Endocrine Abstracts

Background: Several lines of evidence support the view that sarcopenia and osteoporosis are strictly connected. However, the capability of the updated sarcopenia definition to capture the concomitant presence of osteoporosis has been scarcely investigated.

Aim: To assess the association between sarcopenia defined according to the revised criteria from the European Working Group on Sarcopenia in Older People (EWGSOP2) and osteoporosis in women with a fragility fracture of the hip.

Methods: We focused on women who were consecutively admitted to our ward for subacute rehabilitation following a fragility fracture of the hip. A scan by dual-energy x-ray absorptiometry (DXA) was performed to assess body composition. A Jamar dynamometer was used to measure handgrip strength. Sarcopenia was diagnosed with both handgrip strength < 16kg and appendicular lean mass (aLM) < 15kg. Osteoporosis was identified with femoral bone mineral density lower than 2.5 standard deviations below the mean of the young reference population.

Results: We studied 262 of 290 women. Osteoporosis was found in 189 of the 262 women (72%; 95% CI from 67% to 78%) whereas sarcopenia in 147 of the 262 (56%; 95% CI from 50% to 62%). The unadjusted odds ratio to have osteoporosis for a sarcopenic woman was 2.93 (95% CI from 1.69 to 5.19, P<0.001). After adjustment for age, time interval between fracture and DXA scan and body fat percentage the odds ratio was 2.30 (95% CI from 1.27 to 4.14; P=0.006). The significant association between sarcopenia and osteoporosis persisted after substituting body mass index for body fat percentage among the potential confounders.

Conclusions: We show that the diagnosis of sarcopenia according to the EWGSOP2 criteria can successfully capture the concomitant presence of osteoporosis in women with hip fracture. The updated definition of sarcopenia can help clinicians to focus on the damages of both the components of the muscle-bone unit, thus emerging as a promising tool to investigate osteosarcopenia in older people. Our findings need confirmation by robust prospective studies.