title: Osteosarcopenic obesity is associated with reduced handgrip strength, walking abilities, and balance in postmenopausal women.
abstract: We determined the prevalence of osteosarcopenic obesity (loss of bone and muscle coexistent with increased adiposity) in overweight/obese postmenopausal women and compared their functionality to obese-only women. Results showed that osteosarcopenic obese women were outperformed by obese-only women in handgrip strength and walking/balance abilities indicating their higher risk for mobility impairments.
  
  
  BACKGROUND
  Osteosarcopenic obesity (OSO) is a recently defined triad of osteopenia/osteoporosis, sarcopenia, and adiposity. We identified women with OSO in overweight/obese postmenopausal women and evaluated their functionality comparing them with obese-only (OB) women. Additionally, women with osteopenic/osteoporotic obesity (OO), but no sarcopenia, and those with sarcopenic obesity (SO), but no osteopenia/osteoporosis, were identified and compared. We hypothesized that OSO women will have the lowest scores for each of the functionality measures.
  
  
  METHODS
  Participants (n = 258; % body fat ≥35) were assessed using a Lunar iDXA instrument for bone and body composition. Sarcopenia was determined from negative residuals of linear regression modeled on appendicular lean mass, height, and body fat, using 20th percentile as a cutoff. Participants with T-scores of L1-L4 vertebrae and/or total femur <-1, but without sarcopenia, were identified as OO (n = 99) and those with normal T-scores, but with sarcopenia, as SO (n = 28). OSO (n = 32) included women with both osteopenia/osteoporosis and sarcopenia, while those with normal bone and no sarcopenia were classified as OB (n = 99). Functionality measures such as handgrip strength, normal/brisk walking speed, and right/left leg stance were evaluated and compared among groups.
  
  
  RESULTS
  Women with OSO presented with the lowest handgrip scores, slowest normal and brisk walking speed, and shortest time for each leg stance, but these results were statistically significantly different only from the OB group.
  
  
  CONCLUSIONS
  These findings indicate a poorer functionality in women presenting with OSO, particularly compared to OB women, increasing the risk for bone fractures and immobility from the combined decline in bone and muscle mass, and increased fat mass.
authors.affiliation: Department of Nutrition, Food and Exercise Sciences, Florida State University, 120 Convocation Way, 418 Sandels Building, Tallahassee, FL, 32306-1493, USA. jilichernst@fsu.edu.
authors.forename: J Z
authors.initials: JZ
authors.lastname: Ilich
authors.affiliation: Department of Nutrition, Food and Exercise Sciences, Florida State University, 120 Convocation Way, 418 Sandels Building, Tallahassee, FL, 32306-1493, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Inglis
authors.affiliation: Abbott Nutrition, Scientific and Medical Affairs, Columbus, OH, 43219, USA.
authors.forename: O J
authors.initials: OJ
authors.lastname: Kelly
authors.affiliation: Department of Statistics, Florida State University, Tallahassee, FL, 32306, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: McGee
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D050154:Adiposity / Q000502:physiology; D000368:Aged; D000886:Anthropometry / Q000379:methods; D001823:Body Composition / Q000502:physiology; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009765:Obesity / Q000503:physiopathology*; D015663:Osteoporosis, Postmenopausal / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology; D055948:Sarcopenia / Q000503:physiopathology*; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D016138:Walking / Q000502:physiology*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Handgrip strength; One leg stance; Osteopenic/osteoporotic obesity; Osteosarcopenic obesity; Sarcopenic obesity; Walking speed