title: Sarcopenic Obesity and Its Temporal Associations With Changes in Bone Mineral Density, Incident Falls, and Fractures in Older Men: The Concord Health and Ageing in Men Project.
abstract: Body composition and muscle function have important implications for falls and fractures in older adults. We aimed to investigate longitudinal associations between sarcopenic obesity and its components with bone mineral density (BMD) and incident falls and fractures in Australian community-dwelling older men. A total of 1486 men aged ≥70 years from the Concord Health and Ageing in Men Project (CHAMP) study were assessed at baseline (2005-2007), 2-year follow-up (2007-2009; n = 1238), and 5-year follow-up (2010-2013; n = 861). At all three time points, measurements included appendicular lean mass (ALM), body fat percentage and total hip BMD, hand-grip strength, and gait speed. Participants were contacted every 4 months for 6.1 ± 2.1 years to ascertain incident falls and fractures, the latter being confirmed by radiographic reports. Sarcopenic obesity was defined using sarcopenia algorithms of the European Working Group on Sarcopenia (EWGSOP) and the Foundation for the National Institutes of Health (FNIH) and total body fat ≥30% of total mass. Sarcopenic obese men did not have significantly different total hip BMD over 5 years compared with non-sarcopenic non-obese men (p > 0.05). EWGSOP-defined sarcopenic obesity at baseline was associated with significantly higher 2-year fall rates (incidence rate ratio [IRR] 1.66; 95% confidence interval [CI] 1.16-2.37), as were non-sarcopenic obesity (1.30; 1.04-1.62) and sarcopenic non-obesity (1.58; 1.14-2.17), compared with non-sarcopenic non-obese. No association with falls was found for sarcopenic obesity using the FNIH definition (1.01; 0.63-1.60), but after multivariable adjustment, the FNIH-defined non-sarcopenic obese group had a reduced hazard for any 6-year fracture compared with sarcopenic obese men (hazard ratio 0.44; 95% CI 0.23-0.86). In older men, EWGSOP-defined sarcopenic obesity is associated with increased fall rates over 2 years, and FNIH-defined sarcopenic obese men have increased fracture risk over 6 years compared with non-sarcopenic obese men. © 2016 American Society for Bone and Mineral Research.
authors.affiliation: School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.|Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Scott
authors.affiliation: Bone Research Program, ANZAC Research Institute, and Department of Endocrinology and Metabolism, Concord Hospital, The University of Sydney, Sydney, Australia.
authors.forename: Markus
authors.initials: M
authors.lastname: Seibel
authors.affiliation: School of Public Health, University of Sydney, Sydney, Australia.|Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia.|The ARC Centre of Excellence in Population Ageing Research, University of Sydney, Sydney, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Cumming
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia.
authors.forename: Vasi
authors.initials: V
authors.lastname: Naganathan
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Blyth
authors.affiliation: ANZAC Research Institute and Charles Perkins Centre, University of Sydney, Sydney, Australia.
authors.forename: David G
authors.initials: DG
authors.lastname: Le Couteur
authors.affiliation: Department of Andrology, Concord Hospital and ANZAC Research Institute, University of Sydney, Sydney, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Handelsman
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia.
authors.forename: Louise M
authors.initials: LM
authors.lastname: Waite
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, Australia.|School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia.
authors.forename: Vasant
authors.initials: V
authors.lastname: Hirani
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000375:Aging / Q000502:physiology*; D001315:Australia / Q000453:epidemiology; D015519:Bone Density; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D006615:Hip / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D055948:Sarcopenia / Q000150:complications* / Q000503:physiopathology; D013997:Time Factors
keywords: FALLS; FRACTURE; OBESITY; OSTEOPOROSIS; SARCOPENIA