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The Predictive Value of Sarcopenia and Falls for 2-Year Major Osteoporotic Fractures in Community-Dwelling Older Adults

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Abstract

To evaluate the associations of sarcopenia and previous falls with 2-year major osteoporotic fractures (MOFs) in community-dwelling older adults. Four thousand Chinese men and women ≥ 65 years recruited from Hong Kong communities were prospectively followed up. Measures of muscle mass, grip strength, gait speed and falls in the previous year were recorded at baseline, the 2nd year and the 4th year visit for each subject. The associations of fall history, sarcopenia and its components with 2-year MOFs were evaluated using generalized linear mixed models. Poor grip strength and poor gait speed were significantly associated with a higher 2-year MOFs risk, with an adjusted OR (95% CI) per one SD decrease of 1.48 (1.17, 1.87) and 1.17 (1.00, 1.36), respectively. Falls in the previous year was a significant predictor for 2-year MOFs risk, with an adjusted OR (95% CI) per one added fall of 1.85 (1.40, 2.44) in men and 1.26 (1.01, 1.58) in women. The adjusted OR (95% CI) of height adjusted appendicular lean muscle mass (ALM/height2) per one SD decrease and sarcopenia for 2-year MOFs risk were 1.34 (0.87, 2.06) and 1.72 (0.92, 3.21) in men, and were 0.73 (0.57, 0.93) and 0.76 (0.39, 1.47) in women, respectively (P for interaction by gender = 0.012 and 0.017, respectively). Poor sarcopenia-related physical performance and falls in the previous year were significant predictors for 2-year MOFs in community-dwelling older adults. The predictive value of ALM by DXA for near-term fracture risk is limited and different across genders.

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Acknowledgements

The authors wish to thank all participants dedicated contributing to the study and The Chinese University of Hong Kong Jockey Club Centre for Osteoporosis Care and Control supporting the study.

Funding

The study was supported by the National Institutes of Health R01 Grant AR049439–01A1 and the Chinese University of Hong Kong Research Grants Council Earmarked Grant CUHK4101/02M.

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Authors and Affiliations

  1. Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China

    Yi Su, Freddy M. H. Lam & Timothy Kwok

  2. Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China

    Jason Leung & Timothy Kwok

  3. Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China

    Wing-Hoi Cheung

  4. Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China

    Suzanne C. Ho

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  1. Yi Su
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Contributions

Study concept and design: TK and YS; Acquisition of data: JL; Analysis and interpretation of data: YS, JL, SCH and TK; Drafting of the manuscript: YS; Critical revision of the manuscript for important intellectual content: FL, W-HC, SCH and TK; Final approval of the version to be published: YS, FL, JL, W-HC, SCH and TK.

Corresponding author

Correspondence to Timothy Kwok.

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Conflict of interest

Yi Su, Freddy Lam, Jason Leung, Wing-Hoi Cheung, Suzanne C Ho and Timothy Kwok declare that they have no conflict of interest.

Ethical Approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Clinical Research Ethics Committee of the Chinese University of Hong Kong (CRE-2003.102). Informed consent was obtained from all individual participants included in the study.

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Su, Y., Lam, F.M.H., Leung, J. et al. The Predictive Value of Sarcopenia and Falls for 2-Year Major Osteoporotic Fractures in Community-Dwelling Older Adults. Calcif Tissue Int 107, 151–159 (2020). https://doi.org/10.1007/s00223-020-00709-z

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