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Novel effects of sarcopenic osteoarthritis on metabolic syndrome, insulin resistance, osteoporosis, and bone fracture: the national survey

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Abstract

Summary

This study compared the effects sarcopenic osteoarthritis on metabolic syndrome, insulin resistance, osteoporosis, and bone fracture. By using national survey data, we suggest that the relationship between sarcopenia and metabolic syndrome or insulin resistance is potentiated by the severity of osteoarthritis and is independent of body weight.

Introduction

Sarcopenia and osteoarthritis are known risk factors for metabolic syndrome. However, their combined effects on metabolic syndrome, insulin resistance and osteoporosis remain uncertain.

Methods

We used data from the fifth Korean National Health and Nutrition Examination Survey using a total of 3158 adults (age >50 years). Sarcopenia was defined as a skeletal muscle index score (appendicular skeletal muscle mass/body weight) within the fifth percentile of sex-matched younger reference participants. Radiographic knee osteoarthritis was defined as a Kellgren-Lawrence (K-L) grade of 2 or greater. Metabolic syndrome was diagnosed using the National Cholesterol Education Program criteria. Insulin resistance was evaluated using the homeostasis model assessment-estimated insulin resistance index (HOMA-IR). Osteoporosis was defined using the World Health Organization T-score criteria.

Results

In multivariable logistic regression analysis, the sarcopenic osteoarthritis group had a higher odds ratio (OR) for metabolic syndrome (OR = 11.00, 95 % confidential interval (CI) = 2.12–56.99, p = 0.013) than the non-sarcopenic osteoarthritis (OR = 1.02, 95 % CI = 0.65–1.62, p = 0.972) and sarcopenic non-osteoarthritis groups (OR = 7.15, 95 % CI = 1.57–32.53, p = 0.027). Similarly, sarcopenic osteoarthritis had a greater OR of highest HOMA-IR quartiles (OR = 8.19, 95 % CI = 2.03–33.05, p = 0.003) than the other groups. Overall, the association between the K-L grade and body mass index was significant; however, this significance was lower in individuals with sarcopenia and was lost in those with sarcopenic osteoarthritis. Additionally, osteoporosis and bone fracture were not associated to sarcopenic osteoarthritis (p > 0.05).

Conclusions

These results suggest that the relationship between sarcopenia and metabolic syndrome or insulin resistance is potentiated by the severity of osteoarthritis and is independent of body weight.

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Abbreviations

ANCOVA:

Analysis of covariance

ASM:

Appendicular skeletal muscle mass

BMI:

Body mass index

BP:

Blood pressure

BMD:

Bone mineral densitometry

CI:

Confidential intervals

HDL:

High-density lipoprotein

HOMA-IR:

Homeostasis model assessment-estimated insulin resistance index.

IL:

Interleukin

K-L grade:

Kellgren-Lawrence grade

KNHANES:

Korean National Health and Nutrition Examination Survey

LDL:

Low-density lipoprotein

MetS:

Metabolic syndrome

NCEP-ATP:

National Cholesterol Education Program-Adult Treatment Panel

OA:

Osteoarthritis

OR:

Odds ratio

SE:

Standard error

SMI:

Skeletal muscle index

SR:

Sarcopenia

TNF:

Tumor necrosis factor

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Authors’ contributions

Sang Mi Chung, Myung Han Hyun, Eunmi Lee, and Hong Seog Seo are responsible for the conception and design of the study. Sang Mi Chung, Eunmi Lee, and Myung Han Hyun are responsible for the the acquisition of data. Sang Mi Chung, Myung Han Hyun, Eunmi Lee, and Hong Seog Seo are responsible for the analysis and interpretation of data. Sang Mi Chung, Myung Han Hyun, Eunmi Lee, and Hong Seog Seo are responsible for the drafting of the manuscript. Sang Mi Chung, Myung Han Hyun, Eunmi Lee, and Hong Seog Seo are responsible for the critical revision of the manuscript for important intellectual content. Myung Han Hyun is responsible for the statistical analysis. Hong Seog Seo is responsible for the administrative support and study supervision. Sang Mi Chung, Myung Han Hyun, Eunmi Lee, and Hong Seog Seo are responsible for the final approval of manuscript.

Author access to data

Hong Seog Seo and Eunmi Lee had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

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    Authors and Affiliations

    1. Cardiovascular Center, Korea University Guro Hospital, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 152-703, Republic of Korea

      S. M. Chung, M. H. Hyun & H. S. Seo

    2. Department of Cardiology, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, 321, Sanbon-ro, Gunpo, Gyeonggi-province, 435-040, Republic of Korea

      E. Lee

    3. Korea Institute of Science and Technology (KU-KIST) Graduate School of Converging Science and Technology, Korea University, Seoul, Republic of Korea

      H. S. Seo

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    1. S. M. Chung
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    Correspondence to E. Lee or H. S. Seo.

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    Source of funding and support

    This work was supported by a grant from the Korea Institute of Science and Technology Institutional Program (Project No. 2E24080), a grant from the Korea University-Korea Institute of Science and Technology (KU-KIST) Graduate School of Converging Science and Technology (R1307921).

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    S. M. Chung and M. H. Hyun contributed equally to this work.

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    Chung, S.M., Hyun, M.H., Lee, E. et al. Novel effects of sarcopenic osteoarthritis on metabolic syndrome, insulin resistance, osteoporosis, and bone fracture: the national survey. Osteoporos Int 27, 2447–2457 (2016). https://doi.org/10.1007/s00198-016-3548-0

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