High Prevalence of Sarcopenia in Korean Patients after Hip Fracture: a Case-Control Study

Abstract

Sarcopenia-related falls and fractures are increasing worldwide due to the aging population. The purpose of this study was to 1) evaluate anthropometric characteristics related to hip fracture in Korean patients, 2) investigate sarcopenia prevalence in hip fracture (HF) and non-hip fracture (NF) groups, and 3) investigate the correlation between sarcopenia and osteoporosis. This case-control study examined 359 HF and 1,614 NF normal populations using Korea National Health and Nutrition Examination Survey data. We performed whole-body dual energy X-ray absorptiometry to analyze body composition using the skeletal muscle mass index (SMI: lean mass/height2) and bone mineral density (BMD). In the HF group, using the AWGS definition, the prevalence of sarcopenia in women and men was 44.3% and 68.2%, respectively; in the NF group, it was 7.1% and 16.1%, respectively. Lower appendicular SMI (P < 0.001), leg muscle mass (P < 0.001), and higher prevalence of sarcopenia (P < 0.001) were observed in the HF group after adjustment for age and gender. In multivariate analysis, sarcopenia (OR = 6.52; 95% CI = 4.67-9.09), age (OR = 1.15; 95% CI = 1.13-1.17), and osteoporosis (OR = 1.87; 95% CI = 1.35-2.58) were associated with the occurrence of a hip fracture. This study showed a higher prevalence of sarcopenia in patients with hip fractures compared with a normal population, and higher prevalence of sarcopenia in men.

Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta‐analysis

“…Review of the titles and abstracts yielded 241 relevant studies for full‐text screening. Thirty‐six studies met all inclusion criteria and were included in this review . A total of 33 studies were included in the meta‐analysis; four of them presented data for both falls and fractures, leaving 20 studies included in the meta‐analysis for falls and 17 studies for fractures …”

“…Study populations included community‐dwelling individuals (22 studies), hospitalized patients (3 studies), outpatients (4 studies), and nursing home residents (3 studies) . Four studies included a combined group of hospitalized patients with fractures and community‐dwelling individuals without fractures . Two studies reported retrospective data, 20 studies were cross‐sectional, 13 studies were prospective, and 1 study was a randomized controlled trial examining the effect of nutritional supplementation on bone mineral density and risk of falls .…”

“…Four studies included a combined group of hospitalized patients with fractures and community‐dwelling individuals without fractures . Two studies reported retrospective data, 20 studies were cross‐sectional, 13 studies were prospective, and 1 study was a randomized controlled trial examining the effect of nutritional supplementation on bone mineral density and risk of falls . Most of the studies were performed in Europe (12 studies), and Asia (12 studies), followed by Australia (5 studies), South America (4 studies), and North America (3 studies) .…”

“…The prevalence of sarcopenia varied from 0.3% to 73.0%, depending on the sarcopenia definition applied and the study population. Sarcopenia was diagnosed using one definition or more than one definition . Out of the 36 included studies, EWGSOP (23 studies) was the most commonly used definition, followed by FNIH (7 studies), Baumgartner definition (5 studies), AWGS (4 studies), and IWGS (4 studies) …”

Mean Hand Grip Strength and Cut-off Value for Sarcopenia in Korean Adults Using KNHANES VI

“…(1) It is an indicator of overall muscular strength, nutritional status, muscle mass, and walking performance (234). Recently, HGS has been used as important index of low muscle strength to diagnose sarcopenia because low HGS is a clinical marker of poor mobility and a better predictor of clinical outcome of low muscle mass (567). According to guideline for European working group on sarcopenia in older people (EWGSOP, the Sarcopenia Working Group), low muscle strength using cut-off point for HGS at two standard deviations below the mean reference value is defined as < 30 kg in men and < 20 kg in women.…”