Higher skeletal muscle mass predicts reduced minimal trauma fracture and greater bone mineral density in australian post-menopausal women — ASN Events
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  3. Higher skeletal muscle mass predicts reduced minimal trauma fracture and greater bone mineral density in australian post-menopausal women

Higher skeletal muscle mass predicts reduced minimal trauma fracture and greater bone mineral density in australian post-menopausal women (#41)

David M Medveczky 1 2 3 , Tripti Joshi 1 , Lili Yuen 1 , Marcus Wong 3
  1. Gosford Hospital, Gosford, NSW, Australia
  2. Royal Prince Alfred Hospital, Sydney, NSW, Australia
  3. University of Newcastle, Newcastle, NSW, Australia

Ageing and menopause in combination are associated with an accelerated loss of skeletal muscle mass (SMM) with corresponding increase in fat mass (FM), which may contribute to increased fracture risk and bone mineral density (BMD) loss. However, studies investigating the relationships between SMM, FM, BMD and minimal trauma fracture (MTF) have reported variable findings. We performed a cross-sectional study of post-menopausal, treatment naïve women aged 50-75 years referred to our osteoporosis refracture prevention (ORP) program with DEXA-derived body composition data available from September 2022 to December 2024. Relative skeletal muscle index (RSMI) (kg/m2) was used to estimate SMM. Modelling was performed controlling for traditional risk factors for MTF and BMD loss. 93 patients were included. Average age was 63.4±6 years old with mean age at menopause of 48.5±5.3 years.100% of patients were Caucasian. Mean BMI was 28.7±6 kg/m2 with mean body fat percentage 44.8±7.0% and mean RSMI 6.65±1.15 kg/m2. The majority of fractures were appendicular (88%). 73.1% sustained MTF (vs traumatic fracture) with approximately 20% reporting prior MTF. Only patients presenting with MTF reported prior MTF. Approximately 50% of patients reported ≥1 hour of weight bearing exercise/week and approximately 33% reported ≥1 hour of strengthening exercise/week. Patients reported mean intake of 2.7±0.6 serves of dietary calcium daily. Mean BMD at the total right and left hips showed osteopaenia (0.88 ± 0.12 g/cm2, T score -1.31±0.91 and 0.87 ± 0.13 g/cm2, T score -1.39±0.95 respectively) and 25% had radiological osteoporosis. RSMI was negatively associated with MTF (OR 0.29 (95% CI 0.08-0.96), p-value=0.04) alongside exercise and bone mineral density. RSMI was positively associated with BMD at the lumbar spine (ß=0.06, p-value=0.01), average total hip (ß=0.04, p-value=0.02) and total body (ß=0.05, p-value≤0.001). Body fat (kg) was not associated with MTF or BMD in our modelling. In conclusion, RSMI was a significant negative predictor of MTF and positive predictor of BMD while FM was non-contributory. This study supports the benefit of assessing SMM in patients attending ORP programs. Future prospective studies may focus on the preservation of SMM and function in ORP programs and potential benefits of reducing fracture risk and BMD loss.