Journal of Bone and Mineral Metabolism

, Volume 31, Issue 5, pp 556–561 | Cite as

Prevalence of sarcopenia in Japanese women with osteopenia and osteoporosis

  • Naohisa Miyakoshi
  • Michio Hongo
  • Yoichi Mizutani
  • Yoichi Shimada
Original Article


Sarcopenia and osteoporosis are both significant health burdens among postmenopausal women. This study examined associations between sarcopenia and osteopenia/osteoporosis in Japanese women and evaluated the prevalence of sarcopenia in women with osteopenia and osteoporosis. A total of 2400 Japanese women aged 40–88 years underwent dual-energy x-ray absorptiometry (DXA) scans of the whole body, lumbar spine, and total hip. Osteopenia and osteoporosis were defined according to World Health Organization criteria using bone mineral density (BMD) of the lumbar spine or hip. Sarcopenia was defined as a relative skeletal muscle index (RSMI) more than 2 standard deviations below the mean for a young adult reference population, calculated as the appendicular skeletal muscle mass (ASM) obtained from whole-body DXA divided by height in meters squared (RSMI = ASM/height2). Significant and marginal/moderate positive correlations were observed between RSMI and lumbar spine/total hip BMDs (r = 0.197 and r = 0.274, respectively; p < 0.0001 each). The BMDs of the lumbar spine and total hip showed significant moderate negative correlations with age (r = −0.270 and r = −0.375, respectively; p < 0.0001 each), but RSMI showed no association with age in this population (r = 0.056). When osteopenia/osteoporosis was defined using lumbar spine BMD, prevalences of sarcopenia in subjects with normal BMD, osteopenia and osteoporosis were 10.4, 16.8, and 20.4 %, respectively. When osteopenia/osteoporosis was defined using total hip BMD, the prevalences of sarcopenia in these subjects were 9.0, 17.8, and 29.7 %, respectively. A Chi-square test for independence showed a significant association between sarcopenia and osteopenia/osteoporosis (p < 0.0001). These results indicate that sarcopenia is significantly associated with osteopenia and osteoporosis in Japanese women.


Sarcopenia Osteopenia Osteoporosis Dual-energy X-ray absorptiometry Muscle mass 


  1. 1.
    WHO Scientific Group (2003) Prevention and management of osteoporosis. World Health Organ Tech Rep Ser 921:1–164Google Scholar
  2. 2.
    Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE et al (2011) Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc 12:249–256PubMedCrossRefGoogle Scholar
  3. 3.
    Morley JE (2008) Sarcopenia: diagnosis and treatment. J Nutr Health Aging 12:452–456PubMedCrossRefGoogle Scholar
  4. 4.
    Di Monaco M, Vallero F, Di Monaco R, Tappero R (2011) Prevalence of sarcopenia and its association with osteoporosis in 313 older women following a hip fracture. Arch Gerontol Geriatr 52:71–74PubMedCrossRefGoogle Scholar
  5. 5.
    Sirola J, Kröger H (2011) Similarities in acquired factors related to postmenopausal osteoporosis and sarcopenia. J Osteoporos 2011:536735PubMedGoogle Scholar
  6. 6.
    Kaptoge S, Benevolenskaya LI, Bhalla AK, Cannata JB, Boonen S et al (2005) Low BMD is less predictive than reported falls for future limb fractures in women across Europe: results from the European Prospective Osteoporosis Study. Bone 36:387–398PubMedCrossRefGoogle Scholar
  7. 7.
    Douchi T, Yamamoto S, Nakamura S, Ijuin T, Oki T, Maruta K, Nagata Y (1998) The effect of menopause on regional and total body lean mass. Maturitas 29:247–252PubMedCrossRefGoogle Scholar
  8. 8.
    Messier V, Rabasa-Lhoret R, Barbat-Artigas S, Elisha B, Karelis AD, Aubertin-Leheudre M (2011) Menopause and sarcopenia: a potential role for sex hormones. Maturitas 68:331–336PubMedCrossRefGoogle Scholar
  9. 9.
    Kasukawa Y, Miyakoshi N, Mohan S (2004) The anabolic effects of GH/IGF system on bone. Curr Pharm Des 10:2577–2592PubMedCrossRefGoogle Scholar
  10. 10.
    Perrini S, Laviola L, Carreira MC, Cignarelli A, Natalicchio A, Giorgino F (2010) The GH/IGF1 axis and signaling pathways in the muscle and bone: mechanisms underlying age-related skeletal muscle wasting and osteoporosis. J Endocrinol 205:201–210PubMedCrossRefGoogle Scholar
  11. 11.
    Visser M, Deeg DJ, Lips P (2003) Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam. J Clin Endocrinol Metab 88:5766–5772PubMedCrossRefGoogle Scholar
  12. 12.
    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 47:207–212PubMedCrossRefGoogle Scholar
  13. 13.
    Douchi T, Oki T, Nakamura S, Ijuin H, Yamamoto S, Nagata Y (1997) The effect of body composition on bone density in pre- and postmenopausal women. Maturitas 27:55–60PubMedCrossRefGoogle Scholar
  14. 14.
    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 147:755–763PubMedCrossRefGoogle Scholar
  15. 15.
    Delmonico MJ, Harris TB, Lee JS, Visser M, Nevitt M, Kritchevsky SB, Tylavsky FA, Newman AB (2007) Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women. J Am Geriatr Soc 55:769–774PubMedCrossRefGoogle Scholar
  16. 16.
    Visser M, Fuerst T, Lang T, Salamone L, Harris TB (1999) Validity of fan-beam dual-energy X-ray absorptiometry for measuring fat-free mass and leg muscle mass. Health, aging, and body composition study–dual-energy X-ray absorptiometry and body composition working group. J Appl Physiol 87:1513–1520PubMedGoogle Scholar
  17. 17.
    Salamone LM, Fuerst T, Visser M, Kern M, Lang T, Dockrell M, Cauley JA, Nevitt M, Tylavsky F, Lohman TG (2000) Measurement of fat mass using DEXA: a validation study in elderly adults. J Appl Physiol 89:345–352PubMedGoogle Scholar
  18. 18.
    Walsh MC, Hunter GR, Livingstone MB (2006) Sarcopenia in premenopausal and postmenopausal women with osteopenia, osteoporosis and normal bone mineral density. Osteoporos Int 17:61–67PubMedCrossRefGoogle Scholar
  19. 19.
    Sanada K, Miyachi M, Tanimoto M, Yamamoto K, Murakami H, Okumura S, Gando Y, Suzuki K, Tabata I, Higuchi M (2010) A cross-sectional study of sarcopenia in Japanese men and women: reference values and association with cardiovascular risk factors. Eur J Appl Physiol 110:57–65PubMedCrossRefGoogle Scholar
  20. 20.
    Gillette-Guyonnet S, Nourhashemi F, Lauque S, Grandjean H, Vellas B (2000) Body composition and osteoporosis in elderly women. Gerontology 46:189–193PubMedCrossRefGoogle Scholar
  21. 21.
    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 50:889–896PubMedCrossRefGoogle Scholar
  22. 22.
    Shimokata H, Ando F (2011) Epidemiology of sarcopenia (in Japanese). Mod Physician 31:1283–1287Google Scholar
  23. 23.
    Kirchengast S, Huber J (2012) Sex-specific associations between soft tissue body composition and bone mineral density among older adults. Ann Hum Biol 39:206–213PubMedCrossRefGoogle Scholar
  24. 24.
    Miyakoshi N, Itoi E, Murai H, Wakabayashi I, Ito H, Minato T (2003) Inverse relation between osteoporosis and spondylosis in postmenopausal women as evaluated by bone mineral density and semiquantitative scoring of spinal degeneration. Spine (Phila Pa 1976) 28:492–495Google Scholar
  25. 25.
    Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinková E, Vandewoude M, Zamboni M (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing 39:412–423PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2013

Authors and Affiliations

  • Naohisa Miyakoshi
    • 1
  • Michio Hongo
    • 1
  • Yoichi Mizutani
    • 2
  • Yoichi Shimada
    • 1
  1. 1.Department of Orthopedic SurgeryAkita University Graduate School of MedicineAkitaJapan
  2. 2.Joto Orthopedic ClinicAkitaJapan

Personalised recommendations