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Is there a definition of low lean mass that captures the associated low bone mineral density? A cross-sectional study of 80 men with hip fracture

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Abstract

Background and aims

Subjects with osteosarcopenia, the concurrent presence of sarcopenia and osteoporosis, have prognostic disadvantages and can benefit from treatments targeted at both the conditions. Our aim was to elucidate whether the available definitions of low appendicular lean mass (aLM) capture or not the men with associated low bone mineral density (BMD) following a hip fracture.

Methods

80 men admitted to our rehabilitation hospital underwent a dual-energy X-ray absorptiometry scan 19.1 ± 4.1 (mean ± SD) days after hip fracture occurrence. Low aLM was identified according to either Baumgartner’s definition (aLM/height2 < 7.26 kg/m2) or the criteria from the Foundation for the National Institutes of Health (FNIH): aLM < 19.75 kg, or aLM adjusted for body mass index (BMI) < 0.789. Low BMD was diagnosed with a T-score < − 2.5 at the unfractured femur.

Results

We found a significant positive correlation between aLM and BMD assessed at either femoral neck (r = 0.44; p < 0.001) or total hip (r = 0.50; p < 0.001). After categorization according to the FNIH threshold for aLM, we found a significant association between low aLM and low BMD: χ2(1, n = 80) = 5.4 (p = 0.020), which persisted after adjustment for age and fat mass. Conversely, categorization according to neither Baumgartner’s threshold for aLM/height2 nor to the FNIH threshold for aLM/BMI was associated with low BMD.

Conclusions

The association between low aLM and low BMD in men with hip fracture dramatically depends on the adopted definition of low aLM. FNIH threshold for aLM (< 19.75 kg) emerges as a useful tool to capture men with damage to both the components of the muscle–bone unit.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Physical and Rehabilitation Medicine, Osteoporosis Research Center, Presidio Sanitario San Camillo, Fondazione Opera San Camillo, Strada Santa Margherita 136, 10131, Turin, Italy

    Marco Di Monaco, Carlotta Castiglioni & Edoardo Milano

  2. Division of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University of Turin, Corso Bramante 88, 10128, Turin, Italy

    Giuseppe Massazza

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  1. Marco Di Monaco
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Correspondence to Marco Di Monaco.

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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.

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Di Monaco, M., Castiglioni, C., Milano, E. et al. Is there a definition of low lean mass that captures the associated low bone mineral density? A cross-sectional study of 80 men with hip fracture. Aging Clin Exp Res 30, 1429–1435 (2018). https://doi.org/10.1007/s40520-018-1058-y

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