Sex Differences in Bone Health Among Indian Older Adults with Obesity, Sarcopenia, and Sarcopenic Obesity

Abstract

Age-related changes in fat and lean mass contribute to bone health, but these associations may be influenced by sex and ethnicity. This study investigated sex-specific associations of obesity and sarcopenia with bone mineral density (BMD) and bone mineral apparent density (BMAD) among Indian older adults. 1057 adults aged ≥ 50 years were included. Dual-energy X-ray absorptiometry (DXA) measured BMD at the hip, spine and whole-body, and BMAD was calculated as BMD/√bone area. Obesity was defined by body fat percentage (cut points; > 25% for men and > 35% for women), and sarcopenia was defined using the revised Asian Working Group for Sarcopenia classification with low hand grip strength (< 28 kg for men and < 18 kg for women) and appendicular lean mass index (< 7.0 kg/m2 for men and < 5.4 kg/m2 for women). Participants were classified into four groups: controls (no obesity or sarcopenia), obesity, sarcopenia, or sarcopenic obesity. Linear regression (β-coefficients and 95%CI) analyses were performed with adjustments for age, smoking status, protein intake, and socioeconomic status. Prevalence of sarcopenia (37%) and sarcopenic obesity (6%) were higher in men than women (17% and 4%, respectively). Compared with controls, men with obesity had lower whole-body BMD and BMAD, but women with obesity had higher hip and spine BMD and BMAD (all p < 0.05). Men, but not women, with sarcopenic obesity, had lower hip and whole-body BMD and BMAD (all p < 0.05) than controls. Men with sarcopenia had lower BMD and BMAD at the hip only, whereas women had lower BMD at all three sites and had lower BMAD at the hip and spine (all p < 0.05), compared with controls. Obesity, sarcopenia, and sarcopenic obesity have sex-specific associations with BMD and BMAD in Indian older adults. With the aging population in India, it is important to understand how body composition contributes to poor bone health among older adults.

Predictive Roles of Basal Metabolic Rate and Body Water Distribution in Sarcopenia and Sarcopenic Obesity: The link to Carbohydrates

“…Participants in the sarcopenia and sarcopenic obesity groups were older than the rest of the population. This phenomenon has also been found in older Indian adults [ 26 ]. The results also showed that people with sarcopenic obesity had a higher fat mass and visceral fat area than people with sarcopenia but lower fat mass and visceral fat area than those with obesity.…”

“…Similar findings were observed in a 24-year follow-up cohort, which showed that sarcopenic obesity is clinically useful as a predictor of all-cause mortality [ 33 ]. Sarcopenic obesity is also related to cognitive impairment [ 29 ], low bone mineral density [ 26 ], frailty [ 7 ], and metabolic diseases [ 34 ]. A study found that carbohydrate intake could be the best indicator for determining sarcopenic obesity in older adults [ 35 ], and body composition plays an important role in sarcopenia.…”

“…Sarcopenia was defined as HGS < 28 kg and SMI < 7.0 kg/m 2 for males and HGS < 18 kg and SMI < 5.7 kg/m 2 for females by using previously reported definitions [ 5 , 25 ]. Obesity was defined as BMI (≥28.0 kg/m 2 ) or body fat (≥25.0% for males, ≥35.0% for females) [ 26 ] or WC (≥90 cm for males, ≥80 cm for females) [ 27 ] in this study. Patients with sarcopenia and obesity were considered to have sarcopenic obesity [ 24 , 28 ].…”

Association of possible sarcopenia with major chronic diseases and multimorbidity among middle‐aged and older adults: Findings from a national cross‐sectional study in China

“…In the present study, we discovered that PSA group participants were more likely to be women than their non‐PSA counterparts. The result is consistent with previous research emphasizing sex differences in sarcopenia, and showing that women were more frequently influenced by sarcopenia than men 26–28 . We noted that the majority of PSA group members had shorter sleep duration and lower bodyweight.…”

“…The result is consistent with previous research emphasizing sex differences in sarcopenia, and showing that women were more frequently influenced by sarcopenia than men. [26][27][28] We noted that the majority of PSA group members had shorter sleep duration and lower bodyweight. The present results are in line with that of a prospective study.…”