Abstract
BackgroundBone and skeletal muscle represent a single functional unit. We cross-sectionally investigated body composition, risk of fall and circulating osteocalcin (OC) isoforms in osteoporotic postmenopausal women to test the hypothesis of an involvement of OC in the bone-muscle crosstalk.Materials and MethodsTwenty-nine non-diabetic, non-obese, postmenopausal osteoporotic women (age 72.4 ± 6.8 years; BMI 23.0 ± 3.3 kg/m2) underwent to: 1) fasting blood sampling for biochemical and hormone assays, including carboxylated (cOC) and uncarboxylated (uOC) osteocalcin; 2) whole-body dual energy X-ray absorptiometry (DXA) to assess total and regional body composition; 3) magnetic resonance imaging to determine cross-sectional muscle area (CSA) and intermuscular adipose tissue (IMAT) of thigh muscles; 4) risk of fall assessment through the OAK system.ResultsAppendicular skeletal muscle index (ASMMI) was low in 45% of patients. Forty percent got a low OAK score, consistent with moderate-severe risk of fall, which was predicted by low legs lean mass and increased total fat mass. Circulating cOC levels showed significantly correlated with βCTx-I, lean mass parameters including IMAT, and OAK score. Fractured and unfractured women did not differ for any of the analyzed parameters, though cOC and uOC positively correlated with legs lean mass, OAK score and bone markers only in fractured women.ConclusionsData supported the relationship between OC and skeletal muscle mass and function in postmenopausal osteoporotic women. Serum cOC, but not uOC, emerges as mediator in the bone-muscle crosstalk. Circulating cOC and uOC levels may be differentially regulated in fractured and unfractured osteoporotic women, suggesting underlying differences in bone metabolism.
Highlights
Aging results in the progressive and parallel loss of bone, known as osteopenia, and in skeletal muscles, known as sarcopenia
Sarcopenia is defined as the loss of skeletal muscle mass and quality, which accelerates with aging and is associated with functional decline
Considering a cut-off of 5.7 kg/m2 for the diagnosis of low muscle mass in elderly women according the Consensus Report produced by European Working Group on Sarcopenia in Older People 2 (EWGSOP2) [30], low muscle mass was detected in 13 (45%) out of the 29 osteoporotic women, with Appendicular Skeletal Muscle Mass Index (ASMMI) ranging between 4.20 and 5.62 kg/m2
Summary
Aging results in the progressive and parallel loss of bone, known as osteopenia, and in skeletal muscles, known as sarcopenia. Sarcopenia is defined as the loss of skeletal muscle mass and quality, which accelerates with aging and is associated with functional decline. Osteopenia and sarcopenia are two main determinants of aging-related fragility [1], and sarcopenia represents one of the main causes of increased risk of falls and, directly or indirectly, fractures [2]. Sarcopenia in elderly women associated with an increased risk of all-cause mortality [3, 4]. In older adults, the coexistence of osteopenia and sarcopenia, namely osteosarcopenia, has to be regarded as the major risk factor for fractures and further functional decline due to low physical performance [5,6,7]. We crosssectionally investigated body composition, risk of fall and circulating osteocalcin (OC) isoforms in osteoporotic postmenopausal women to test the hypothesis of an involvement of OC in the bone-muscle crosstalk
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