Relationship between obesity, sarcopenia, sarcopenic obesity, and bone mineral density in elderly subjects aged 80 years and over

Santos, Vanessa Ribeiro dos; Christofaro, Diego Giulliano Destro; Gomes, Igor Conterato; Freitas Júnior, Ismael Forte; Gobbo, Luís Alberto

doi:10.1016/j.rboe.2017.09.002

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Artigos Originais • Rev. bras. ortop. 53 (3) • May-Jun 2018 • https://doi.org/10.1016/j.rboe.2017.09.002 linkcopy

Relationship between obesity, sarcopenia, sarcopenic obesity, and bone mineral density in elderly subjects aged 80 years and over^☆

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective This study sought to analyze the relationship between the components and aggravations of body composition (obesity, sarcopenia, and sarcopenic obesity) and bone mineral density in elderly subjects aged ≥80 years.

Methods A cross-sectional study design was utilized to assess 128 subjects aged between 80 and 95 years. Body composition and bone mineral density were measured by dual energy X-ray absorptiometry. Gait speed was assessment by walking test. The statistical analyses included Spearman's correlation, one-way analysis of variance, the chi-squared test, and binary logistic regression analysis.

Results The elderly subjects with sarcopenia had lower bone mineral density compared to the obesity group, with higher risk for presence of osteopenia/osteoporosis in the spine (OR: 2.81; CI: 1.11–7.11) and femur (OR: 2.75; CI: 1.02–7.44). Obesity was shown to be a protective factor for osteopenia/osteoporosis in the spine (OR: 0.43; CI: 0.20–0.93) and femur (OR: 0.27; CI: 0.12–0.62).

Conclusion It was found that lean mass is more directly related to bone mineral density (total, femur, and spine) and sarcopenia is associated with osteopenia/osteoporosis. Obesity represents a possible protective factor for osteopenia/osteoporosis in elderly subjects aged 80 years and over.

Keywords
Body composition; Osteoporosis; Aged 80 years and over

Variables	Normal (n = 57)	Obesity (n = 38)	Sarcopenia (n = 20)	Sarcopenic obesity (n = 13)	p
	Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD
Age (years)	83.3 ± 3.1^a,b	82.5 ± 1.8^a	84.2 ± 3.0^a,b	84.8 ± 2.7^b	0.024
Weight (kg)	59.8 ± 13.3^ac	73.1 ± 12.3^b	54.2 ± 10.2^a	67.5 ± 12.5^b,c	≤0.001
Height (cm)	155.9 ± 11.0	155.1 ± 9.1	157.8 ± 9.0	156.6 ± 7.7	0.794
BMI (kg/m²)	24.3 ± 3.1^a	30.2 ± 3.2^b	21.7 ± 3.1^c	27.4 ± 3.5^d	≤0.001
Fat mass (kg)	18.369 ± 6.6^a	31.114 ± 6.9^b	15.199 ± 4.8^a	27.008 ± 6.0^b	≤0.001
Lean mass (kg)	36.914 ± 12.6	37.791 ± 9.5	35.589 ± 7.4	37.295 ± 8.2	0.903
ALM (kg/m²)	6.9 ± 1.1^a	6.8 ± 1.0^a	6.1 ± 0.8^b	6.4 ± 1.1.0^a,b	0.007

Composition	Density (g/cm²)
	Femur		Spine		Total
	r	p	r	p	r	p
FM total (kg)	0.39	p ≤ 0.001	0.32	p ≤ 0.001	0.41	p ≤ 0.001
LM total (kg)	0.55	p ≤ 0.001	0.52	p ≤ 0.001	0.67	p ≤ 0.001
ALM (kg/m²)	0.53	p ≤ 0.001	0.42	p ≤ 0.001	0.62	p ≤ 0.001

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Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
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[TFN1] SD, standard deviation; BMI, body mass index; ALM, appendicular lean mass.^a,b,c,d Different letters are used to identify differences among groups (normal, obesity, sarcopenia and sarcopenic obesity).

Groups	Spine
	n (%)	OR (CI 95%)	AOR (CI 95%)
Obesity
No	41 (53.2)	1.00	1.00 0.43 (0.20-0.93)
Yes	18 (35.3)	0.48 (0.23-0.99)	1.00 0.43 (0.20-0.93)
Sarcopenia
No	39 (41.9)	1.00	1.00 2.81 (1.11-7.11)
Yes	20 (57.1)	1.87 (0.84-4.00)	1.00 2.81 (1.11-7.11)
Sarcopenic obesity
No	52 (45.6)	1.00	1.00 1.84 (0.53-6.40)
Yes	7 (50.0)	1.66 (0.50-5.48)	1.00 1.84 (0.53-6.40)
Groups	Femur
	n (%)	OR (CI 95%)	AOR (CI 95%)
Obesity
No	53 (68.8)	1.00	1.00 0.27 (0.12-0.62)
Yes	20 (39.2)	0.29 (0.14-0.61)	1.00 0.27 (0.12-0.62)
Sarcopenia
No	46 (49.5)	1.00	1.00 2.75 (1.02-7.44)
Yes	27 (77.1)	3.45 (1.42-8.38)	1.00 2.75 (1.02-7.44)
Sarcopenic obesity
No	64 (56.1)	1.00	1.00 0.90 (0.23-3.49)
Yes	09 (64.3)	1.79 (0.52-6.16)	1.00 0.90 (0.23-3.49)

Relationship between obesity, sarcopenia, sarcopenic obesity, and bone mineral density in elderly subjects aged 80 years and over☆

ABSTRACT

Relationship between obesity, sarcopenia, sarcopenic obesity, and bone mineral density in elderly subjects aged 80 years and over^☆