Resumen de Risk of Fracture in Women with Sarcopenia, Low Bone Mass, or Both

Rebekah Harris, Yuefang Chang, Kristen Beavers, Deepika Laddu Patel, Jennifer Bea-, Karen C. Johnson, Meryl S. Leboff, Catherine Womack, Robert B. Wallace, Wenjun Li, Carolyn J. Crandall, Jane A. Cauley

• Objectives:

  To determine whether women with sarcopenia and low bone mineral density (BMD) are at greater risk of clinical fractures than those with sarcopenia or low BMD alone.

  Design:

  Women's Health Initiative (WHI) Observational and Clinical trials.

  Setting:

  Three U.S. clinical centers (Pittsburgh, PA; Birmingham, AL; Phoenix/Tucson, AZ).

  Participants:

  Women (mean age 63.3 ± 0.07) with BMD measurements (N = 10,937).

  Measurements:

  Sarcopenia was defined as appendicular lean mass values corrected for height and fat mass. Low BMD was defined as a femoral neck T-score less than −1.0 based on the Third National Health and Nutrition Examination Survey reference database for white women. Cox proportional hazards analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). We followed women for incident fractures over a median of 15.9 years.

  Results:

  Participants were classified into mutually exclusive groups based on BMD and sarcopenia status: normal BMD and no sarcopenia (n = 3,857, 35%), sarcopenia alone (n = 774, 7%), low BMD alone (n = 4,907, 45%), and low BMD and sarcopenia (n = 1,399, 13%). Women with low BMD, with (HR = 1.72, 95% CI = 1.44–2.06) or without sarcopenia (HR = 1.58, 95% CI = 1.37–1.83), had greater risk of fracture than women with normal BMD; the difference remained statistically significant after adjustment for important covariates. Women with low BMD, with (HR = 2.78, 95% CI = 1.78–4.30 and without (HR = 2.42, 95% CI = 1.63–3.59) sarcopenia had higher risk of hip fractures. Women with sarcopenia alone had similar HRs to women with normal BMD.

  Conclusion:

  Compared to women with normal BMD.