Prevalence and Risk Factors of Osteosarcopenia: a Systematic Review and Meta-analysis

Overview

Journal BMC Geriatr

Publisher Biomed Central

Specialty Geriatrics

Date 2023 Jun 15

PMID 37322416

Authors

Tianjin Huang

Chen Li

Faxiu Chen

Dunan Xie

Chuhua Yang

Yuting Chen

Jintao Wang

Jiming Li

Fei Zheng

Affiliations

Soon will be listed here.

Abstract

Background: Osteosarcopenia is a syndrome with a concomitant presence of both sarcopenia and osteopenia/osteoporosis. It increases the risk of frailty, falls, fractures, hospitalization, and death. Not only does it burden the lives of older adults, but it also increases the economic burden on health systems around the world. This study aimed to review the prevalence and risk factors of osteosarcopenia to generate important references for clinical work in this area.

Methods: Pubmed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, CBM, and VIP databases were searched from inception until April 24th, 2022. The quality of studies included in the review was evaluated using the NOS and AHRQ Scale. Pooled effects of the prevalence and associated factors were calculated using random or fixed effects models. Egger's test, Begg's test, and funnel plots were used to test the publication bias. Sensitivity analysis and subgroup analysis were conducted to identify the sources of heterogeneity. Statistical analysis was performed using Stata 14.0 and Review Manager 5.4.

Results: A total of 31 studies involving 15,062 patients were included in this meta-analysis. The prevalence of osteosarcopenia ranged from 1.5 to 65.7%, with an overall prevalence of 21% (95% CI: 0.16-0.26). The risk factors for osteosarcopenia were female (OR 5.10, 95% CI: 2.37-10.98), older age (OR 1.12, 95% CI: 1.03-1.21), and fracture (OR 2.92, 95% CI: 1.62-5.25).

Conclusion: The prevalence of osteosarcopenia was high. Females, advanced age, and history of fracture were independently associated with osteosarcopenia. It is necessary to adopt integrated multidisciplinary management.

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References

Kirk B, Phu S, Brennan-Olsen S, Bani Hassan E, Duque G . Associations between osteoporosis, the severity of sarcopenia and fragility fractures in community-dwelling older adults. Eur Geriatr Med. 2020; 11(3):443-450. DOI: 10.1007/s41999-020-00301-6. View

DI Monaco M, Castiglioni C, Bardesono F, Milano E, Massazza G . Sarcopenia, osteoporosis and the burden of prevalent vertebral fractures: a cross-sectional study of 350 women with hip fracture. Eur J Phys Rehabil Med. 2020; 56(2):184-190. DOI: 10.23736/S1973-9087.20.05991-2. View

Inoue T, Maeda K, Satake S, Matsui Y, Arai H . Osteosarcopenia, the co-existence of osteoporosis and sarcopenia, is associated with social frailty in older adults. Aging Clin Exp Res. 2021; 34(3):535-543. PMC: 8421463. DOI: 10.1007/s40520-021-01968-y. View

Beaudart C, McCloskey E, Bruyere O, Cesari M, Rolland Y, Rizzoli R . Sarcopenia in daily practice: assessment and management. BMC Geriatr. 2016; 16(1):170. PMC: 5052976. DOI: 10.1186/s12877-016-0349-4. View

Lopez-Teros M, Rosas-Carrasco O, Sanchez-Garcia S, Castro-Porras L, Luna-Lopez A, Agudelo-Botero M . The Association of Osteosarcopenia With Functional Disability in Community-Dwelling Mexican Adults 50 and Older. Front Med (Lausanne). 2021; 8:674724. PMC: 8215205. DOI: 10.3389/fmed.2021.674724. View

Lin Y, Shih Y, Teng M . The Impact of the "Osteo" Component of Osteosarcopenia on Fragility Fractures in Post-Menopausal Women. Int J Mol Sci. 2021; 22(10). PMC: 8155869. DOI: 10.3390/ijms22105256. View

Frost H . Bone's mechanostat: a 2003 update. Anat Rec A Discov Mol Cell Evol Biol. 2003; 275(2):1081-101. DOI: 10.1002/ar.a.10119. View

Dent E, Morley J, Cruz-Jentoft A, Arai H, Kritchevsky S, Guralnik J . International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, Diagnosis and Management. J Nutr Health Aging. 2018; 22(10):1148-1161. DOI: 10.1007/s12603-018-1139-9. View

Khosla S, Oursler M, Monroe D . Estrogen and the skeleton. Trends Endocrinol Metab. 2012; 23(11):576-81. PMC: 3424385. DOI: 10.1016/j.tem.2012.03.008. View

10.

Salech F, Marquez C, Lera L, Angel B, Saguez R, Albala C . Osteosarcopenia Predicts Falls, Fractures, and Mortality in Chilean Community-Dwelling Older Adults. J Am Med Dir Assoc. 2020; 22(4):853-858. DOI: 10.1016/j.jamda.2020.07.032. View

11.

Hamrick M . A role for myokines in muscle-bone interactions. Exerc Sport Sci Rev. 2010; 39(1):43-7. PMC: 3791922. DOI: 10.1097/JES.0b013e318201f601. View

12.

Chen L, Woo J, Assantachai P, Auyeung T, Chou M, Iijima K . Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020; 21(3):300-307.e2. DOI: 10.1016/j.jamda.2019.12.012. View

13.

Trajanoska K, Rivadeneira F, Kiel D, Karasik D . Genetics of Bone and Muscle Interactions in Humans. Curr Osteoporos Rep. 2019; 17(2):86-95. PMC: 6424938. DOI: 10.1007/s11914-019-00505-1. View

14.

Sepulveda-Loyola W, Phu S, Bani Hassan E, Brennan-Olsen S, Zanker J, Vogrin S . The Joint Occurrence of Osteoporosis and Sarcopenia (Osteosarcopenia): Definitions and Characteristics. J Am Med Dir Assoc. 2019; 21(2):220-225. DOI: 10.1016/j.jamda.2019.09.005. View

15.

Yoo J, Ha Y . Review of Epidemiology, Diagnosis, and Treatment of Osteosarcopenia in Korea. J Bone Metab. 2018; 25(1):1-7. PMC: 5854818. DOI: 10.11005/jbm.2018.25.1.1. View

16.

Yoo J, Ha Y, Kwon H, Lee Y, Koo K, Yoo M . High Prevalence of Sarcopenia in Korean Patients after Hip Fracture: a Case-Control Study. J Korean Med Sci. 2016; 31(9):1479-84. PMC: 4974192. DOI: 10.3346/jkms.2016.31.9.1479. View

17.

Saeki C, Takano K, Oikawa T, Aoki Y, Kanai T, Takakura K . Comparative assessment of sarcopenia using the JSH, AWGS, and EWGSOP2 criteria and the relationship between sarcopenia, osteoporosis, and osteosarcopenia in patients with liver cirrhosis. BMC Musculoskelet Disord. 2019; 20(1):615. PMC: 6933666. DOI: 10.1186/s12891-019-2983-4. View

18.

Pourhassan M, Buehring B, Stervbo U, Rahmann S, Molder F, Rutten S . Osteosarcopenia, an Asymmetrical Overlap of Two Connected Syndromes: Data from the OsteoSys Study. Nutrients. 2021; 13(11). PMC: 8618221. DOI: 10.3390/nu13113786. View

19.

Nielsen B, Andersen H, Haddock B, Hovind P, Schwarz P, Suetta C . Prevalence of muscle dysfunction concomitant with osteoporosis in a home-dwelling Danish population aged 65-93 years - The Copenhagen Sarcopenia Study. Exp Gerontol. 2020; 138:110974. DOI: 10.1016/j.exger.2020.110974. View

20.

Teng Z, Zhu Y, Teng Y, Long Q, Hao Q, Yu X . The analysis of osteosarcopenia as a risk factor for fractures, mortality, and falls. Osteoporos Int. 2021; 32(11):2173-2183. DOI: 10.1007/s00198-021-05963-x. View