Risk of Fracture in Women with Sarcopenia, Low Bone Mass, or Both - American Geriatric Society

Objectives

To determine whether women with sarcopenia and low bone mineral density (BMD) are at greater risk of clinical fractures than those with sarcopenia or low BMD alone.

Design

Women's Health Initiative (WHI) Observational and Clinical trials.

Setting

Three U.S. clinical centers (Pittsburgh, PA; Birmingham, AL; Phoenix/Tucson, AZ).

Participants

Women (mean age 63.3 ± 0.07) with BMD measurements (N = 10,937).

Measurements

Sarcopenia was defined as appendicular lean mass values corrected for height and fat mass. Low BMD was defined as a femoral neck T-score less than −1.0 based on the Third National Health and Nutrition Examination Survey reference database for white women. Cox proportional hazards analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). We followed women for incident fractures over a median of 15.9 years.

Results

Participants were classified into mutually exclusive groups based on BMD and sarcopenia status: normal BMD and no sarcopenia (n = 3,857, 35%), sarcopenia alone (n = 774, 7%), low BMD alone (n = 4,907, 45%), and low BMD and sarcopenia (n = 1,399, 13%). Women with low BMD, with (HR = 1.72, 95% CI = 1.44–2.06) or without sarcopenia (HR = 1.58, 95% CI = 1.37–1.83), had greater risk of fracture than women with normal BMD; the difference remained statistically significant after adjustment for important covariates. Women with low BMD, with (HR = 2.78, 95% CI = 1.78–4.30 and without (HR = 2.42, 95% CI = 1.63–3.59) sarcopenia had higher risk of hip fractures. Women with sarcopenia alone had similar HRs to women with normal BMD.

Conclusion

Compared to women with normal BMD.

from Journal of the American Geriatrics Society http://ift.tt/2xAK5yv
via IFTTT