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Association of possible sarcopenic obesity with osteoporosis and fragility fractures in postmenopausal women

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Abstract

Summary

Possible sarcopenic obese women had a decreased likelihood of osteoporosis but an increased likelihood of fragility fractures compared with non-sarcopenic non-obese and sarcopenia-only women. Furthermore, possible sarcopenic obese women had lower values of trabecular bone score than non-sarcopenic non-obese and sarcopenia-only women.

Purpose

The coexistence of possible sarcopenia and obesity may have opposing effects on osteoporosis. This study aimed to investigate whether possible sarcopenic obesity is associated with osteoporosis or fragility fracture.

Methods

In this cross-sectional study of 1007 postmenopausal women from Taiwan, bone mineral density of the spine and hips was evaluated using dual-energy X-ray absorptiometry (DXA), and bone microarchitecture was evaluated using the trabecular bone score (TBS) derived from a lumbar spine image acquired by DXA. According to the definition of sarcopenia by the 2019 Asian Working Group for Sarcopenia, possible sarcopenia was defined by either low muscle strength or reduced physical performance. Obesity was defined as a body mass index of ≥ 27 kg/m2. Based on the presence of possible sarcopenia and obesity, study participants were classified as follows: control (non-sarcopenic non-obese), sarcopenic (non-obese), obese (non-sarcopenic), and sarcopenic obese. Prevalent fragility fractures were determined by retrospectively reviewing medical records.

Results

In this study, 10.1% of participants were classified as sarcopenic obese, 9.1% as obese, 35.2% as sarcopenic, and 45.6% as control. Relative to the control group, the sarcopenic obese group (OR, 0.28; 95% CI 0.18, 0.46) and obese group (OR, 0.38; 95% CI 0.23, 0.61) had a decreased likelihood of osteoporosis. However, the sarcopenic obese group (OR, 2.29; 95% CI 1.31, 4.00) and obese group (OR, 1.94; 95% CI 1.04, 3.62) had an increased likelihood of fragility fractures than with the control group. In addition, the sarcopenic obese group had a higher likelihood of fragility fractures than the sarcopenic group. Possible sarcopenic obese women also had significantly lower TBS values than those in the control and sarcopenic groups.

Conclusions

Possible sarcopenic obese women had a lower likelihood of osteoporosis but a higher likelihood of fragility fractures than non-sarcopenic non-obese and sarcopenia-only women. Furthermore, possible sarcopenic obese individuals had lower values of TBS than non-sarcopenic non-obese and sarcopenia-only women.

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Availability of data and material

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by grants CHGH110-(N)20 and CHGH111-(N)21 from the Cheng Hsin General Hospital, Taipei, Taiwan.

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Authors and Affiliations

Authors

Contributions

Yen-Huai Lin and Michael Mu Huo Teng initiated the study, and all authors contributed to its design. Yen-Huai Lin and Michael Mu Huo Teng managed the data collection, performed the data analysis, and wrote the first draft of the manuscript. Yen-Huai Lin and Michael Mu Huo Teng are collectively responsible for interpreting the results and critically reviewed subsequent drafts of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Michael Mu Huo Teng.

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Ethics approval

All procedures performed in 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. This study was approved by the institutional review board of Cheng Hsin General Hospital (IRB no. (660)107A-32).

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Informed consent was obtained from all the participants included in the study.

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None.

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Lin, YH., Teng, M.M.H. Association of possible sarcopenic obesity with osteoporosis and fragility fractures in postmenopausal women. Arch Osteoporos 17, 65 (2022). https://doi.org/10.1007/s11657-022-01107-8

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