Low bone mineral density in middle-aged women: a red flag for sarcopenia

OBJECTIVE: This study evaluated whether low bone density, a condition related to aging, is associated with low muscle mass, a surrogate for sarcopenia, and whether it could be used as a marker of the condition. METHODS: We studied 483 women aged 35 to 69 years old who appeared healthy and attended a preventive gynecological examination. Dual-energy X-ray absorptiometry was used to measure bone mineral density (BMD) and regional body composition. BMD was assessed using the T-score. Low appendicular lean mass (aLM) adjusted by height (aLM index) was defined according to Baumgartner et al (<5.45 kg/m). The association of low aLM index with bone mass was evaluated with a binary logistic regression using a cutoff point on the receiver operating characteristic curves for the T-score of -1.5. RESULTS: The participants had a mean age of 54.7 ± 9.1 years, body mass index of 24.6 ± 3.6 kg/m, aLM index of 5.9 ± 0.6 kg/m (22.6% showed sarcopenia), abdominal fat percentage of 44.0 ± 9.1%, and T-score of -0.48 ± 0.97. In the logistic regression model, we found that low BMD implied a significant risk for sarcopenia (odds ratio [OR] 1.77; 95% CI, 1.02-3.06). In contrast, excess body weight was a protective factor (OR 0.12; 95% CI, 0.06-0.25). Neither age nor abdominal fat percentage, however, influenced the likelihood of sarcopenia in these women. CONCLUSIONS: A BMD T-score below -1.5 suggests low muscle mass in middle-aged women, which is a central element in the diagnosis of sarcopenia. Early diagnosis provides the opportunity to introduce preventive and therapeutic options.