Sarcopenic Obesity Worsens Bone Strength: Hip Strength Analysis in Post-Menopausal Women

Objective: The aim of this retrospective case-control study is to investigate the influence of sarcopenic obesity on hip bone strength indices: femoral strength index (FSI), cross-sectional moment of inertia (CSMI), cross-sectional area (CSA), section modulus (z), and buckling ratio (BR). Setting: Outpatient Clinic University Hospital. Participants: Participants were recruited among patients who were assessed for osteoporosis using DXA method from January 2011 to December 2013. Inclusion criteria were: post-menopausal women aged 50 years or older; BMI 30 kg/m2 . We classified all the included patients in sarcopenic obese and non sarcopenic obese following Newman’s criteria based on appendicular lean mass adjusted for height and body fat mass (residuals). Main Outcome Measures: We performed a hip structural analysis (HSA) from hip DXA images to measure FSI, CSMI, CSA, z, and BR. Results: We evaluated 127 women mean aged 63.50 years 8.69 SD (min. 50 years; max. 84 years) with a mean BMI of 34.27 kg/m2 4.01 SD (min. 30.04; max. 53.97). Forty-five sarcopenic obese patients (35.43%) had a mean FSI of 1.17 0.33 SD, a mean CSMI of 9613 mm4 2403 SD, a mean CSA of 134 mm2 23 SD, a mean z of 556 mm3 113 SD and a mean BR of 9.11 4.23 SD. Eighty-two non sarcopenic obese patients (64.57%) had a mean FSI of 1.30 0.30 SD, a mean CSMI of 9886 mm4 1970 SD, and a mean CSA of 135 mm2 21 SD, a mean z of 571 mm3 102 SD and a mean BR of 7.11 2.67 SD. Conclusions: In our cohort of post-menopausal women, sarcopenic obese patients had worse bone quality and strength