Clinical impact of osteosarcopenia on mortality, physical function and chronic inflammation: a 9-year follow up cohort study

Walter Sepúlveda Loyola; Jaqueline de Barros Morselli; F. Araya Quintanilla; Denilson Teixeira; Alejandro Álvarez Bustos; Mario Molari; Juan José Valenzuela; Vanessa Suziane Probst

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Clinical impact of osteosarcopenia on mortality, physical function and chronic inflammation: a 9-year follow up cohort study

Walter sepulveda loyola ^[1] ; Jaqueline de Barros Morselli ^[4] ; Felipe Araya-Quintanilla ^[2] ; Denilson Teixeira ^[4] ; Alejandro Alvarez-Bustos ^[5] ; Mario Molari ^[4] ; Juan José Valenzuela- Fuenzalida ^[3] ; Vanessa Suziane Probst ^[4]
1. [1] Universidad de las Américas
  
  Universidad de las Américas
  
  Santiago, Chile
2. [2] Universidad San Sebastián
  
  Universidad San Sebastián
  
  Comuna de Concepción, Chile
3. [3] Universidad Andrés Bello
  
  Universidad Andrés Bello
  
  Santiago, Chile
4. [4] Program of Masters and Doctoral degree in Rehabilitation Sciences, Londrina State University (UEL) and University of Northern Parana (UNOPAR), Londrina, Brazil.
5. [5] Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, Madrid, Spain.
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Localización: Nutrición clínica y dietética hospitalaria, ISSN 0211-6057, Vol. 43, Nº. 4, 2023, págs. 133-140
Idioma: inglés
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- Objective: This study aimed to determine the impact of osteosarcopenia on important clinical and functional outcomes in older adults.
  
  Methods: 242 community-dwelling older adults from the study on ageing and longevity (ELLO data from 2009 to 2018). Subjects underwent body composition analysis by dual energy X-ray absorptiometry and bioelectrical impedance, and assessments for aerobic capacity and muscle strength including the incremental shuttle walking test (ISWT), 6-minutes walking test (6MWT), handgrip strength (HGS) and sit-to stand test (STS). Static balance was assessed by one-legged stance test (OLST) and chronic inflammation by IL-6 and tumor necrosis factor alpha (TNF-α). Osteosarcopenia was defined as low bone mineral density (BMD) (T-score<-1) combined with low phase angle (PhA). Comparisons were run with Students T test and Man-Whitney test. Survival probabilities were estimated using the Kaplan-Meier method. Receiver operating characteristic curve was used to analyze the association of PhA with mortality and to find the best cut-point.
  
  Results: The proportion of individuals who died in a 9-year follow up was higher in individuals with Osteosarcopenia (25%) compared to without osteosarcopenia (9%) (p=0.015). Osteosarcopenia was associated with mortality (HR: 1.4; 95% CI 1.02 - 1.29; p = 0.0151). Subjects with osteosarcopenia compared to without it presented worse performance in the ISWT (514 ±19 m vs. 621 ± 16 m), 6MWT (515 ± 7 m vs. 538 ± 6 m, p< 0.05), OLST (13.5 ±10.2 s vs.16.7 ±8.3 s) and HGS (25 ± 7 Kg vs. 28 ± 9 K5); p< 0.05 for all. The cut point used to PhA was ≤ 6.07º for both male and female (AUC: 0.687; Sensibility: 64% and Specificity: 61% for mortality).
  
  Conclusion: Osteosarcopenia diagnosed with low phase angle combined with low BMD is highly associated with mortality. Additionally, older adults with osteosarcopenia presented worse aerobic capacity, balance and muscle strength.