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Risk factors for osteosarcopenia in postmenopausal women with osteoporosis

Key clinical point: Postmenopausal osteoporotic women with low body mass index (BMI) have a higher risk of developing osteosarcopenia. Moreover, appropriate assessments, including the presence of comorbidities, will help in identifying patients at a greater risk of developing osteosarcopenia, especially for patients aged 65-74 years.

Major finding: Patients with osteosarcopenia had a higher risk of frailty vs. those with osteoporosis alone (odds ratio [OR], 2.33; P = .028). BMI (per 1 kg/m2 decrease) seemed to be the strongest factor associated with osteosarcopenia risk (adjusted OR [aOR], 1.71; P less than .01). In patients aged 65-74 years, estimated glomerular filtration rate (per 10 mL/min/1.73m2 decrease) and glycated hemoglobin (per 1% decrease) were identified as independent predictors of osteosarcopenia (aOR, 1.75; P = .01 and aOR, 5.01; P = .01, respectively).

Study details: The data come from a retrospective study of 276 patients with postmenopausal osteoporosis (osteoporosis alone: n=222 and osteosarcopenia: n=54).

Disclosures: The study was supported by grants awarded to Dr. Koji Ishikawa by KAKENHI and Grant of Japan Orthopaedics and Traumatology Research Foundation. The authors declared no conflicts of interest.


“Osteosarcopenia refers to the co-existence of osteoporosis and sarcopenia. The factors associated with the development of osteosarcopenia are not well understood. This single-center retrospective cross-sectional study conducted in Japan included 276 patients with postmenopausal osteoporosis who were included based on age over 65 years old, lack of severe chronic kidney disease requiring hemodialysis, and availability of physical performance measurements, bone density measurements, laboratory data, fall risk score, and frailty score. Participants had mean age of 77.07 ± 6.74 years and 54 (19.6%) had osteosarcopenia. Patients with osteosarcopenia had 2.33-fold higher odds of frailty compared to those with osteoporosis alone. Lower BMI was the strongest risk factor associated with osteosarcopenia risk in people in the 75–84 and ≥ 85 years groups. In patients aged 65-74 years, lower BMI, kidney dysfunction and abnormal glycated hemoglobin were identified as independent predictors of osteosarcopenia. These findings suggest the importance of evaluating women with lower BMI and comorbidities (e.g., chronic kidney disease, and pre- and diabetes) for the presence of osteosarcopenia.”

Maria I. Danila, MD, MSc, MSPH

University of Alabama at Birmingham


Okamura H et al. PLoS One. 2020 Aug 7. doi: 10.1371/journal.pone.0237454.