Risk of sarcopenia in subjects with osteoporosis and osteoarthritis

The study aimed to determine the relationship between the risk of sarcopenia (SP) and common age-related diseases of the musculoskeletal system, such as osteoporosis (OP) and osteoarthritis (OA). There were examined 460 women aged 50-85 years (mean age 66.4 ± 8.8 years) and they were divided into 4 groups. Group I included 176 women without bone and joint diseases (BJD); Group II included 137 persons with a diagnosis of systemic OP; Group III included 95 subjects with knee and/or hip OA (2nd-3rd degree of Kellgren-Lawrence grades); IV group included 52 females with OP and large joints OA (2nd-3rd degree of Kellgren-Lawrence grades). Bone mineral density (BMD) and trabecular bone score (TBS) were determined in all patients using dual-energy X-ray absorptiometry (DXA), which was subsequently taken into account in the calculation of the 10-year probability of the major osteoporotic fractures according to the Ukrainian version of FRAX®. The following questionnaires were used: SARC-F, IADL, Desmond Fall Risk Questionnaire, and KOOS-12. Also, we used the chair stand test (5 times sit-to-stand) and hand grip dynamometer test. The frequency of persons with risk of SP in Group I was 20.3 %, and it was significantly higher in women with OP (33.5 %, χ2= 6.9 [3.4 – 23.0], p < 0.05), subjects with OA (34.7 %, χ2= 6.7 [3.4 – 25.7], p < 0.05), and women with combined pathology (44.2 %, χ2= 12.1 [9.8 – 38.2], p < 0.05). In patients with OA and risk of SP, pain intensity was significantly higher (43.7 [31.3 – 62.5] points compared to patients with OA without risk of SP - 68.8 [50.0 – 93.8] points, Z = 3.6, p < 0.05), as well as function, and daily living (43.8 [31.3 – 68.8] and 75.0 [56.3 – 100.0] points, respectively, Z = 4.1, p < 0.05 and quality of life 43.8 [37.5 – 62.8] and 75.0 [43.8 – 87.5] points, respectively (Z = 3.0, p < 0.05) according to the KOOS-12. The probability of the major OP fracture was significantly higher in the group of OP and risk of SP (11.0 [8.5 – 12.0] % compared to patients with OP without risk of SP - 8.1 [5.4 – 10.0] %, Z = - 3.8, p < 0.05). The same differences were found for the 10-year probability of hip fracture (5.0 [2.8 – 7.3] and 2.1 [1.5 – 3.5] %, respectively, Z = - 4.9, p < 0.05). High Risk of SP, falls and the need for external assistance were recorded significantly more often in women with OP pathology, and their skeletal muscle strength was significantly lower. Women with a high risk of SP had significantly lower skeletal muscle strength (according to hand grip dynamometry), a higher risk of falls and fractures, and a greater need for assistance. The combination of a risk of SP and OA was associated with more severe joint pain intensity, lower function, and quality of life, and the risk of SP and OP combination was associated with a higher risk of OP fracture. _________________________________________________________________________________________ Keywords: sarcopenia; osteoporosis; osteoarthritis; FRAX; fracture; fall; pain; quality of life.