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Sarcopenic obesity is associated with lower proximal tibial cortical bone quality, increased intermuscular adipose tissue and poor physical function in community-dwelling older adults
Abstract   Peer reviewed

Sarcopenic obesity is associated with lower proximal tibial cortical bone quality, increased intermuscular adipose tissue and poor physical function in community-dwelling older adults

D Scott, C Shore-Lorenti, L McMillan, Ross Clark, K M Sanders, G Duque and P R Ebeling
Osteoporosis International, Vol.28(Supplement 1), pp.S276-S277
WCO-IOF-ESCEO World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (Florence, Italy, 23-Mar-2017–26-Mar-2017)
2017
DOI: https://doi.org/10.1007/s00198-017-3950-2
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https://doi.org/10.1007/s00198-017-3950-2View
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Abstract

Clinical Sciences Biomedical Engineering
Objectives: We previously reported increased incident fracture risk in sarcopenic obese compared with obese alone older adults, but no differences in falls risk. We aimed to determine whether bone quality is compromised in sarcopenic obesity, and which components of sarcopenic obesity contribute to poor bone quality in older adults. Materials and Methods: 83 community-dwelling older adults (mean age 72.8±5.4 years; 53% women) underwent whole-body dual-energy X-ray absorptiometry to assess appendicular lean mass (ALM), body fat percentage, bone mineral content (BMC) and density (BMD). Peripheral quantitative computed tomography assessed mid-calf muscle and inter-muscular adipose tissue (IMAT) cross-sectional areas (CSA), muscle density and proximal tibial (66%) cortical volumetric BMD, area and thickness. Physical function assessments including muscle strength (dynamometry) and postural sway (computerised posturography) were performed. Sarcopenia was defined as either low relative ALM or hand grip strength according to the Foundation for the National Institutes of Health Biomarkers Consortium Sarcopenia Project definition; obesity was defined as high body fat percentage. Results: Seventeen (20.5%) participants were sarcopenic obese. Obese alone and non-sarcopenic non-obese demonstrated better knee extension strength and postural sway than sarcopenic obese (all P<0.05). Non-sarcopenic non-obese and sarcopenic alone (both P<0.05) had significantly lower midcalf IMAT (relative to muscle CSA) compared with sarcopenic obese, and obese alone also tended to have lower relative IMAT (B=-1.8%; 95% CI -3.7, 0.1; P=0.06). Nonsarcopenic non-obese had significantly greater proximal tibia cortical volumetric BMD (26.3mg/cm3 ; 3.0, 49.5), and obese alone had greater whole-body BMC (222.8g; 32.3, 413.3) and proximal tibial cortical area (32.6mm2 ; 5.0, 60.2) and thickness (0.5mm; 0.1, 0.9), than sarcopenic obese. Amongst components of sarcopenic obesity, only ALM was independently and positively associated with proximal tibial cortical area (8.8mm2 ; 4.6, 13.0) and thickness (0.07mm; 0.01, 0.14). Mid-calf IMAT was the only independent predictor of cortical volumetric BMD (-0.5mg/cm3 ; -1.04, -0.03). Conclusions: Sarcopenic obesity is associated with lower proximal tibial cortical volumetric BMD, area and thickness, as well as poor muscle strength and balance. Higher amounts of IMAT may contribute to the poorer bone quality and physical performance of sarcopenic obese older adults, increasing their risk for falls and fractures.

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