1
|
Chen S, Xu X, Gong H, Chen R, Guan L, Yan X, Zhou L, Yang Y, Wang J, Zhou J, Zou C, Huang P. Global epidemiological features and impact of osteosarcopenia: A comprehensive meta-analysis and systematic review. J Cachexia Sarcopenia Muscle 2024; 15:8-20. [PMID: 38086772 PMCID: PMC10834350 DOI: 10.1002/jcsm.13392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/04/2023] [Accepted: 11/02/2023] [Indexed: 02/03/2024] Open
Abstract
Osteosarcopenia is defined as the concurrent occurrence of osteopenia/osteoporosis and sarcopenia. The aim of the current study was to perform a systematic review with meta-analysis to determine the global prevalence, risk factors and clinical outcomes of osteosarcopenia. This review was registered in PROSPERO (CRD42022351229). PubMed, Cochrane, Medline and Embase were searched from inception to February 2023 to retrieve eligible observational population-based studies. Pooled osteosarcopenia prevalence was calculated with 95% confidence interval (CI), and subgroup analyses were performed. The risk factor of osteosarcopenia and its association with clinical outcomes were expressed as odds ratio (OR) and hazard ratio (HR), respectively. Heterogeneity was estimated using the I2 test. Study quality was assessed using validated instruments matched to study designs. The search identified 55 158 studies, and 66 studies (64 404 participants, mean age from 46.6 to 93 years) were analysed in the final analysis, including 48 cross-sectional studies, 17 cohort studies and 1 case-control study. Overall, the pooled prevalence of osteosarcopenia was 18.5% (95% CI: 16.7-20.3, I2 = 98.7%), including 15.3% (95% CI: 13.2-17.4, I2 = 97.6%) in men and 19.4% (95% CI: 16.9-21.9, I2 = 98.5%) in women. The prevalence of osteosarcopenia diagnosed using sarcopenia plus osteopenia/osteoporosis was 20.7% (95% CI: 17.1-24.4, I2 = 98.55%), and the prevalence of using sarcopenia plus osteoporosis was 16.1% (95% CI: 13.3-18.9, I2 = 98.0%). The global osteosarcopenia prevalence varied in different regions with 22.9% in Oceania, 21.6% in Asia, 20.8% in South America, 15.7% in North America and 10.9% in Europe. A statistically significant difference was found in the subgroups of the study population between the hospital (24.7%) and community (12.9%) (P = 0.001). Frailty (OR = 4.72, 95% CI: 2.71-8.23, I2 = 61.1%), malnutrition (OR = 2.35, 95% CI: 1.62-3.40, I2 = 50.0%), female sex (OR = 5.07, 95% CI: 2.96-8.69, I2 = 73.0%) and higher age (OR = 1.10, 95% CI: 1.06-1.15, I2 ==86.0%) were significantly associated with a higher risk for osteosarcopenia. Meta-analysis of cohort studies showed that osteosarcopenia significantly increased the risk of fall (HR = 1.54, 95% CI: 1.20-1.97; I2 = 1.0%, three studies), fracture (HR = 2.13, 95% CI: 1.61-2.81; I2 = 67.8%, seven studies) and mortality (HR = 1.75, 95% CI: 1.34-2.28; I2 = 0.0%, five studies). Despite the heterogeneity arising from varied definitions and criteria, our findings highlight a significant global prevalence of osteosarcopenia and its negative impact on clinical health. Standardizing diagnostic criteria for osteosarcopenia would be advantageous in the future, and early detection and management should be emphasized in this patient population.
Collapse
Affiliation(s)
- Shanping Chen
- Department of Gerontology and Geriatric, Chengdu Fifth People's Hospital, Chengdu, China
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Xiao Xu
- Affiliated Hospital of Jinggangshan University, Center for Clinical Medicine Research of Jinggangshan University, Ji'an, China
- Department of Medicine, Jinggangshan University, Ji'an, China
- Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch, Ji'an, China
| | - Huping Gong
- College of Nursing, Gannan Medical University, Ganzhou, China
| | - Ruzhao Chen
- Affiliated Hospital of Jinggangshan University, Center for Clinical Medicine Research of Jinggangshan University, Ji'an, China
- Department of Medicine, Jinggangshan University, Ji'an, China
- Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch, Ji'an, China
| | - Lijuan Guan
- Department of Gerontology and Geriatric, Chengdu Fifth People's Hospital, Chengdu, China
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Xuedan Yan
- Department of Gerontology and Geriatric, Chengdu Fifth People's Hospital, Chengdu, China
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Lihua Zhou
- Department of Gerontology and Geriatric, Chengdu Fifth People's Hospital, Chengdu, China
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Yongxue Yang
- Department of Gerontology and Geriatric, Chengdu Fifth People's Hospital, Chengdu, China
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Jiang Wang
- Affiliated Hospital of Jinggangshan University, Center for Clinical Medicine Research of Jinggangshan University, Ji'an, China
- Department of Medicine, Jinggangshan University, Ji'an, China
- Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch, Ji'an, China
| | - Jianghua Zhou
- Department of Cardiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Chuan Zou
- The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Geriatric Diseases Institute of Chengdu, Chengdu, China
- Department of General Practice, Chengdu Fifth People's Hospital, Chengdu, China
| | - Pan Huang
- College of Nursing, Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
2
|
Chou YY, Lin CF, Lee YS, Weng SC, Kuo FH, Hsu CY, Lin SY. The associations of osteoporosis and possible sarcopenia with disability, nutrition, and cognition in community-dwelling older adults. BMC Geriatr 2023; 23:730. [PMID: 37950206 PMCID: PMC10638752 DOI: 10.1186/s12877-023-04431-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Osteoporosis and sarcopenia, respectively, have detrimental impact on health, and combination of both conditions, termed osteosarcopenia, is becoming an increasingly important disorder in older adults as populations age. This study aimed to explore the relationship between osteoporosis and possible sarcopenia and their joint effect on physical performance, nutritional status, and cognition in community-dwelling older adults. METHODS This study was conducted at a medical center in Taiwan, which included the adjacent community care station. The participants were recruited through regular activities at the community care station between January 01, 2015 and February 28, 2022. During the study period, dual-energy X-ray absorptiometry and comprehensive geriatric assessment consisting of comorbidity burden, functional status, cognition, mood, and nutritional status were performed during the study period. Possible sarcopenia was identified utilizing the criteria set by the Asian Working Group on Sarcopenia in 2019 using the criteria of low muscle strength alone, and osteoporosis was defined by the World Health Organization criteria. Accordingly, the study subjects were divided into four groups: normal, only osteoporosis, only possible sarcopenia, and possible osteosarcopenia. RESULTS There were 337 participants (68.6% female) with a median age of 78.0 years (interquartile range: 71.0-85.0 y/o). According to the clinical definition of osteosarcopenia, 78 participants were normal, 69 participants showed possible sarcopenia, 61 participants had osteoporosis, and 129 had osteoporosis with possible sarcopenia. Among the four groups, the prevalence rates of chronic illness, functional capacity, physical performance, cognitive impairment, and malnutrition revealed statistically significant differences. Using logistic regression analysis after adjusting for the other covariates, osteoporosis with possible sarcopenia was associated with an increased odds ratio of cognitive impairment. CONCLUSIONS The findings suggest that compared to osteoporosis or possible sarcopenia alone, osteoporosis with possible sarcopenia was more likely to be associated with cognitive impairment. Early identification and targeted interventions for cognitive impairment in older adults with osteosarcopenia may be valuable in maintaining cognitive well-being and overall quality of life.
Collapse
Affiliation(s)
- Yin-Yi Chou
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
| | - Cheng-Fu Lin
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Division of Occupational Medicine, Department of Emergency, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Geriatrics and Gerontology Research Center, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan
| | - Yu-Shan Lee
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Division of Neurology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
| | - Shuo-Chun Weng
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Geriatrics and Gerontology Research Center, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan
| | - Fu-Hsuan Kuo
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
- Geriatrics and Gerontology Research Center, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan
- Division of Neurology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
| | - Chiann-Yi Hsu
- Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, 40705, Taiwan
| | - Shih-Yi Lin
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan.
- Geriatrics and Gerontology Research Center, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan.
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, 40200, Taiwan.
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan.
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 40705, Taiwan.
| |
Collapse
|
3
|
Lee BC, Cho KH, Moon CW. Physical activity and osteosarcopenia in Korean adults aged 65 years and older: a national cross-sectional study using the KNHANES data. BMC Geriatr 2023; 23:415. [PMID: 37420226 PMCID: PMC10329310 DOI: 10.1186/s12877-023-04121-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/20/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Osteosarcopenia is a syndrome characterized by the co-existence of osteoporosis and sarcopenia. This study aimed to examine the relationship between various types of physical activity and osteosarcopenia in community-dwelling Korean adults aged 65 years or older. METHODS This cross-sectional study used raw data from the fourth and fifth editions of the Korean National Health and Nutritional Survey Examination, conducted from 2008 to 2011. The researchers exclusively recruited participants aged 65 years or older for the study. These participants were categorized into four distinct groups based on their clinical factors, namely individuals without osteoporosis or sarcopenia, those with osteoporosis alone, those with sarcopenia alone, and individuals with osteosarcopenia. The International Physical Activity Short-Form was used to calculate the weekly time spent walking, moderate-intensity aerobic physical activity, and vigorous aerobic physical activity. Number of days in performing strengthening or stretching exercises were also surveyed. We used logistic regression analyses to examine the association between various physical activities and occurrence of osteosarcopenia. RESULTS A total of 1,342 participants (639 men and 703 women) were included in the analysis. No significant difference was observed in the amount and level of aerobic physical activity between the groups. The odds ratios below were based on participants without osteoporosis or sarcopenia as the reference category. The un-adjusted odds ratio of participants who performed stretching (male, 0.179, 95% CI 0.078-0.412; female 0.430, 95% CI 0.217-0.853) and strengthening exercises (male, 0.143, 95% CI 0.051-0.402; female, 0.044, 95% CI 0.006-0.342) at least twice per week was significantly lower in participants with osteosarcopenia compared to those without. In the adjusted analysis (adjusted by age, body mass index, house income, educational level, smoking habits, drinking status, and protein intake), only female patients in the osteosarcopenia group had a significantly lower adjusted odds ratio for performing strengthening exercise compared to female participants without osteoporosis or sarcopenia (0.062, 95% CI 0.007-0.538). CONCLUSIONS After adjusting for confounding factors and protein intake, women aged 65 years and older who suffered osteosarcopenia had considerably lower odds ratio of performing strengthening exercises.
Collapse
Affiliation(s)
- Byung Chan Lee
- Department of Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Seoul, Korea
| | - Kang Hee Cho
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, 266 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea
- Department of Biomedical Institute, Chungnam National University, Daejeon, Korea
| | - Chang-Won Moon
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, 266 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea.
- Department of Biomedical Institute, Chungnam National University, Daejeon, Korea.
| |
Collapse
|
4
|
Diet-induced inflammation is associated with sarcopenia and muscle strength in older adults who visit a frailty clinic. Aging Clin Exp Res 2022; 34:2525-2532. [PMID: 35841498 DOI: 10.1007/s40520-022-02195-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 07/03/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Diet-induced inflammation may be associated with sarcopenia; however, few reports have examined this relationship. AIM To examine the association between the dietary inflammatory index (DII) and sarcopenia in older adults who visited a frailty clinic in Japan. METHODS This cross-sectional study used outpatient data from the Frailty Registry Study. The DII is an index of diet-induced inflammation, and a dietary assessment was performed using a brief self-administered diet history questionnaire to calculate the DII score. We classified DII scores by quartiles (Q1-Q4), and sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 consensus. Logistic regression analyses for sarcopenia were performed. Age, sex, comorbidities, and physical activity were entered as confounding factors (Model 1) and Models 2, 3, and 4 with BMI, protein intake, and energy intake added to Model 1. RESULTS We included 304 patients in the analysis (mean age, 77.6 ± 6.3 years; female, 67.4%). The prevalence of sarcopenia was 14.5%. Logistic regression analyses showed that DII scores were significantly associated with sarcopenia in Model 1 and 2 (Model 1, reference: Q1, Q4: OR 3.10, P = 0.020; Model 2, Q4: OR 3.40, P = 0,022) but not in Model 3 and 4. DISCUSSION Diet-induced inflammation is associated with a higher likelihood of sarcopenia; however, this association disappeared after confounding for protein and energy intake. CONCLUSIONS The results demonstrated that dietary protein and energy parameters were the main drivers for muscle health in medical patients.
Collapse
|
5
|
Polito A, Barnaba L, Ciarapica D, Azzini E. Osteosarcopenia: A Narrative Review on Clinical Studies. Int J Mol Sci 2022; 23:ijms23105591. [PMID: 35628399 PMCID: PMC9147376 DOI: 10.3390/ijms23105591] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/09/2022] [Accepted: 05/14/2022] [Indexed: 02/06/2023] Open
Abstract
Osteosarcopenia (OS) is defined by the concurrent presence of osteopenia/osteoporosis and sarcopenia. The pathogenesis and etiology of OS involve genetic, biochemical, mechanical, and lifestyle factors. Moreover, an inadequate nutritional status, such as low intake of protein, vitamin D, and calcium, and a reduction in physical activity are key risk factors for OS. This review aims to increase knowledge about diagnosis, incidence, etiology, and treatment of OS through clinical studies that treat OS as a single disease. Clinical studies show the relationship between OS and the risk of frailty, falls, and fractures and some association with Non-communicable diseases (NCDs) pathologies such as diabetes, obesity, and cardiovascular disease. In some cases, the importance of deepening the related mechanisms is emphasized. Physical exercise with adequate nutrition and nutritional supplementations such as proteins, Vitamin D, or calcium, represent a significant strategy for breaking OS. In addition, pharmacological interventions may confer benefits on muscle and bone health. Both non-pharmacological and pharmacological interventions require additional randomized controlled trials (RCT) in humans to deepen the synergistic effect of exercise, nutritional interventions, and drug compounds in osteosarcopenia.
Collapse
|