J Korean Med Sci.  2016 Sep;31(9):1479-1484. 10.3346/jkms.2016.31.9.1479.

High Prevalence of Sarcopenia in Korean Patients after Hip Fracture: a Case-Control Study

• Yoo JI
• Ha YC
• Kwon HB
• Lee YK
• Koo KH
• Yoo MJ

• KMID: 2468283
• DOI: http://doi.org/10.3346/jkms.2016.31.9.1479

Abstract

Sarcopenia-related falls and fractures are increasing worldwide due to the aging population. The purpose of this study was to 1) evaluate anthropometric characteristics related to hip fracture in Korean patients, 2) investigate sarcopenia prevalence in hip fracture (HF) and non-hip fracture (NF) groups, and 3) investigate the correlation between sarcopenia and osteoporosis. This case-control study examined 359 HF and 1,614 NF normal populations using Korea National Health and Nutrition Examination Survey data. We performed whole-body dual energy X-ray absorptiometry to analyze body composition using the skeletal muscle mass index (SMI: lean mass/height2) and bone mineral density (BMD). In the HF group, using the AWGS definition, the prevalence of sarcopenia in women and men was 44.3% and 68.2%, respectively; in the NF group, it was 7.1% and 16.1%, respectively. Lower appendicular SMI (P < 0.001), leg muscle mass (P < 0.001), and higher prevalence of sarcopenia (P < 0.001) were observed in the HF group after adjustment for age and gender. In multivariate analysis, sarcopenia (OR = 6.52; 95% CI = 4.67-9.09), age (OR = 1.15; 95% CI = 1.13-1.17), and osteoporosis (OR = 1.87; 95% CI = 1.35-2.58) were associated with the occurrence of a hip fracture. This study showed a higher prevalence of sarcopenia in patients with hip fractures compared with a normal population, and higher prevalence of sarcopenia in men.

Keyword

Dual Energy X-ray Absorptiometry; Hip Fracture; Sarcopenia; Skeletal Muscle Mass

MeSH Terms

Absorptiometry, Photon
Aged
Aged, 80 and over
Asian Continental Ancestry Group
Bone Density
Case-Control Studies
Female
Hip Fractures/complications/*epidemiology
Humans
Male
Muscle, Skeletal/physiology
Nutrition Surveys
Odds Ratio
Osteoporosis/complications/epidemiology
Prevalence
Republic of Korea/epidemiology
Sarcopenia/complications/*epidemiology
Vitamin D/analogs & derivatives/blood
Whole Body Imaging
Vitamin D

Figure

• 

  Fig. 1 Correlation of appendicular skeletal muscle mass index (SMI) and femur bone mineral density (BMD). (A) The hip fracture (HF) group. (B) The non-fracture (NF) group. Correlation of appendicular SMI and femur neck BMD in (C) the HF group and (D) the NF group. Correlation of appendicular SMI and spine BMD in (E) the HF group and (F) the NF group.

Reference

1. Cassell E, Clapperton A. A decreasing trend in fall-related hip fracture incidence in Victoria, Australia. Osteoporos Int. 2013; 24:99–109.

2. Melton LJ 3rd, Khosla S, Crowson CS, O’Connor MK, O’Fallon WM, Riggs BL. Epidemiology of sarcopenia. J Am Geriatr Soc. 2000; 48:625–630.

3. Vanitallie TB. Frailty in the elderly: contributions of sarcopenia and visceral protein depletion. Metabolism. 2003; 52:22–26.

4. Kaji H. Interaction between muscle and bone. J Bone Metab. 2014; 21:29–40.

5. Ha YC, Park YG, Nam KW, Kim SR. Trend in hip fracture incidence and mortality in Korea: a prospective cohort study from 2002 to 2011. J Korean Med Sci. 2015; 30:483–488.

6. Lloyd BD, Williamson DA, Singh NA, Hansen RD, Diamond TH, Finnegan TP, Allen BJ, Grady JN, Stavrinos TM, Smith EU, et al. Recurrent and injurious falls in the year following hip fracture: a prospective study of incidence and risk factors from the Sarcopenia and Hip Fracture study. J Gerontol A Biol Sci Med Sci. 2009; 64:599–609.

7. Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, Chou MY, Chen LY, Hsu PS, Krairit O, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014; 15:95–101.

8. Frisoli A Jr, Chaves PH, Ingham SJ, Fried LP. Severe osteopenia and osteoporosis, sarcopenia, and frailty status in community-dwelling older women: results from the Women’s Health and Aging Study (WHAS) II. Bone. 2011; 48:952–957.

9. Park Y, Kwon SJ, Ha YC. Association between urinary sodium excretion and bone health in male and female adults. Ann Nutr Metab. 2016; 68:189–196.

10. Reginster JY, Beaudart C, Buckinx F, Bruyère O. Osteoporosis and sarcopenia: two diseases or one? Curr Opin Clin Nutr Metab Care. 2016; 19:31–36.

11. Yoon HK, Park C, Jang S, Jang S, Lee YK, Ha YC. Incidence and mortality following hip fracture in Korea. J Korean Med Sci. 2011; 26:1087–1092.

12. Lee SR, Ha YC, Kang H, Park YG, Nam KW, Kim SR. Morbidity and mortality in Jeju residents over 50-years of age with hip fracture with mean 6-year follow-up: a prospective cohort study. J Korean Med Sci. 2013; 28:1089–1094.

13. Hida T, Ishiguro N, Shimokata H, Sakai Y, Matsui Y, Takemura M, Terabe Y, Harada A. High prevalence of sarcopenia and reduced leg muscle mass in Japanese patients immediately after a hip fracture. Geriatr Gerontol Int. 2013; 13:413–420.

14. Di Monaco M, Castiglioni C, Vallero F, Di Monaco R, Tappero R. Sarcopenia is more prevalent in men than in women after hip fracture: a cross-sectional study of 591 inpatients. Arch Gerontol Geriatr. 2012; 55:e48–52.

15. González-Montalvo JI, Alarcón T, Gotor P, Queipo R, Velasco R, Hoyos R, Pardo A, Otero A. Prevalence of sarcopenia in acute hip fracture patients and its influence on short-term clinical outcome. Geriatr Gerontol Int. Forthcoming. 2015.

16. Gumieiro DN, Murino Rafacho BP, Buzati Pereira BL, Cavallari KA, Tanni SE, Azevedo PS, Polegato BF, Mamede Zornoff LA, Dinhane DI, Innocenti Dinhane KG, et al. Vitamin D serum levels are associated with handgrip strength but not with muscle mass or length of hospital stay after hip fracture. Nutrition. 2015; 31:931–934.

17. Liu G, Lu L, Sun Q, Ye X, Sun L, Liu X, Zong G, Jin Q, Li H, Lin X. Poor vitamin D status is prospectively associated with greater muscle mass loss in middle-aged and elderly Chinese individuals. J Acad Nutr Diet. 2014; 114:1544–1551.e2.

18. Ganda K, Nguyen TV, Pocock N. Gender disparity in BMD conversion: a comparison between Lunar and Hologic densitometers. Arch Osteoporos. 2014; 9:180.