Osteoporosis International

, Volume 24, Issue 1, pp 87–98 | Cite as

Sarcopenia and its relationship with bone mineral density in middle-aged and elderly European men

  • S. Verschueren
  • E. Gielen
  • T. W. O’Neill
  • S. R. Pye
  • J. E. Adams
  • K. A. Ward
  • F. C. Wu
  • P. Szulc
  • M. Laurent
  • F. Claessens
  • D. Vanderschueren
  • S. BoonenEmail author
Original Article



The aim of this study was to determine the relationship between reduced muscle mass (sarcopenia) and areal bone mineral density (BMDa) in middle-aged and elderly community-dwelling European men. Men with sarcopenia had significantly lower BMDa and were more likely to have osteoporosis compared with men without sarcopenia.


In men, the relationship between reduced muscle mass (sarcopenia) and BMDa is unclear. This study aimed to determine this relationship in middle-aged and elderly community-dwelling men.


Men aged 40–79 years from the Manchester (UK) and Leuven (Belgium) cohorts of the European Male Ageing Study were invited to attend for assessment including dual-energy X-ray absorptiometry, from which appendicular lean mass (aLM), fat mass (FM) and whole-body, spine and hip BMDa were determined. Relative appendicular skeletal muscle mass (RASM) was calculated as aLM/height². Muscle strength was assessed in subjects from Leuven. Sarcopenia was defined by RASM at <7.26 kg/m² and by the recent definition of the European Working Group on Sarcopenia in Older People (RASM at <7.26 kg/m2 plus low muscle function). Linear regression was used to determine the associations between aLM, FM, muscle strength and BMDa and logistic regression to determine the association between sarcopenia and osteoporosis.


Six hundred seventy-nine men with a mean age of 59.6 (SD = 10.7), contributed data to the analysis; 11.9 % were sarcopenic by the conventional definition. After adjustment for age and centre, aLM, RASM and FM were positively associated with BMDa. Men with RASM at <7.26 kg/m² had significantly lower BMDa compared with those with RASM at ≥7.26 kg/m2. In a multivariable model, aLM was most consistently associated with BMDa. Men with sarcopenia were more likely to have osteoporosis compared with those with normal RASM (odds ratio = 3.0; 95 % CI = 1.6–5.8).


Sarcopenia is associated with low BMDa and osteoporosis in middle-aged and elderly men. Further studies are necessary to assess whether maintaining muscle mass contributes to prevent osteoporosis.


Areal bone mineral density (BMDaLean mass Muscle strength Osteoporosis Relative appendicular skeletal muscle mass (RASM), sarcopenia 



The European Male Ageing Study (EMAS) was funded by the Commission of the European Communities Fifth Framework Programme “Quality of Life and Management of Living Resources” Grant QLK6-CT-2001-00258. S. Boonen is senior clinical investigator of the Fund for Scientific Research (FWO-Vlaanderen) and holder of the Leuven University Chair in Gerontology and Geriatrics. This work was supported also by grant G.0488.08 from the Fund for Scientific Research (FWO-Vlaanderen) to S. Boonen, research grants OT-05-53 and OT-09-035 from the KU Leuven to D. Vanderschueren, and research funding from Arthritis Research UK. D. Vanderschueren is a senior clinical investigator of the Leuven University Hospital Clinical Research Fund. K. Ward is a senior research scientist working within the Nutrition and Bone Health Core Program at MRC Human Nutrition Research, funded by the UK Medical Research Council (grant code U105960371). S. Verschueren and E. Gielen provided an equal contribution to this manuscript.

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2012

Authors and Affiliations

  • S. Verschueren
    • 1
  • E. Gielen
    • 2
  • T. W. O’Neill
    • 3
  • S. R. Pye
    • 3
  • J. E. Adams
    • 4
  • K. A. Ward
    • 4
    • 5
  • F. C. Wu
    • 6
  • P. Szulc
    • 7
  • M. Laurent
    • 2
    • 8
  • F. Claessens
    • 8
  • D. Vanderschueren
    • 9
  • S. Boonen
    • 2
    Email author
  1. 1.Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation SciencesKU LeuvenLeuvenBelgium
  2. 2.Gerontology and Geriatrics, Department of Clinical and Experimental MedicineKU LeuvenLeuvenBelgium
  3. 3.Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre (MAHSC)University of ManchesterManchesterUK
  4. 4.Manchester Academic Health Science Centre (MAHSC) and Radiology at Manchester Royal InfirmaryManchesterUK
  5. 5.Nutrition and Bone Health, MRC Human Nutrition ResearchCambridgeUK
  6. 6.Andrology Research Unit, Manchester Academic Health Science Centre (MAHSC)University of ManchesterManchesterUK
  7. 7.INSERM UMR 1033University of LyonLyonFrance
  8. 8.Laboratory of Molecular Endocrinology, Department of Cellular and Molecular MedicineKU LeuvenLeuvenBelgium
  9. 9.Clinical and Experimental Endocrinology, Department of Clinical and Experimental MedicineKU LeuvenLeuvenBelgium

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