Correction to: Is There Enough Evidence for Osteosarcopenic Obesity as a Distinct Entity? A Critical Literature Review

Impact of Sarcopenia and Bone Mineral Density on Implant Failure after Dorsal Instrumentation in Patients with Osteoporotic Vertebral Fractures

Background and Objectives: Age-related loss of bone and muscle mass are signs of frailty and are associated with an increased risk of falls and consecutive vertebral fractures. Management often necessitates fusion surgery. We determined the impacts of sarcopenia and bone density on implant failures (IFs) and complications in patients with spondylodesis due to osteoporotic vertebral fractures (OVFs). Materials and Methods: Patients diagnosed with an OVF according to the osteoporotic fracture classification (OF) undergoing spinal instrumentation surgery between 2011 and 2020 were included in our study. The skeletal muscle area (SMA) was measured at the third lumbar vertebra (L3) level using axial CT images. SMA z-scores were calculated for the optimal height and body mass index (BMI) adjustment (zSMA_HT). The loss of muscle function was assessed via measurement of myosteatosis (skeletal muscle radiodensity, SMD) using axial CT scans. The bone mineral density (BMD) was determined at L3 in Hounsfield units (HU). Results: A total of 68 patients with OVFs underwent instrumentation in 244 segments (mean age 73.7 ± 7.9 years, 60.3% female). The median time of follow-up was 14.1 ± 15.5 months. Sarcopenia was detected in 28 patients (47.1%), myosteatosis in 45 patients (66.2%), and osteoporosis in 49 patients (72%). The presence of sarcopenia was independent of chronological age (p = 0.77) but correlated with BMI (p = 0.005). The zSMA_HT was significantly lower in patients suffering from an IF (p = 0.0092). Sarcopenia (OR 4.511, 95% CI 1.459–13.04, p = 0.0092) and osteoporosis (OR 9.50, 95% CI 1.497 to 104.7, p = 0.014) increased the likelihood of an IF. Using multivariate analysis revealed that the zSMA_HT (p = 0.0057) and BMD (p = 0.0041) were significantly related to IF occurrence. Conclusion: Herein, we established sarcopenic obesity as the main determinant for the occurrence of an IF after instrumentation for OVF. To a lesser degree, osteoporosis was associated with impaired implant longevity. Therefore, measuring the SMA and BMD using an axial CT of the lumbar spine might help to prevent an IF in spinal fusion surgery via early detection and treatment of sarcopenia and osteoporosis.

Osteosarcopenia School

Osteosarcopenia has been proposed as a syndrome in a subset of frail individuals at higher risk of falls, fractures and institutionalization. In this paper, we will go over the translational aspects of sarcopenia and osteoporosis research and highlight outcomes from different interventions. In addition, preventative measures and therapeutic interventions that can benefit both muscle and bone simultaneously will be analysed also. A new holistic concept called Osteosarcopenia School will be presented. This new concept is based on counselling and education of patients as part of a rehabilitation program, aiming to reduce the risk of social isolation, falls and fractures, and subsequent disability through muscle strengthening and balance training. In this patient group, the combination of pharmaceutical treatments and specific exercise programmes are essential to counteract the consequences of osteosarcopenia. Finally, educational programmes targeting patient functionality through social reintegration may have a substantial impact on their daily living activities and overall quality of life.

A study of correlations between metabolic syndrome factors and osteosarcopenic adiposity

BACKGROUND

Aging reduces the quality and strength of bones and muscles and increases body fat, which can lead to the simultaneous occurrence of sarcopenia, osteopenia, and adiposity, a condition referred to as OsteoSarcopenic Adiposity (OSA). While previous studies have demonstrated that metabolic syndrome is associated with sarcopenia, osteopenia, and adiposity, the relationship between metabolic syndrome and OSA remains largely unknown.

METHODS

We analyzed data for a sample of middle-aged individuals from a Health Management Center database, which was collected in 2016-2018. There are 2991 cases of people over 50 years from a physical examination center in a hospital in Taiwan during 2016-2018. In addition to descriptive statistics, chi-squared test, analysis of variance, and multinomial logistic regression analysis were conducted to examine OSA risk and associated factors.

RESULTS

Based on multinomial logistic regression analysis, in different OSA severity level (1-3 more serious), those who are with metabolic syndrome has increased the 2.49-2.57 times risk of OSA (p < 0.001) in OSA = 2 and 3 groups while there is no significant difference in OSA =1 group.

CONCLUSION

The prevalence of OSA may impair the health and quality of life in the elderly group, especially those diagnosed with metabolic syndrome, increasing the risk of OSA. These results can help promote early diagnosis and treatment of OSA in clinical settings, particularly among aging individuals with abnormal physical function, the group with the highest OSA incidence.

Coexistence of osteoporosis, sarcopenia and obesity in community-dwelling adults - The Yishun Study

OBJECTIVES

To 1) report prevalence of 'osteosarcopenia' (OS) and osteosarcopenic obesity (OSO) entities using evidence-based diagnostic techniques and definitions, 2) examine if OSO offers additional predictive value of functional decline over its components, and 3) identify associated factors in a multi-racial Southeast Asian population.

METHODS

We performed a cross-sectional study of a representative sample of 542 community-dwelling adults (21-90 years old), and assessed anthropometry, cognition, functional performance, and self-report sociodemographic, health and lifestyle questionnaires. Low muscle mass, and the Asian Working Group for Sarcopenia (AWGS) 2019 criteria, were used to assess sarcopenia. Obesity was defined using percentage body fat and fat mass index. Osteopenia/osteoporosis was determined using lumbar spinal bone mineral density. Associated factors were examined using logistic regression, and OSO's value investigated using linear regressions with functional performance.

RESULTS

OS and OSO prevalence were 1.8% and 0% (21-59 years), 12.9% and 2.8% (≥ 60 years), 17.3% and 4.1% (≥ 65 years), and 25.5% and 7.0% (≥75 years), respectively. OSO entity as defined was not a significant predictor (P > 0.05) and did not improve explanations for functional decline over sarcopenia or sarcopenic obesity. Age, sex, race and body mass index (BMI) were associated with OS, while age, sex, race and alcoholism were associated with OSO.

CONCLUSIONS

Our results do not support OSO as a distinct entity in relation to functional decline. Aside from biological age, sex, and race, amenable lifestyle factors such as BMI and alcohol intake are important variables that can influence the co-existence of osteopenia/osteoporosis, sarcopenia and obesity.

Osteosarcopenia: the Path Beyond Controversy

PURPOSE OF REVIEW

Osteosarcopenia is commonly accepted as the presence of low muscle mass and function (sarcopenia) and low bone mineral density (osteopenia and osteoporosis). Osteosarcopenia remains a topic of controversy as researchers worldwide seek to elucidate whether osteosarcopenia is associated with greater risk of negative outcomes than its component parts. This review examines the latest research and controversies, and charts a path forward.

RECENT FINDINGS

Osteosarcopenia may occur in 5-37% of community-dwelling adults over the age of 65. This wide range is driven by variation in population, setting, and definitions applied. These differences in study design have resulted in mixed findings in associations with adverse outcomes for older adults living with osteosarcopenia. Research into interventions to prevent or treat osteosarcopenia, such as exercise, protein supplementation, and pharmacotherapy, is in its infancy but examined herein. The absence of a consensus operational definition of sarcopenia, and inaccurate measures of muscle mass, has hampered global progress in the field. We present a case for the path forward by reflecting on our recent history.