Enhanced Risk of Osteoporotic Fracture in Patients with Sarcopenia: A National Population-Based Study in Taiwan

Zhang, Han-Wei; Tsai, Zhi-Ren; Chen, Ko-Ta; Hsu, Sheng-Lun; Kuo, Yi-Jie; Lin, Ying‐Chin; Huang, Shu-Wei; Chen, Yu‐Pin; Peng, Hsiao-Ching; Tsai, Jeffrey J. P.; Hsu, Chunyi

doi:10.3390/jpm12050791

Cited by 4 publications

(2 citation statements)

References 39 publications

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“…As shown by research studies, the loss of skeletal muscle weakens bones, thereby decreasing BMD and raising the risk of fracture. 62,63 Bone decline, in turn, further exacerbates skeletal muscle deterioration, resulting in an increased risk of falls. 15,16 A vicious circle is thus formed between muscle and skeletal tissues.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, patients with osteosarcopenia had a higher risk of fracture than those with either sarcopenia or osteoporosis/osteopenia (Figure S2). As shown by research studies, the loss of skeletal muscle weakens bones, thereby decreasing BMD and raising the risk of fracture 62,63 . Bone decline, in turn, further exacerbates skeletal muscle deterioration, resulting in an increased risk of falls 15,16 .…”

Section: Discussionmentioning

confidence: 99%

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Global epidemiological features and impact of osteosarcopenia: A comprehensive meta‐analysis and systematic review

Chen,

Xu,

Gong

et al. 2023

J cachexia sarcopenia muscle

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Osteosarcopenia is defined as the concurrent occurrence of osteopenia/osteoporosis and sarcopenia. The aim of the current study was to perform a systematic review with meta‐analysis to determine the global prevalence, risk factors and clinical outcomes of osteosarcopenia. This review was registered in PROSPERO (CRD42022351229). PubMed, Cochrane, Medline and Embase were searched from inception to February 2023 to retrieve eligible observational population‐based studies. Pooled osteosarcopenia prevalence was calculated with 95% confidence interval (CI), and subgroup analyses were performed. The risk factor of osteosarcopenia and its association with clinical outcomes were expressed as odds ratio (OR) and hazard ratio (HR), respectively. Heterogeneity was estimated using the I2 test. Study quality was assessed using validated instruments matched to study designs. The search identified 55 158 studies, and 66 studies (64 404 participants, mean age from 46.6 to 93 years) were analysed in the final analysis, including 48 cross‐sectional studies, 17 cohort studies and 1 case–control study. Overall, the pooled prevalence of osteosarcopenia was 18.5% (95% CI: 16.7–20.3, I2 = 98.7%), including 15.3% (95% CI: 13.2–17.4, I2 = 97.6%) in men and 19.4% (95% CI: 16.9–21.9, I2 = 98.5%) in women. The prevalence of osteosarcopenia diagnosed using sarcopenia plus osteopenia/osteoporosis was 20.7% (95% CI: 17.1–24.4, I2 = 98.55%), and the prevalence of using sarcopenia plus osteoporosis was 16.1% (95% CI: 13.3–18.9, I2 = 98.0%). The global osteosarcopenia prevalence varied in different regions with 22.9% in Oceania, 21.6% in Asia, 20.8% in South America, 15.7% in North America and 10.9% in Europe. A statistically significant difference was found in the subgroups of the study population between the hospital (24.7%) and community (12.9%) (P = 0.001). Frailty (OR = 4.72, 95% CI: 2.71–8.23, I2 = 61.1%), malnutrition (OR = 2.35, 95% CI: 1.62–3.40, I2 = 50.0%), female sex (OR = 5.07, 95% CI: 2.96–8.69, I2 = 73.0%) and higher age (OR = 1.10, 95% CI: 1.06–1.15, I2==86.0%) were significantly associated with a higher risk for osteosarcopenia. Meta‐analysis of cohort studies showed that osteosarcopenia significantly increased the risk of fall (HR = 1.54, 95% CI: 1.20–1.97; I2 = 1.0%, three studies), fracture (HR = 2.13, 95% CI: 1.61–2.81; I2 = 67.8%, seven studies) and mortality (HR = 1.75, 95% CI: 1.34–2.28; I2 = 0.0%, five studies). Despite the heterogeneity arising from varied definitions and criteria, our findings highlight a significant global prevalence of osteosarcopenia and its negative impact on clinical health. Standardizing diagnostic criteria for osteosarcopenia would be advantageous in the future, and early detection and management should be emphasized in this patient population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Global epidemiological features and impact of osteosarcopenia: A comprehensive meta‐analysis and systematic review

Chen,

Xu,

Gong

et al. 2023

J cachexia sarcopenia muscle

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Sarcopenia definitions and their association with fracture risk in older Swedish women

Gandham,

Gregori,

Johansson

et al. 2024

Journal of Bone and Mineral Research

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The purpose of this study was to investigate the prevalence of three sarcopenia definitions and their associations with fracture risk in a population of older Swedish women when adjusted for FRAX-based risk factors. 2883 women 77.8 years (mean) old were included. Sarcopenia was defined based on the Sarcopenia Definitions and Outcomes Consortium (SDOC; low handgrip strength and gait speed), revised European Working Group on Sarcopenia in Older People (EWGSOP2; low appendicular lean mass index (ALM, appendicular lean mass/height (kg/m2)), and hand grip strength (kg)) and Asian Working Group for Sarcopenia (AWGS; low ALM, and hand grip strength (kg)) definition. Femoral neck T-score was obtained from dual-energy X-ray absorptiometry. All fractures, confirmed by X-ray or medical record review, were subsequently categorized as major osteoporotic fractures (MOF) and hip fractures. Deaths were verified through regional registers. The total follow-up time was 6.4 ± 1.3 (mean ± SD) years. Cox regression (hazard ratios (HR) and 95% confidence intervals (CI)) analyses were performed adjusted for age, fracture risk assessment (FRAX) variables and femoral neck T-score. Sarcopenia prevalence was 4.5% (n = 129) according to SDOC, 12.5% (n = 360) for EWGSOP2 and 10.3% (n = 296) defined by AWGS. Individuals with sarcopenia defined by SDOC had a higher mortality risk than individuals without sarcopenia (HR: 3.41; 95% CI: 2.51, 4.62) after adjusting for age and FRAX variables. Sarcopenia according to EWGSOP2 and AWGS was not associated with an increased fracture risk after adjusting for age and FRAX variables. Individuals with sarcopenia defined by SDOC had a higher risk for any fractures (HR: 1.48; 95% CI: 1.10, 1.99) and MOF (HR: 1.42; 95% CI: 1.03, 1.98) compared with individuals without sarcopenia after adjusting for clinical risk factors used in FRAX. In conclusion, sarcopenia defined by SDOC, incorporating muscle function/strength, was the only sarcopenia definition associated with fracture risk in older women.

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The Relationship Between the Time and Location Distribution of Falls in Elderly Hip Fracture Patients and Clinical Characteristics

Chen,

Kuo

et al. 2024

Preprint

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Background Falls can be detrimental for older adults, causing hip fracture that result in disability and increased risk of mortality. This study aimed to investigate the temporal distribution of falls among the geriatric patents with hip fractures and compare the characteristics of falls occurring at different times and locations. Methods This study recruited older with hip fractures resulting from accidental falls. The participants were categorized into two groups based on the timing and location of their falls. Information regarding fall times, locations, and causes was obtained through interviews. Additionally, demographic data, handgrip strength, Charlson Comorbidity Index (CCI), and responses to quality of life, activities of daily living (ADL), and dementia screening questionnaires using the Portable Mental Status Questionnaire (SPMSQ) were collected. Results This study encompassed 801 hip fracture patients, with 560 women (70%) and 241 men (30%), and a median age of 81 years. Among these patients, 546 (68.3%) experienced falls during the daytime, while 255 (31.7%) fell at night. Furthermore, 577 (74.9%) hip fractures occurred indoors, with 193 (25.1%) falls taking place outdoors. The analysis revealed that patients with lower handgrip strength and BMI were significantly more susceptible to daytime falls compared to nighttime falls. Furthermore, patients who fell indoors exhibited notably higher CCI and SPMSQ error scores, along with lower BMI, handgrip strength, and pre-fracture ADL, in comparison to those who fell outdoors. Conclusions Our findings indicate that falls during the daytime were more prevalent among geriatric hip fracture patients in Taiwan compared to nighttime falls. Moreover, we observed that more fragile patients were relatively susceptible to falling indoors and at night, emphasizing the potential clinical value for clinicians to take proactive measures in fall prevention.

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Enhanced Risk of Osteoporotic Fracture in Patients with Sarcopenia: A National Population-Based Study in Taiwan

Cited by 4 publications

References 39 publications

Global epidemiological features and impact of osteosarcopenia: A comprehensive meta‐analysis and systematic review

Global epidemiological features and impact of osteosarcopenia: A comprehensive meta‐analysis and systematic review

Sarcopenia definitions and their association with fracture risk in older Swedish women

The Relationship Between the Time and Location Distribution of Falls in Elderly Hip Fracture Patients and Clinical Characteristics

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