THE RELATIONSHIP OF SARCOPENIA, SARCOPENIC-OBESITY ANDSARCO-OSTEOPOROSIS WITH HANDGRIP STRENGTH IN

COMMUNITY DWELLING ELDERLY MEN1,3Asta Mastaviciute*, 1,2Vidmantas Alekna, 2,3Vaidile Strazdiene, 1,3Marija Tamulaitiene

1 Vilnius University, Faculty of Medicine; 2 State Research Institute Centre For Innovative Medicine; 3 National Osteoporosis Center; Vilnius, Lithuania

OBJECTIVEThis study was designed to investigate relationship of sarcopenia, sarcopenic-obesity and sarco-osteoporosis with handgrip strength in community dwelling elderly men.

CONCLUSIONThis study showed higher handgrip strength in men with sarcopenia comparing to sarco-osteoporotic men. There was found the relationship between lean mass and handgrip strength in all body composition types. Bone mineral content positively associated with handgrip strength only in sarcopenic men.

BACKGROUNDAging is associated with alterations in body composition: body fat percentage increas-

es and fat mass redistributes, bone mineral density decreases, fat-free mass decreases1. A progressive and generalized loss of skeletal muscle mass and strength, and/or low physical performance, is called sarcopenia2. A combination of excess weight with reduced mus-cle mass and strength is called as sarcopenic obesity3 and a combination of sarcopenia

and osteoporosis is called sarco-osteoporosis4. The decreased muscle strength is closely correlated with functional limitation, poor quality of life and mortality5. There are not sufficient data about sarcopenic-obesity, sarco-osteoporosis and handgrip strength in elderly men.

MATERIAL AND METHODSThis cross-sectional study included 58 men aged 65 years and older. Exclusion criteria

were metabolic or endocrine disorders known to affect musculoskeletal system and re-striction of movement in the upper extremities. All participants answered face-to-face questionnaires addressing medical history, lifestyle habits and medications use. Writ-ten informed consent was obtained from each participant. Physical examination was performed. Dual-energy X-ray absorptiometry (iDXA, GE Lunar) was used to measure lean mass, fat mass, body fat percentage (% BF), bone mineral content (BMC), total body bone mineral density (BMD). Sarcopenia was defined when appendicular lean mass (ALM) divided to squared height was less than 7.26 kg/m2. Obesity was based on the relative fat mass, and it was defined as percentage of body fat greater than 27%. Osteoporosis was defined using World Health (WHO) definition, when T-score was

≤ -2.5 at the lumbar spine or total hip. In case of the combination of sarcopenia and obesity subjects were classified as sarcopenic-obese. Subjects with sarcopenia and os-teoporosis were called sarco-osteoporotic. Handgrip strength as a surrogate measure-ment of total body strength was used. All subjects performed three maximum attempts for dominant handgrip strength measurements with handle dynamometer (Presision Druck, Germany) and the mean value of these trials was recorded in kilograms (kg). Statistical analysis was carried out using SPSS version 18.0 for Windows. Differences between groups at the 5% significance level (p < 0.05) were assessed by LSD post hoc probability test for multiple comparisons. Simple correlations were determined using Pearson’s correlation coefficient.

Coefficients of correlations between body composition components and handgrip strength in men with sarcopenia, sarcopenic-obesity and sarco-osteoporosis were cal-culated for further analysis (Table 2).

There were positive significant correlations between lean mass and handgrip strength in sarcopenic, sarcopenic-obese and sarco-osteoporotic men. This study revealed pos-tive correlation between bone mineral content and handgrip strength in sarcopenic men.

RESULTSOf all men investigated, 31 subjects were sarcopenic, 16 - sarcopenic-obese and 11

men had sarco-osteoporosis. Distribution of body composition types in percentage is shown in figure 1.

Descriptive data of the study subjects are shown in table 1. The smallest handgrip strength was determined in sarco-osteoporosis group (p=0.03). Using one-way ANO-VA test the statistically significant handgrip strength difference was found between sar-copenic, sarcopenic-obese, and sarco-osteoporotic men (p=0.04). Post hoc analysis re-vealed the statistically significant difference of handgrip strength between sarcopenic and sarco-osteoporotic men (Table 1).

Data are presented as mean ± SD; SD – standard deviation; BMI – body mass index; BF – body fat;BMD – bone mineral density.

Table 1. Descriptive basic characteristics of the study subjects

Characteristic, units of measurements

Sarcopenicmen

(n =31)

Sarcopenic-obese men

(n=16)

Sarco-osteoporotic men

(n=11)

p

value

Age (year) 75.8 ± 7.6 80.6 ± 4.1 76.8 ± 8.1 0.18

BMI (kg/m2) 25.2 ± 3.9 26.1 ± 3.5 22.1 ±4.2 0.001

Fat mass (kg) 20.9 ± 9.7 23.7 ± 4.5 19.1 ± 8.5 0.001

BF (%) 27.4 ± 9.6 33.8 ± 3.7 28.4 ± 9.4 0.002

BMC (kg) 2.7 ± 0.5 2.4 ± 0.2 2.3 ± 0.3 0.001

Total body BMD (g/cm2) 1.088 ± 0.209 1.033 ±0.574 1.033 ± 0.117 0.001

Handgrip strength (kg) 26.9 ± 9.9 28.5 ± 9.6 26.4 ± 11.1 0.001

r – correlation coefficient; BMC – bone mineral content.

Table 2. Correlations between body composition components and handgrip strength in men according to type of body composition

Characteristic, unitsof measurements

Type of body composition

Sarcopenic (n = 31)

Sarcopenic-obese (n = 16)

Sarco-osteoporotic(n = 11)

r p value r p value r p value

Lean mass (kg) 0.5 0.001 0.9 0.03 0.8 0.001

Fat mass (kg) 0.2 0.6 0.4 0.3 -0.2 0.5

BMC (kg) 0.4 0.001 0.3 0.4 0.5 0.2

ACNOWLEDGMENTSWe would like to thank Audrone Misiunaite, Edita Merkeliuniene for the skillful per-forming of the body composition measurements, and Elvyra Stapcinskiene for valuable assistance in coordination of this study.

IOF Regionals – 2nd Middle East & Africa Osteoporosis Meeting & 6th Pan Arab Osteoporosis Congress, PAOC’6

*Contact address: asta.mastaviciute@osteo.lt

Figure 1. Distribution of body composition types in the study population

53.4%27.6%

19%

sarcopenic men

sarcopenic-obese men

sarco-osteoporotic men

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