Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3168, Australia.
Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
Calcif Tissue Int. 2022 Aug;111(2):152-161. doi: 10.1007/s00223-022-00981-1. Epub 2022 May 4.
Age-related changes in fat and lean mass contribute to bone health, but these associations may be influenced by sex and ethnicity. This study investigated sex-specific associations of obesity and sarcopenia with bone mineral density (BMD) and bone mineral apparent density (BMAD) among Indian older adults. 1057 adults aged ≥ 50 years were included. Dual-energy X-ray absorptiometry (DXA) measured BMD at the hip, spine and whole-body, and BMAD was calculated as BMD/√bone area. Obesity was defined by body fat percentage (cut points; > 25% for men and > 35% for women), and sarcopenia was defined using the revised Asian Working Group for Sarcopenia classification with low hand grip strength (< 28 kg for men and < 18 kg for women) and appendicular lean mass index (< 7.0 kg/m for men and < 5.4 kg/m for women). Participants were classified into four groups: controls (no obesity or sarcopenia), obesity, sarcopenia, or sarcopenic obesity. Linear regression (β-coefficients and 95%CI) analyses were performed with adjustments for age, smoking status, protein intake, and socioeconomic status. Prevalence of sarcopenia (37%) and sarcopenic obesity (6%) were higher in men than women (17% and 4%, respectively). Compared with controls, men with obesity had lower whole-body BMD and BMAD, but women with obesity had higher hip and spine BMD and BMAD (all p < 0.05). Men, but not women, with sarcopenic obesity, had lower hip and whole-body BMD and BMAD (all p < 0.05) than controls. Men with sarcopenia had lower BMD and BMAD at the hip only, whereas women had lower BMD at all three sites and had lower BMAD at the hip and spine (all p < 0.05), compared with controls. Obesity, sarcopenia, and sarcopenic obesity have sex-specific associations with BMD and BMAD in Indian older adults. With the aging population in India, it is important to understand how body composition contributes to poor bone health among older adults.
年龄相关的脂肪和瘦体重变化会影响骨骼健康，但这些关联可能受到性别和种族的影响。本研究旨在探讨肥胖和肌肉减少症与印度老年人骨密度（BMD）和骨矿物质表观密度（BMAD）的性别特异性关联。共纳入了 1057 名年龄≥50 岁的成年人。双能 X 射线吸收法（DXA）测量了髋部、脊柱和全身的 BMD，BMAD 则通过 BMD/√骨面积计算得出。肥胖定义为体脂肪百分比（切点；男性>25%，女性>35%），肌肉减少症则采用修订后的亚洲肌肉减少症工作组分类，根据低握力（男性<28kg，女性<18kg）和四肢瘦体重指数（男性<7.0kg/m，女性<5.4kg/m）进行定义。参与者被分为四组：对照组（无肥胖或肌肉减少症）、肥胖组、肌肉减少症组或肌肉减少症合并肥胖组。采用线性回归（β系数和 95%CI）分析，并对年龄、吸烟状况、蛋白质摄入量和社会经济地位进行了调整。与女性相比，男性肌肉减少症（37%）和肌肉减少症合并肥胖症（6%）的患病率更高（分别为 17%和 4%）。与对照组相比，男性肥胖者的全身 BMD 和 BMAD 较低，但女性肥胖者髋部和脊柱 BMD 和 BMAD 较高（均 P<0.05）。与对照组相比，男性肌肉减少症合并肥胖症患者髋部和全身 BMD 和 BMAD 较低（均 P<0.05），而女性患者髋部和全身 BMD 和 BMAD 均较低，髋部和脊柱 BMAD 也较低（均 P<0.05）。与对照组相比，男性肌肉减少症患者仅髋部 BMD 和 BMAD 较低，而女性患者在所有三个部位的 BMD 均较低，且髋部和脊柱的 BMAD 也较低（均 P<0.05）。在印度老年人群中，肥胖、肌肉减少症和肌肉减少症合并肥胖症与 BMD 和 BMAD 存在性别特异性关联。随着印度人口老龄化，了解身体成分如何导致老年人骨骼健康状况不佳非常重要。
