Relationship of sarcopenia and body composition with osteoporosis

H. He, Y. Liu, Q. Tian, C. J. Papasian, T. Hu, H. W. Deng

Research output: Contribution to journalArticlepeer-review

133 Scopus citations


Summary: The purpose of the study is to investigate the relationship between sarcopenia and body composition and osteoporosis in cohorts of three different races with a total of 17,891 subjects. Lean mass and grip strength were positively associated with bone mineral densities (BMDs). Subjects with sarcopenia were two times more likely to have osteoporosis compared with normal subjects. Introduction: The relationship between sarcopenia and osteoporosis is not totally clear. First, the present study assessed this relationship by using two different definitions for sarcopenia. Second, we examined the associations of body composition (including muscle mass as a major and important component) and muscle strength on regional and whole-body BMDs. Methods: In total, 17,891 subjects of African American, Caucasian, and Chinese ethnicities were analyzed. Sarcopenia was defined by relative appendicular skeletal muscle mass (RASM) cut points and also by the definition of the European Working Group on Sarcopenia in Older People (low RASM plus low muscle function). Multiple regression analyses were conducted to examine the association of fat mass, lean mass (including muscle mass), and grip strength with regional and whole-body BMDs. Multivariate logistic regression analysis was performed to explore the association between sarcopenia and osteopenia/osteoporosis. Results: BMDs were positively associated with lean mass and negatively associated with fat mass, after controlling for potential confounders. Grip strength was significantly associated with higher BMDs. Each standard deviation (SD) increase in RASM resulted in a ~37 % reduction in risk of osteopenia/osteoporosis (odds ratio (OR) = 0.63; 95 % confidence interval (CI) = 0.59, 0.66). Subjects with sarcopenia defined by RASM were two times more likely to have osteopenia/osteoporosis compared with the normal subjects (OR = 2.04; 95 % CI = 1.61, 2.60). Similarly, subjects with sarcopenia (low muscle mass and low grip strength) were ~1.8 times more likely to have osteopenia/osteoporosis than normal subjects (OR = 1.87; 95 % CI = 1.09, 3.20). Conclusions: High lean mass and muscle strength were positively associated with BMDs. Sarcopenia is associated with low BMD and osteoporosis.

Original languageEnglish (US)
Pages (from-to)473-482
Number of pages10
JournalOsteoporosis International
Issue number2
StatePublished - Feb 1 2016

Bibliographical note

Funding Information:
We appreciate all study participants who provided with phenotypic information. We would like to thank all staff who provided the clinical expertise, collected, and managed the data. We appreciate suggestions from Dr. Jian Li. This work was partially supported by grants from the National Institutes of Health (P50AR055081, R01AG026564, R01AR050496, RC2DE020756, R01AR057049, and R03TW008221) and startup funds from Tulane University and University of Missouri-Kansas City.

Publisher Copyright:
© 2015, International Osteoporosis Foundation and National Osteoporosis Foundation.


  • Body composition
  • Muscle strength
  • Osteoporosis
  • Relative appendicular skeletal muscle mass
  • Sarcopenia


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