Diet and HealthUniversity of UlsterColeraine, Co. LondonderryUK
  2. 2.Division of Physiology and Metabolism, Departments of Human Studies and Nutritional SciencesUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.Room 205 Education BuildingUniversity of Alabama at BirminghamBirminghamUSA

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