Skip to main content

Advertisement

SpringerLink
Log in

The relationship between sarcopenia-related measurements and osteoporosis: The SARCOP study

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

As muscle and bone are closely-related, we have explored the association between sarcopenia-related measurements and bone mineral density (BMD) (and osteoporosis) in postmenopausal women. Grip strength, anterior thigh muscle thickness and chair stand test were found to be related with BMD. Additionally, grip strength < 22 kg increased the odds ratio of osteoporosis 1.6 times.

Introduction

As muscle and bone are two closely related tissues, we aimed to investigate the association between sarcopenia-related measurements (i.e., sonographic anterior thigh muscle thickness, grip strength, chair stand test (CST), gait speed) and clinical factors, lumbar/femoral BMD, and the presence of osteoporosis (OP) in postmenopausal women.

Methods

Community dwelling postmenopausal women from two physical and rehabilitation medicine outpatient clinics were consecutively included in this cross-sectional study. Demographic data, age, weight, height, education/exercise status, smoking, and comorbidities were registered. BMD measurements were performed from lumbar vertebrae (L1-4) and femoral neck using dual energy X-ray absorptiometry (DXA). A T-score of ≤ -2.5 SD in the lumbar vertebrae (L1-L4) and/or femoral neck was accepted as OP. Anterior thigh muscle thickness (MT) at the midthigh level was measured sonographically using a linear probe. Grip strength was measured from the dominant side. Physical performance was assessed by CST and gait speed.

Results

Among 546 postmenopausal women, 222 (40.7%) had OP. Among sarcopenia-related parameters, grip strength and anterior thigh MT were positively associated with lumbar vertebral BMD. CST performance was positively associated with femoral neck BMD. After adjusting for confounding factors, low grip strength (< 22 kg) increased 1.6 times the risk of OP.

Conclusion

Loss of muscle mass/function (i.e., sarcopenia) can coexist with loss of trabecular and cortical bone. To this end, grip strength and anterior thigh MT seem to be associated with the lumbar vertebral BMD, while CST is associated with the femoral neck BMD. Lastly, low grip strength might have an association with postmenopausal OP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Greco EA, Pietschmann P, Migliaccio S (2019) Osteoporosis and sarcopenia increase frailty syndrome in the elderly. Front Endocrinol (Lausanne) 10:255. https://doi.org/10.3389/fendo.2019.00255

    Article  Google Scholar 

  2. Kara M, Kaymak B, Frontera W, Ata AM, Ricci V, Ekiz T et al (2021) Diagnosing sarcopenia: functional perspectives and a new algorithm from the ISarcoPRM. J Rehabil Med 53:jrm00209. https://doi.org/10.2340/16501977-2851

  3. Messier V, Rabasa-Lhoret R, Barbat-Artigas S, Elisha B, Karelis AD, Aubertin-Leheudre M (2011) Menopause and sarcopenia: a potential role for sex hormones. Maturitas 68:331–336. https://doi.org/10.1016/j.maturitas.2011.01.014

    Article  CAS  Google Scholar 

  4. Hamad B, Basaran S, Coskun Benlidayi I (2020) Osteosarcopenia among postmenopausal women and handgrip strength as a practical method for predicting the risk. Aging Clin Exp Res 32:1923–1930. https://doi.org/10.1007/s40520-019-01399-w

    Article  Google Scholar 

  5. Paintin J, Cooper C, Dennison E. Osteosarcopenia (2018) Br J Hosp Med 79:253–258. https://doi.org/10.12968/hmed.2018.79.5.253

  6. Drey M, Sieber CC, Bertsch T, Bauer JM, Schmidmaier R, FiAT T, intervention group, (2016) Osteosarcopenia is more than sarcopenia and osteopenia alone. Aging Clin Exp Res 28:895–899. https://doi.org/10.1007/s40520-015-0494-1

    Article  Google Scholar 

  7. da Cruz GF, Lunz TM, de Jesus TR, Costa MB, Vidigal CV, Albergaria BH et al (2021) Influence of the appendicular skeletal muscle mass index on the bone mineral density of postmenopausal women. BMC Musculoskelet Disord 22:861. https://doi.org/10.1186/s12891-021-04748-x

    Article  CAS  Google Scholar 

  8. Geraci A, Calvani R, Ferri E, Marzetti E, Arosio B, Cesari M (2021) Sarcopenia and menopause: the role of estradiol. Front Endocrinol 12:1–5. https://doi.org/10.3389/fendo.2021.682012

    Article  Google Scholar 

  9. Karvonen-Gutierrez C, Kim C (2016) Association of mid-life changes in body size, body composition and obesity status with the menopausal transition. Healthcare (Basel) 4:42. https://doi.org/10.3390/healthcare4030042

    Article  Google Scholar 

  10. Clarke B (2008) Normal bone anatomy and physiology. Clin J Am Soc Nephrol 3:S131–S139. https://doi.org/10.2215/CJN.04151206

    Article  CAS  Google Scholar 

  11. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994;843:1–129

  12. Schousboe JT, Shepherd JA, Bilezikian JP, Baim S (2013) Executive summary of the 2013 International Society for Clinical Densitometry Position Development Conference on bone densitometry. J Clin Densitom 16:455–466. https://doi.org/10.1016/j.jocd.2013.08.004

    Article  Google Scholar 

  13. Akhter M, Lappe J, Davies K, Recker R (2007) Transmenopausal changes in the trabecular bone structure. Bone 41:111–116. https://doi.org/10.1016/j.bone.2007.03.019

    Article  CAS  Google Scholar 

  14. Ravn P, Cizza G, Bjarnason N, Thompson D, Daley M, Wasnich R et al (1999) Low body mass index is an important risk factor for low bone mass and increased bone loss in early postmenopausal women. J Bone Miner Res 14:1622–1627. https://doi.org/10.1359/jbmr.1999.14.9.1622

    Article  CAS  Google Scholar 

  15. Krall EA, Dawson-Hughes B (1999) Smoking increases bone loss and decreases intestinal calcium absorption. J Bone Miner Res 14:215–220. https://doi.org/10.1359/jbmr.1999.14.2.215

    Article  CAS  Google Scholar 

  16. Cummings SR, Nevitt MC, Browner WS, Stone K, Fox KM, Ensrud KE et al (1995) Risk factors for hip fracture in white women. N Engl J Med 332:767–773. https://doi.org/10.1056/NEJM199503233321202

    Article  CAS  Google Scholar 

  17. Lane NE, MD, (2006) Epidemiology, etiology and diagnosis of osteoporosis. Am J Obstet Gynecol 194:S3-11. https://doi.org/10.1016/j.ajog.2005.08.047

    Article  CAS  Google Scholar 

  18. Ensrud KE, Lipschutz RC, Cauley JA, Seeley D, Nevitt MC, Scott J et al (1997) Body size and hip fracture risk in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Am J Med 103:274–280. https://doi.org/10.1016/s0002-9343(97)00025-9

    Article  CAS  Google Scholar 

  19. Todd JA, Robinson RJ (2003) Osteoporosis and exercise. Postgrad Med J 79:320–323. https://doi.org/10.1136/pmj.79.932.320

    Article  CAS  Google Scholar 

  20. Anupama DS, Norohna JA, Acharya KK, Ravishankar GA (2020) Effect of exercise on bone mineral density and quality of life among postmenopausal women with osteoporosis without fracture: a systematic review. Int J Orthop Trauma Nurs 39:100796. https://doi.org/10.1016/j.ijotn.2020.100796

    Article  CAS  Google Scholar 

  21. Brennan SL, Wluka AE, Gould H, Nicholson GC, Leslie WD, Ebeling PR et al (2012) Social determinants of bone densitometry uptake for osteoporosis risk in patients aged 50 yr and older: a systematic review. J Clin Densitom 15:165–175. https://doi.org/10.1016/j.jocd.2011.12.005

    Article  Google Scholar 

  22. Du Y, Zhao LJ, Xu Q, Wu KH, Deng HW (2017) Socioeconomic status and bone mineral density in adults by race/ethnicity and gender: the Louisiana osteoporosis study. Osteoporos Int 28:1699–1709. https://doi.org/10.1007/s00198-017-3951-1

    Article  CAS  Google Scholar 

  23. Bonds DE, Larson JC, Schwartz AV, Strotmeyer ES, Robbins J, Rodriguez BL et al (2006) Risk of fracture in women with type 2 diabetes: the Women’s Health Initiative Observational Study. J Clin Endocrinol Metab 91:3404–3410. https://doi.org/10.1210/jc.2006-0614

    Article  CAS  Google Scholar 

  24. Ma L, Oei L, Jiang L, Estrada K, Chen H, Wang Z et al (2012) Association between bone mineral density and type 2 diabetes mellitus: a meta-analysis of observational studies. Eur J Epidemiol 27:319–332. https://doi.org/10.1007/s10654-012-9674-x

    Article  CAS  Google Scholar 

  25. Leslie WD, Morin SN, Majumdar SR, Lix LM (2018) Effects of obesity and diabetes on rate of bone density loss. Osteoporos Int 29:61–67. https://doi.org/10.1007/s00198-017-4223-9

    Article  CAS  Google Scholar 

  26. Schwartz AV, Vittinghoff E, Bauer DC, Hillier TA, Strotmeyer ES, Ensrud KE et al (2011) Association of BMD and FRAX score with risk of fracture in older adults with type 2 diabetes. JAMA 305:2184–2192. https://doi.org/10.1001/jama.2011.715

    Article  CAS  Google Scholar 

  27. Lin YH, Chen HC, Hsu NW, Chou P, Teng MMH (2021) Hand grip strength in predicting the risk of osteoporosis in Asian adults. J Bone Miner Metab 39:289–294. https://doi.org/10.1007/s00774-020-01150-w

    Article  Google Scholar 

  28. Kritz-Silverstein D, Barrett-Connor E (1994) Grip strength and bone mineral density in older women. J Bone Miner Res 9:45–51. https://doi.org/10.1002/jbmr.5650090107

    Article  CAS  Google Scholar 

  29. Li YZ, Zhuang HF, Cai SQ, Lin CK, Wang PW, Yan LS et al (2018) Low grip strength is a strong risk factor of osteoporosis in postmenopausal women. Orthop Surg 10:17–22. https://doi.org/10.1111/os.12360

    Article  Google Scholar 

  30. Dixon WG, Lunt M, Pye SR, Reeve J, Felsenberg D, Silman AJ et al (2005) Low grip strength is associated with bone mineral density and vertebral fracture in women. Rheumatol (Oxford) 44:642–646. https://doi.org/10.1093/rheumatology/keh569

    Article  CAS  Google Scholar 

  31. Luo Y, Jiang K, He M (2020) Association between grip strength and bone mineral density in general US population of NHANES 2013–2014. Arch Osteoporos 15:47. https://doi.org/10.1007/s11657-020-00719-2

    Article  Google Scholar 

  32. Khazzani H, Allali F, Bennani L, Ichchou L, El Mansouri L, Abourazzak FE et al (2009) The relationship between physical performance measures, bone mineral density, falls, and the risk of peripheral fracture: a cross-sectional analysis. BMC Public Health 9:297. https://doi.org/10.1186/1471-2458-9-297

    Article  Google Scholar 

  33. Dai D, Xu F, Sun R, Yuan L, Sheng Z, Xie Z (2020) Decreased lower-extremity muscle performance is associated with decreased hip bone mineral density and increased estimated fracture risk in community-dwelling postmenopausal women. Arch Osteoporos 15:173. https://doi.org/10.1007/s11657-020-00835-z

    Article  Google Scholar 

  34. Kara M, Kara Ö, Ceran Y, Kaymak B, Kaya TC, Çıtır BN et al (2022) SARcopenia assessment in hypertension: the SARAH study. Am J Phys Med Rehabil (In Press). https://doi.org/10.1097/PHM.0000000000002045

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Ankara Education and Research Hospital, Ankara, Turkey

    Tülay Tiftik, Ömer Faruk Çelik, İrem Çiftçi, Cevriye Mülkoğlu & Hakan Genç

  2. Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey

    Murat Kara, Esra Gizem Koyuncu, Bayram Kaymak, Gizem Olgu Korkmaz, Pelin Analay, Mahmud Fazıl Aksakal, Hasan Ocak, Ayşen Akıncı & Levent Özçakar

Authors
  1. Tülay Tiftik
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Murat Kara
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Esra Gizem Koyuncu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bayram Kaymak
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ömer Faruk Çelik
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. İrem Çiftçi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gizem Olgu Korkmaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Pelin Analay
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mahmud Fazıl Aksakal
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hasan Ocak
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Cevriye Mülkoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Hakan Genç
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Ayşen Akıncı
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Levent Özçakar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tülay Tiftik.

Ethics declarations

Conflict of interest

None.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tiftik, T., Kara, M., Koyuncu, E.G. et al. The relationship between sarcopenia-related measurements and osteoporosis: The SARCOP study. Osteoporos Int 34, 53–58 (2023). https://doi.org/10.1007/s00198-022-06563-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-022-06563-z

Keywords

Search

Navigation