Skip to main content
SpringerLink
Log in

Osteosarcopenic obesity is associated with reduced handgrip strength, walking abilities, and balance in postmenopausal women

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

We determined the prevalence of osteosarcopenic obesity (loss of bone and muscle coexistent with increased adiposity) in overweight/obese postmenopausal women and compared their functionality to obese-only women. Results showed that osteosarcopenic obese women were outperformed by obese-only women in handgrip strength and walking/balance abilities indicating their higher risk for mobility impairments.

Introduction

Osteosarcopenic obesity (OSO) is a recently defined triad of osteopenia/osteoporosis, sarcopenia, and adiposity. We identified women with OSO in overweight/obese postmenopausal women and evaluated their functionality comparing them with obese-only (OB) women. Additionally, women with osteopenic/osteoporotic obesity (OO), but no sarcopenia, and those with sarcopenic obesity (SO), but no osteopenia/osteoporosis, were identified and compared. We hypothesized that OSO women will have the lowest scores for each of the functionality measures.

Methods

Participants (n = 258; % body fat ≥35) were assessed using a Lunar iDXA instrument for bone and body composition. Sarcopenia was determined from negative residuals of linear regression modeled on appendicular lean mass, height, and body fat, using 20th percentile as a cutoff. Participants with T-scores of L1–L4 vertebrae and/or total femur <−1, but without sarcopenia, were identified as OO (n = 99) and those with normal T-scores, but with sarcopenia, as SO (n = 28). OSO (n = 32) included women with both osteopenia/osteoporosis and sarcopenia, while those with normal bone and no sarcopenia were classified as OB (n = 99). Functionality measures such as handgrip strength, normal/brisk walking speed, and right/left leg stance were evaluated and compared among groups.

Results

Women with OSO presented with the lowest handgrip scores, slowest normal and brisk walking speed, and shortest time for each leg stance, but these results were statistically significantly different only from the OB group.

Conclusion

These findings indicate a poorer functionality in women presenting with OSO, particularly compared to OB women, increasing the risk for bone fractures and immobility from the combined decline in bone and muscle mass, and increased fat mass.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ilich JZ, Kelly OJ, Inglis JI, Panton LB, Duque G, Ormsbee MJ (2014) Interrelationship among muscle, fat, and bone: connecting the dots on cellular, hormonal, and whole body levels. Ageing Res Rev 15:51–60

    Article  CAS  PubMed  Google Scholar 

  2. Ormsbee MJ, Prado CM, Ilich JZ, Purcel S, Siervo M, Folsom A, Panton L (2014) Osteosarcopenic obesity: the role of bone, muscle and fat in health. J Cachexia Sarcopenia Mus 5:183–192

    Article  Google Scholar 

  3. Walsh MC, Hunter GR, Livingstone MC (2006) Sarcopenia in premenopausal and postmenopausal women with osteopenia, osteoporosis and normal bone mineral density. Osteoporos Int 17:61–67

    Article  PubMed  Google Scholar 

  4. International Osteoporosis Foundation. www.iofbonehealth.org/facts-statistics. Accessed August 2014

  5. Kanis JA, McCloskey EV, Johansson H, Oden A, Strom O, Borgstrom F (2010) Development and use of FRAX in osteoporosis. Osteoporos Int 21(Suppl 2):S407–S441

    Article  PubMed  Google Scholar 

  6. Roux S, Cabana F, Carrier N, Beaulieu M, April PM, Beaulieu MC, Boire G (2014) The World Health Organization fracture risk assessment tool (FRAX) underestimates incident and recurrent fractures in consecutive patients with fragility fractures. Clin Endocrinol Metab 7:2400–2408

    Article  Google Scholar 

  7. Bolland MJ, Siu AT, Mason BH, Horne AM, Ames RW, Grey AB, Gamble GD, Reid IR (2011) Evaluation of the FRAX and Garvan fracture risk calculators in older women. J Bone Miner Res 26:420–427

    Article  PubMed  Google Scholar 

  8. Newman AB, Kupelian V, Visser M, Simonsick E, Goodpaster B, Nevitt M, Kritchevsky SB, Tylavsky FA, Rubin SM, Harris TB (2003) Sarcopenia: alternative definitions and associations with lower extremity function. J Amer Geriatric Soc 51:1602–1609

    Article  Google Scholar 

  9. Binkley N, Krueger D, Buehrin B (2013) What’s in a name revisited: should osteoporosis and sarcopenia be considered components of “dysmobility syndrome?”. Osteoporos Int 24:2955–2959

    Article  CAS  PubMed  Google Scholar 

  10. Shin H, Liu PY, Panton LB, Ilich JZ (2014) Physical performance in relation to body composition and bone mineral density in healthy, overweight and obese postmenopausal women. J Ger Phys Therapy 37:7–16

    Article  Google Scholar 

  11. Shin H, Panton LB, Dutton GR, Ilich JZ (2011) Relationship of physical performance with body composition and bone mineral density in individuals over 60 years of age: a systematic review. J Aging Res. doi:10.4061/2011/191896

    PubMed Central  PubMed  Google Scholar 

  12. Lindsey C, Brownbill RA, Bohannon RA, Ilich JZ (2005) Association of physical performance measures with bone mineral density in postmenopausal women. Arch Phys Med Rehab 86:1102–1107

    Article  Google Scholar 

  13. Savino E, Martini E, Lauretani F, Pioli G, Zagatti AM, Frondini C, Pellicciotti F, Giordano A, Ferrari A, Nardelli A, Davoli ML, Zurlo A, Lunardelli ML, Volpato S (2013) Handgrip strength predicts persistent walking recovery after hip fracture surgery. Am J Med 126:1068–1075

    Article  PubMed  Google Scholar 

  14. Cruz-Jentoft AJ, Landi F, Schneider SM, et al. (2014) Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing. 2014; pii: afu115

  15. Lusardi MM (2012) Is walking speed a vital sign? Absolutely! Top Ger Rehab 28:67–76

    Article  Google Scholar 

  16. Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, Garry PJ, Lindeman RD (1998) Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 147:755–763

    Article  CAS  PubMed  Google Scholar 

  17. Domiciano D, Figueiredo C, Lopes J, Caparbo V, Takayama L, Menezes P, Bonfak E, Pereirak R (2012) Discriminating sarcopenia in community-dwelling older women with high frequency of overweight/obesity: the Sao Paulo Ageing & Health Study (SPAH). Osteoporos Int 24:595–603

    Article  PubMed  Google Scholar 

  18. Lourenco R, Perez-Zepeda M, Gutierrez-Robledo L, Rodriguez-Manas L, Garcia-Garcia F (2015) Performance of the European Working Group on Sarcopenia in Older People algorithm in screening older adults for muscle mass assessment. Age Ageing 44:334–8. doi:10.1093/ageing/afu192

    Article  PubMed  Google Scholar 

  19. Ilich JZ, Brownbill RA (2008) Habitual and low-impact activities are associated with better bone outcomes and lower body fat in older women. Calcif Tissue Int 83:260–271

    Article  CAS  PubMed  Google Scholar 

  20. Institute of Medicine of the National Academies (2012) Dietary reference intakes for calcium and vitamin D. Report. National Academy of Sciences, USA

    Google Scholar 

  21. Dufour AB, Hannan MT, Murabito JM, Kielk DP, McLean RR (2013) Sarcopenia definitions considering body size and fat mass are associated with mobility limitations: the Framingham Study. J Gerontol A Biol Sci Med Sci 68:168–174

    Article  PubMed Central  PubMed  Google Scholar 

  22. Liu P-Y, Ilich JZ, Brummel-Smith K, Ghosh S (2014) New insight into fat, muscle and bone relationship in women: determining the threshold at which body fat assumes negative relationship with bone mineral density. Inter J Prev Med 5:1452–1463

    Google Scholar 

  23. American Society of Bariatric Physicians (ASBP) (2015) Obesity algorithm. http://www.asbp.org/obesityalgorithm.html

  24. Shah NR, Braverman ER (2012) Measuring adiposity in patients: the utility of body mass index (BMI), percent body fat, and leptin. PLoS ONE 7(4):e33308. doi:10.1371/journal.pone.0033308

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. Peterson MD, Al Snih S, Stoddard J, Shekar A, Hurvitz E (2014) Obesity misclassification and the metabolic syndrome in adults with functional mobility impairments: Nutrition Examination Survey 2003-2006. Prev Med 60:71–76

    Article  PubMed Central  PubMed  Google Scholar 

  26. Lagari VS, Gómez-Marín O, Levis S (2014) Study design and baseline characteristics of participants in the vitamin D in vulnerable adults at the VA (the VIVA Study). Contemp Clin Trial 39:66–73

    Article  Google Scholar 

  27. Shin H, Shin J, Liu P-Y, Dutton GR, Abood DA, Ilich JZ (2011) Self efficacy improves weight loss in overweight/obese postmenopausal women during a 6-month weight loss intervention. Nutr Res 31:822–828

    Article  CAS  PubMed  Google Scholar 

  28. Beaupre LA, Binder EF, Cameron ID, Jones AC, Orwig D, Sherrington C, Magaziner J (2013) Maximizing functional recovery following hip fracture in frail seniors. Best Pract Res Clin Rheumatol 27:771–788

    Article  PubMed  Google Scholar 

  29. Theou O, Jones GR, Jakobi JM, Mitnitski A, Vandervoort AA (2011) A comparison of the relationship of 14 performance-based measures with frailty in older women. Appl Physiol Nutr Metab 36:928–938

    Article  PubMed  Google Scholar 

  30. Viana JU, Silva SLA, Torres JL, Dias JMD, Pereira LSM, Dias RC (2013) Influence of sarcopenia and functionality indicators on the frailty profile of community-dwelling elderly subjects: a cross-sectional study. Braz J Phys Ther 17:373–381

    Article  PubMed  Google Scholar 

  31. De Laet C, Kanis J, Odén A, Johanson H, Johnell O, Delmas P, Eisman JA, Kroger H, Fujiwara S, Garnero P, McCloskey EV, Mellstrom D, Melton LJ, Meunier PJ, Pols HA, Reeve J, Silman A, Tenenhouse A (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338

    Article  PubMed  Google Scholar 

  32. Lang T, Cauley J, Tylavsky F, Bauer D, Cummings S, Harris T (2010) Computed tomographic measurements of thigh muscle cross-sectional area and attenuation coefficient predict hip fracture: the health, aging, and body composition study. J Bone Miner Res 25:513–519

    Article  PubMed Central  PubMed  Google Scholar 

  33. Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM (2001) C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 286:327–334

    Article  CAS  PubMed  Google Scholar 

  34. Liu P, Hornbuckle L, Panton L, Kim J, Ilich J (2012) Evidence for the association between abdominal fat and cardiovascular risk factors in overweight and obese African American women. J Am Coll Nutr 31:126–132

    Article  CAS  PubMed  Google Scholar 

  35. Ilich JZ, Kelly OJ, Kim Y, Spicer MT (2014) Low-grade chronic inflammation perpetuated by modern diet as a promoter of obesity and osteoporosis. Arch Indust Hygiene Toxicol 65:139–148

    CAS  Google Scholar 

  36. Coombs WT, Algina J, Oltman D (1996) Univariate and multivariate omnibus hypothesis tests selected to control type I error rates when population variances are not necessarily equal. Rev Educ Res 66:137–179

    Article  Google Scholar 

  37. Zimmerman DW, Zumbo BN (1993) Rank transformations and the power of the Student t test and Welch t’ test for non-normal populations. Can J Exp Psychol 47:523

    Article  Google Scholar 

Download references

Acknowledgments

This work was funded in part by the USDA grant (2004-05287) and the Hazel K. Stiebeling Fellowship award.

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Department of Nutrition, Food and Exercise Sciences, Florida State University, 120 Convocation Way, 418 Sandels Building, Tallahassee, FL, 32306-1493, USA

    J. Z. Ilich & J. E. Inglis

  2. Abbott Nutrition, Scientific and Medical Affairs, Columbus, OH, 43219, USA

    O. J. Kelly

  3. Department of Statistics, Florida State University, Tallahassee, FL, 32306, USA

    D. L. McGee

Authors
  1. J. Z. Ilich
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. E. Inglis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. O. J. Kelly
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. L. McGee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Z. Ilich.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ilich, J.Z., Inglis, J.E., Kelly, O.J. et al. Osteosarcopenic obesity is associated with reduced handgrip strength, walking abilities, and balance in postmenopausal women. Osteoporos Int 26, 2587–2595 (2015). https://doi.org/10.1007/s00198-015-3186-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-015-3186-y

Keywords

Search

Navigation