Associations of Sarcopenic Obesity and Dynapenic Obesity with Bone Mineral Density and Incident Fractures Over 5–10 Years in Community-Dwelling Older Adults

Abstract

The purpose of this study is to determine whether low muscle mass (sarcopenia) or strength (dynapenia), in the presence of obesity, are associated with increased risk for osteoporosis and non-vertebral fracture over 5-10 years in community-dwelling older adults. N = 1089 volunteers (mean ± SD age 62 ± 7 years; 51 % female) participated at baseline and 761 attended follow-up clinics (mean 5.1 ± 0.5 years later). Total body, total hip and spine BMD, and appendicular lean and total fat mass were assessed by DXA. Sarcopenic obesity and dynapenic obesity were defined as the lowest sex-specific tertiles for appendicular lean mass or lower-limb strength, respectively, and the highest sex-specific tertile for total fat mass. Fractures were self-reported on three occasions over 10.7 ± 0.7 years in 563 participants. Obese alone participants had significantly higher BMD at all sites compared with non-sarcopenic non-obese. Sarcopenic obese and dynapenic obese men had lower spine and total body BMD, respectively, and sarcopenic obese women had lower total hip BMD, compared with obese alone (all P < 0.05). Sarcopenic obese men had higher non-vertebral fracture rates compared to non-sarcopenic non-obese (incidence rate ratio: 3.0; 95 % CI 1.7-5.5), and obese alone (3.6; 1.7-7.4). Sarcopenic obese women had higher fracture rates compared with obese alone (2.8; 1.4-5.6), but this was non-significant after adjustment for total hip BMD. Sarcopenic and dynapenic obese older adults may have increased risk of osteoporosis and non-vertebral fracture relative to obese alone counterparts. Sarcopenic and dynapenic obese individuals potentially represent a subset of the obese older adult population who require closer monitoring of bone health during ageing.

Dysmobility Syndrome Independently Increases Fracture Risk in the Osteoporotic Fractures in Men (MrOS) Prospective Cohort Study

“…Similarly, Yu and colleagues reported that sarcopenia predicted fractures in the Chinese cohort of the MrOS study and additionally showed improved fracture prediction when combined with FRAX. Similar observations were reported for sarcopenic obesity and osteosarcopenic obesity . Although previous data from the US MrOS study found that impaired physical function predicted hip fractures, current sarcopenia definitions did not consistently predict fractures .…”

Influence of body weight on bone mass, architecture and turnover

“…Sarcopenic and dynopenic obese individuals appear to be at a greater risk for lower BMD and higher fracture risk than obese individuals with normal muscle mass and strength (Scott, et al 2016). This interpretation is consistent with studies reporting that obese osteopenic individuals are at a higher fracture risk compared to normal weight osteopenic individuals (Cawsey, et al 2015).…”

Sarcopenic Obesity, Insulin Resistance, and Their Implications in Cardiovascular and Metabolic Consequences

“…Reduced muscle mass synergistically accompanies accumulation of fat mass, resulting in sarcopenic obesity [3]. Compared to obesity alone, sarcopenic obesity is associated with a heightened risk of adverse health outcomes, such as disability or impairment, cardiometabolic diseases, other comorbidities, and mortality [4][5][6][7].…”