Association between biomarkers of bone health and osteosarcopenia among Iranian older people: The Bushehr Elderly Health (BEH) program

Maryam Fathi,Ali Fathi,Maryam Moghaddassi,Gita Shafiee,Ahmad Salimzadeh,Ramin Heshmat,Afshin Ostovar,Iraj Nabipour,Farideh Razi,Mehdi Ebrahimi

doi:10.1186/s12877-021-02608-w

Abstract

BackgroundOsteosarcopenia is referred to as co-incidence of osteoporosis/osteopenia and sarcopenia which is defined as a geriatric syndrome with a significant prevalence that increases morbidity and mortality. There are some relevant factors that can show an increased risk of incidence of osteosarcopenia.AimWe aimed to consider the association of bone turnover markers such as Osteocalcin (OC), C-terminal cross-linked telopeptide (CTX), Tartrate Resistant acid Phosphatase (TRAP), Bone Alkaline Phosphatase (BALP) and also other factors like vitamin D, calcium, phosphorous, and ALP with osteosarcopenia in elderly.Methods We carried out a cross-sectional study on a random sample including 400 elder participants of Bushehr Elderly Health (BEH) study, in Iran. Osteopenia/ osteoporosis was defined as a T-score ≤ -1.0 standard deviation below the mean values of a young healthy adult. We defined sarcopenia as low muscle strength (handgrip strength<26 kg for men and <18 kg for women) with reduced skeletal muscle mass [Skeletal muscle index (SMI) < 7.0 kg/m2 for male and <5.4 kg/m2 for female]. Osteosarcopenia was considered as the presence of both osteopenia/osteoporosis and sarcopenia. We estimated the age-standardized prevalence of osteosarcopenia for men and women, separately. We used multivariable logistic regression to address the factors associated with osteosarcopenia.ResultsThe results showed that there was a statistically significant difference in OC), CTX, TRAP were between the osteosarcopenia (-) and osteosarcopenia (+) groups. No statistically significant difference was observed in BALP, vitamin D, calcium, phosphorous, and ALP between the compared groups.In the multivariable logistic regression model, OC and CTX were associated with increased likelihood of osteosarcopenia [adjusted OR= 1.023(1.002-1.045 for OC, 4.363(1.389-15.474 for CTX)]. Furthermore, TRAP increases the odds of osteosarcopenia in crude model [OR= 1.333 (1.070- 1.660)].ConclusionsWe observed the association between bone turnover markers particularly OC, CTX and osteosarcopenia. Given the rapid growth of the aging population, we should focus on geriatric diseases such as musculoskeletal disorders. Bone turnover markers maybe improve the early diagnosis, screening and assess the response to therapies in people with osteosarcopenia.

Highlights

Osteopenia and sarcopenia are two important musculoskeletal disorders with adverse outcomes in older people
We observed the association between bone turnover markers OC, CTX and osteosarcopenia
Given the rapid growth of the aging population, we should focus on geriatric diseases such as musculoskeletal disorders

Summary

Introduction

Osteopenia and sarcopenia are two important musculoskeletal disorders with adverse outcomes in older people. Osteosarcopenia is recently defined medical terms that refer to the co-incidence of both osteopenia and sarcopenia [1]. It is associated with higher fracture, morbidity, length of stay at the hospital, and mortality in elder people and could lead to increased burden of disease [2, 3]. In such phenomenon, normal function both of muscle and bone tissues is interrupted due to loss of bone density and decrease in muscle mass and strength [2, 4, 5]. There are some relevant factors that can show an increased risk of incidence of osteosarcopenia

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