Integrating Muscle Health in Predicting the Risk of Asymptomatic Vertebral Fracture in Older Adults.

Fang-Ping Chen,Yu-Hsiang Juan,Yu-Ching Lin,Alice M K Wong,Yu-Jr Lin,Chen-Ming Sung,Kun-Yun Yeh,Wing P Chan,Shu-Chen Chang

doi:10.3390/jcm10051129

Abstract

Background: The utility of muscle health for predicting asymptomatic vertebral fracture (VF) is uncertain. We aimed to determine the effects of muscle health on bone quantity and quality in the older adults and to integrate these factors into a predictive model for VF. Methods: We prospectively recruited participants with a body mass index <37 kg/m2. The total lean mass (TLM), appendicular skeletal muscle index, presence of sarcopenia, and bone mineral density were determined by dual-energy X-ray absorptiometry, and bone quality by the trabecular bone score (TBS). VF was diagnosed based on spine radiography. Results: A total of 414 females and 186 males were included; 257 participants had VF. Lower TLM was significantly associated with poorer bone quantity and quality in both males and females. A low TBS (OR: 11.302, p = 0.028) and sarcopenia (Odds ratio (OR): 2.820, p = 0.002) were significant predictors of VF in males, but not bone quantity. Moreover, integrating TBS and sarcopenia into the predictive model improved its performance. Conclusions: Although TLM was associated with bone quantity and quality in both sexes, sarcopenia and a low TBS were significant predictors of asymptomatic VF only in male participants.

Highlights

Vertebral fracture (VF) is the most common type of osteoporotic fracture [1,2], and its occurrence is both age- and sex-dependent [3]
Bone quantity is often determined based on bone mineral density (BMD), while bone quality can be determined by assessment of the trabecular microarchitecture, bone turnover, and cortical macrogeometry [11,12]
Even though strong correlations of total lean mass (TLM) with bone quantity and quality were seen in both sexes, sarcopenia was only associated with bone quantity in males, and only with bone quality in females (Table 2)

Summary

Introduction

Vertebral fracture (VF) is the most common type of osteoporotic fracture [1,2], and its occurrence is both age- and sex-dependent [3]. A previous study reported a significant association between sarcopenia and lumbar spine or total hip BMD [14]. We aimed to determine the effects of muscle health on bone quantity and quality in the older adults and to integrate these factors into a predictive model for VF. The total lean mass (TLM), appendicular skeletal muscle index, presence of sarcopenia, and bone mineral density were determined by dual-energy X-ray absorptiometry, and bone quality by the trabecular bone score (TBS). A low TBS (OR: 11.302, p = 0.028) and sarcopenia (Odds ratio (OR): 2.820, p = 0.002) were significant predictors of VF in males, but not bone quantity. Conclusions: TLM was associated with bone quantity and quality in both sexes, sarcopenia and a low TBS were significant predictors of asymptomatic VF only in male participants

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