Osteosarcopenia among postmenopausal women and handgrip strength as a practical method for predicting the risk

Abstract

Background

Osteosarcopenia is a recently described geriatric syndrome. Studies concerning its role on physical function are relatively few.

Aim

To evaluate the prevalence of osteosarcopenia and to analyze its relationship with physical function among postmenopausal women.

Methods

Demographic and clinical data, fracture risk, and osteosarcopenia risk factors of 140 postmenopausal women were evaluated between April 2018 and September 2018. Body composition and bone mineral density were measured by dual-energy X-ray absorbtiometry. Handgrip strength and physical performance test results were recorded. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People, whereas osteopenia/osteoporosis was diagnosed according to the World Health Organisation criteria.

Results

The mean age of the patients was 64.1 ± 8.9 years. Among the patients, 64.3% (n = 90) were found to be osteosarcopenic. Insufficient protein and calcium intake and low physical activity level were found to be the most frequent risk factors. When further analysis was done according to the osteosarcopenia, sarcopenia-only, and osteoporosis-only groups, osteosarcopenia group revealed the lowest body mass index, skeletal mass index, handgrip strength values, and physical performance test results. The handgrip strength was found to be a determinant of osteosarcopenia and each 1-unit decrease in handgrip strength increased the risk of osteosarcopenia by 1.162 times (95% CI 1.086–1.25).

Conclusions

The prevalence of osteosarcopenia is high among postmenopausal women. It is recommended to be aware of osteosarcopenia while managing osteoporotic patients, to use handgrip strength as a simple screening method, and to consider sarcopenia treatment as an important component of osteoporosis prevention and treatment.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Paintin J, Cooper C, Dennison E (2018) Osteosarcopenia. Br J Hosp Med 79:253–258. https://doi.org/10.12968/hmed.2018.79.5.253

    Article  Google Scholar 

  2. 2.

    Hassan EB, Duque G (2017) Osteosarcopenia: a new geriatric syndrome. Aust Fam Physician 46:849–853

    PubMed  Google Scholar 

  3. 3.

    Crepaldi G, Maggi S (2005) Sarcopenia and osteoporosis: a hazardous duet. J Endocrinol Invest 28:66–68

    CAS  Article  Google Scholar 

  4. 4.

    Suriyaarachchi P, Gomez F, Curcio CL, Boersma D, Murthy L, Grill V, Duque G (2018) High parathyroid hormone levels are associated with osteosarcopenia in older individuals with a history of falling. Maturitas 113:21–25. https://doi.org/10.1016/j.maturitas.2018.04.006

    CAS  Article  PubMed  Google Scholar 

  5. 5.

    Yoo JI, Ha YC (2018) Review of epidemiology, diagnosis, and treatment of osteosarcopenia in korea. J Bone Metab 25:1–7. https://doi.org/10.11005/jbm.2018.25.1.1

    Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Drey M, Sieber CC, Bertsch T, Bauer JM, Schmidmaier R, The FiAT intervention group (2016) Osteosarcopenia is more than sarcopenia and osteopenia alone. Aging Clin Exp Res 28:895–899. https://doi.org/10.1007/s40520-015-0494-1

    Article  PubMed  Google Scholar 

  7. 7.

    Hirschfeld HP, Kinsella R, Duque G (2017) Osteosarcopenia: where bone, muscle, and fat collide. Osteoporos Int 28:2781–2790. https://doi.org/10.1007/s00198-017-4151-8

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Wang YJ, Wang Y, Zhan JK, Tang ZY, He JY, Tan P, Deng HQ, Huang W, Liu YS (2015) Sarco-osteoporosis: prevalence and association with frailty in chinese community-dwelling older adults. Int J Endocrinol 2015:1–8. https://doi.org/10.1155/2015/482940

    CAS  Article  Google Scholar 

  9. 9.

    Huo YR, Suriyaarachchi P, Gomez F, Curcio CL, Boersma D, Muir SW, Montero-Odasso M, Gunawardene P, Demontiero O, Duque G (2015) Phenotype of osteosarcopenia in older individuals with a history of falling. J Am Med Dir Assoc 16:290–295. https://doi.org/10.1016/j.jamda.2014.10.018

    Article  PubMed  Google Scholar 

  10. 10.

    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 52:71–74. https://doi.org/10.1016/j.archger.2010.02.002

    Article  PubMed  Google Scholar 

  11. 11.

    Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinkova 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 39:412–423. https://doi.org/10.1093/ageing/afq034

    Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Guglielmi G, Ponti F, Agostini M, Amadori M, Battista G, Bazzocchi A (2016) The role of DXA in sarcopenia. Aging Clin Exp Res 28:1047–1060. https://doi.org/10.1007/s40520-016-0589-3

    Article  PubMed  Google Scholar 

  13. 13.

    Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383

    CAS  Article  Google Scholar 

  14. 14.

    Hall WH, Ramachandran R, Narayan S, Jani AB, Vijayakumar S (2004) An electronic application for rapidly calculating Charlson comorbidity score. BMC Cancer 4:94. https://doi.org/10.1186/1471-2407-4-94

    Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Kanis JA (2002) Diagnosis of osteoporosis and assessment of fracture risk. Lancet (London, England) 359:1929–1936. https://doi.org/10.1016/S0140-6736(02)08761-5

    Article  Google Scholar 

  16. 16.

    Beaudart C, McCloskey E, Bruyère O, Cesari M, Rolland Y, Rizzoli R, Araujo de Carvalho I, Amuthavalli Thiyagarajan J, Bautmans I, Bertière MC, Brandi ML, Al-Daghri NM, Burlet N, Cavalier E, Cerreta F, Cherubini A, Fielding R, Gielen E, Landi F, Petermans J, Reginster JY, Visser M, Kanis J, Cooper C (2016) Sarcopenia in daily practice: assessment and management. BMC Geriatr 16:1–10. https://doi.org/10.1186/s12877-016-0349-4

    Article  Google Scholar 

  17. 17.

    Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49:85–94. https://doi.org/10.1093/geronj/49.2.M85

    Article  Google Scholar 

  18. 18.

    Frisoli A, Chaves P, Inghan S, Carvalho A (2018) Osteosarcopenia has stronger association with impaired physical function than sarcopenia only. Innov Aging 2:304. https://doi.org/10.1093/geroni/igy023.1116

    Article  PubMed Central  Google Scholar 

  19. 19.

    Walsh MC, Hunter GR, Livingstone MB (2006) Sarcopenia in premenopausal and postmenopausal women with osteopenia, osteoporosis and normal bone mineral density. Osteoporos Int 17:61–67

    Article  Google Scholar 

  20. 20.

    Lima RM, de Oliveira RJ, Raposo R, Neri SGR, Gadelha AB (2019) Stages of sarcopenia, bone mineral density, and the prevalence of osteoporosis in older women. Arch Osteoporos 14:1–8. https://doi.org/10.1007/s11657-019-0591-4

    Article  Google Scholar 

  21. 21.

    De Rui M, Inelmen EM, Pigozzo S, Trevisan C, Manzato E, Sergi G (2019) Dietary strategies for mitigating osteosarcopenia in older adults: a narrative review. Aging Clin Exp Res 31:897–903. https://doi.org/10.1007/s40520-019-01130-9

    Article  PubMed  Google Scholar 

  22. 22.

    Frisoli A, Martin FG, Carvalho ACC, Borges J, Paes AT, Ingham SJM (2018) Sex effects on the association between sarcopenia EWGSOP and osteoporosis in outpatient older adults: data from the SARCOS study. Arch Endocrinol Metab 62:615–622. https://doi.org/10.20945/2359-3997000000087

    Article  PubMed  Google Scholar 

  23. 23.

    Yoshimura N, Muraki S, Oka H, Iidaka T, Kodama R, Kawaguchi H, Nakamura K, Tanaka S, Akune T (2017) Is osteoporosis a predictor for future sarcopenia or vice versa? four-year observations between the second and third ROAD study surveys. Osteoporos Int 28:189–199. https://doi.org/10.1007/s00198-016-3823-0

    CAS  Article  PubMed  Google Scholar 

  24. 24.

    Kobayashi K, Imagama S, Ando K, Machino M, Ota K, Tanaka S, Morozumi M, Kanbara S, Ito S, Ishiguro N, Hasegawa Y (2019) Epidemiology and effect on physical function of osteosarcopenia in community-dwelling elderly people in Japan. Mod Rheumatol 17:1–15. https://doi.org/10.1080/14397595.2019.1623455

    Article  Google Scholar 

  25. 25.

    Moreno-Aguilar M, Molina MM, Hernandez MFH (2017) Inverse association between body mass index and osteosarcopenia in community dwelling elderly. Surg Obes Relat Dis 13:190. https://doi.org/10.1016/j.soard.2017.09.419

    Article  Google Scholar 

  26. 26.

    Migliaccio S, Greco EA, Fornari R, Donini LM, Lenzi A (2011) Is obesity in women protective against osteoporosis? Diabetes Metab Syndr Obes 4:273–282

    Article  Google Scholar 

  27. 27.

    Ormsbee MJ, Prado CM, Ilich JZ, Purcell S, Siervo M, Folsom A, Panton L (2014) Osteosarcopenic obesity: the role of bone, muscle, and fat on health. J Cachexia Sarcopenia Muscle 5:183–192. https://doi.org/10.1007/s13539-014-0146-x

    Article  PubMed  PubMed Central  Google Scholar 

  28. 28.

    Bonaccorsi G, Cafarelli FP, Cervellati C, De Guio F, Greco P, Giganti M, Guglielmi G (2019) A new corrective model to evaluate TBS in obese post-menopausal women: a cross-sectional study. Aging Clin Exp Res [Epub ahead of print]. https://doi.org/10.1007/s40520-019-01317-0

    Article  Google Scholar 

  29. 29.

    Bruyere O, Cavalier E, Reginster JY (2017) Vitamin D and osteosarcopenia: an update from epidemiological studies. Curr Opin Clin Nutr Metab Care 20:498–503. https://doi.org/10.1097/MCO.0000000000000411

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  30. 30.

    Sjöblom S, Suuronen J, Rikkonen T, Honkanen R, Kröger H, Sirola J (2013) Relationship between postmenopausal osteoporosis and the components of clinical sarcopenia. Maturitas 75:175–180. https://doi.org/10.1016/j.maturitas.2013.03.016

    Article  PubMed  Google Scholar 

  31. 31.

    Schoenau E, Neu CM, Beck B, Manz F, Rauch F (2002) Bone mineral content per muscle cross-sectional area as an index of the functional muscle–bone unit. J Bone Miner Res 17:1095–1101

    Article  Google Scholar 

  32. 32.

    Zhang Y, Guo J, Duanmu Y, Zhang C, Zhao W, Wang L, Cheng X, Veronese N, Cafarelli FP, Guglielmi G (2019) Quantitative analysis of modified functional muscle–bone unit and back muscle density in patients with lumbar vertebral fracture in Chinese elderly men: a case–control study. Aging Clin Exp Res 31:637–644

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Assoc Prof Ilker Unal, PhD from the Department of Biostatistics for his contribution to the statistical analysis of the study.

Funding

This study was supported by the Research Fund of the Cukurova University (Project No: TTU-2018-10936).

Author information

Affiliations

Authors

Contributions

All authors contributed to the study conception, design, and interpretation of data for the work. Material preparation, data collection, and analysis were performed by Buliana Hamad and Sibel Basaran. The first draft of the manuscript was written by Buliana Hamad and all authors revised it critically for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sibel Basaran.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Clinical Research Ethical Committee of the Cukurova University (Date: 02.03.2018, No:75) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Hamad, B., Basaran, S. & Coskun Benlidayi, I. Osteosarcopenia among postmenopausal women and handgrip strength as a practical method for predicting the risk. Aging Clin Exp Res 32, 1923–1930 (2020). https://doi.org/10.1007/s40520-019-01399-w

Download citation

Keywords

  • Handgrip strength
  • Osteopenia
  • Osteoporosis
  • Osteosarcopenia
  • Postmenopausal
  • Sarcopenia