Determination of Cutoff Values for the Screening of Osteosarcopenia in Obese Postmenopausal Women

Osteosarcopenic obesity (OSO) describes the concurrent presence of obesity, low bone mass, and low muscle mass in an individual. Currently, no established criteria exist to diagnose OSO. We hypothesized that obese individuals require different cut-points from standard cut-points to define low bone mass and low muscle mass due to their higher weight load. In this study, we determined cutoff values for the screening of osteosarcopenia (OS) in obese postmenopausal Malaysian women based on the measurements of quantitative ultrasound (QUS), bioelectrical impedance analysis (BIA), and functional performance test. Then, we compared the cutoff values derived by 3 different statistical modeling methods, (1) receiver operating characteristic (ROC) curve, (2) lowest quintile of the study population, and (3) 2 standard deviations (SD) below the mean value of a young reference group, and discussed the most suitable method to screen for the presence of OS in obese population. One hundred and forty-one (n = 141) postmenopausal Malaysian women participated in the study. Bone density was assessed using calcaneal quantitative ultrasound. Body composition was assessed using bioelectrical impedance analyzer. Handgrip strength was assessed using a handgrip dynamometer, and physical performance was assessed using a modified Short Physical Performance Battery test. ROC curve was determined to be the most suitable statistical modeling method to derive the cutoffs for the presence of OS in obese population. From the ROC curve method, the final model to estimate the probability of OS in obese postmenopausal women is comprised of five variables: handgrip strength (HGS, with area under the curve (AUC) = 0.698 and threshold ≤ 16.5 kg), skeletal muscle mass index (SMMI, AUC = 0.966 and threshold ≤ 8.2 kg/m2), fat-free mass index (FFMI, AUC = 0.946 and threshold ≤ 15.2 kg/m2), broadband ultrasonic attenuation (BUA, AUC = 0.987 and threshold ≤ 52.85 dB/MHz), and speed of sound (SOS, AUC = 0.991 and threshold ≤ 1492.15 m/s). Portable equipment may be used to screen for OS in obese women. Early identification of OS can help lower the risk of advanced functional impairment that can lead to physical disability in obese postmenopausal women.

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Faculty Opinions recommendation of Parathyroid hormone(1-84) treatment of postmenopausal women with low bone mass receiving hormone replacement therapy.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1123343.581334 ◽

2008 ◽

Author(s):

Mark Johnson ◽

Cielo Barragan

Keyword(s):

Parathyroid Hormone ◽

Hormone Replacement Therapy ◽

Bone Mass ◽

Replacement Therapy ◽

Postmenopausal Women ◽

Hormone Replacement ◽

Low Bone Mass

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Faculty Opinions recommendation of Comparison of the effect of denosumab and alendronate on BMD and biochemical markers of bone turnover in postmenopausal women with low bone mass: a randomized, blinded, phase 3 trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1126027.583144 ◽

2008 ◽

Author(s):

Peter Taylor

Keyword(s):

Bone Mass ◽

Bone Turnover ◽

Postmenopausal Women ◽

Biochemical Markers ◽

Low Bone Mass ◽

Phase 3 ◽

Markers Of Bone Turnover

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Low bone mass is associated with carotid atherosclerosis in postmenopausal women: The Japanese Population-based Osteoporosis (JPOS) Cohort Study

Osteoporosis International ◽

10.1007/s00198-008-0633-z ◽

2008 ◽

Vol 20 (1) ◽

pp. 53-60 ◽

Cited By ~ 39

Author(s):

J. Tamaki ◽

M. Iki ◽

Y. Hirano ◽

Y. Sato ◽

E. Kajita ◽

...

Keyword(s):

Cohort Study ◽

Bone Mass ◽

Postmenopausal Women ◽

Japanese Population ◽

Carotid Atherosclerosis ◽

Population Based ◽

Low Bone Mass

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Sclareol prevents ovariectomy-induced bone loss in vivo and inhibits osteoclastogenesis in vitro via suppressing NF-κB and MAPK/ERK signaling pathways

Food & Function ◽

10.1039/c9fo00206e ◽

2019 ◽

Vol 10 (10) ◽

pp. 6556-6567 ◽

Cited By ~ 5

Author(s):

Haiming Jin ◽

Zhenxuan Shao ◽

Qingqing Wang ◽

Jiansen Miao ◽

Xueqin Bai ◽

...

Keyword(s):

Bone Loss ◽

Bone Mass ◽

Postmenopausal Women ◽

Postmenopausal Osteoporosis ◽

Bone Quality ◽

Progressive Disease ◽

Erk Signaling ◽

Low Bone Mass

Postmenopausal osteoporosis (PMO) is a progressive disease occurring in elderly postmenopausal women that is characterized by low bone mass and impaired bone quality.

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Circulating activin-A is elevated in postmenopausal women with low bone mass: the three-month effect of zoledronic acid treatment

Osteoporosis International ◽

10.1007/s00198-012-2198-0 ◽

2012 ◽

Vol 24 (7) ◽

pp. 2127-2132 ◽

Cited By ~ 9

Author(s):

A. D. Anastasilakis ◽

S. A. Polyzos ◽

P. Makras ◽

A. Gkiomisi ◽

M. Savvides ◽

...

Keyword(s):

Zoledronic Acid ◽

Bone Mass ◽

Postmenopausal Women ◽

Acid Treatment ◽

Activin A ◽

Low Bone Mass

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Expression of microRNAs that regulate bone turnover in the serum of postmenopausal women with low bone mass and vertebral fractures

Acta Endocrinologica ◽

10.1530/eje-16-0583 ◽

2017 ◽

Vol 176 (2) ◽

pp. 169-176 ◽

Cited By ~ 43

Author(s):

Maria P Yavropoulou ◽

Athanasios D Anastasilakis ◽

Polyzois Makras ◽

Dimitrios G Tsalikakis ◽

Maria Grammatiki ◽

...

Keyword(s):

Bone Mass ◽

Postmenopausal Women ◽

Vertebral Fractures ◽

Patient Population ◽

Group Analysis ◽

Osteoporotic Fractures ◽

Serum Levels ◽

Low Bone Mass ◽

Differential Expression Pattern ◽

Novel Biomarkers

Background Circulating microRNAs (miRs) are currently being investigated as novel biomarkers for osteoporosis and osteoporotic fractures. Aim The aim of this study was to investigate serum levels of specific microRNAs, known regulators of bone metabolism, in postmenopausal women with low bone mass and with or without vertebral fractures (VFs). Methods For the analysis, 14 miRs were isolated from the serum of 35 postmenopausal women with low bone mass and with at least one moderate VF and 35 postmenopausal women with low bone mass without fractures. Thirty postmenopausal women with normal BMD values and no history of fractures served as controls. Main outcome parameters were changes in the expression of selected miRs in the serum of patient population and compared with controls. Results From the 14 miRs that were selected, we identified 5 miRs, namely miR-21-5p, miR-23a, miR-29a-3p, miR-124-3p and miR-2861 that were significantly deregulated in the serum of patients with low bone mass compared with controls. Serum miR-124 and miR-2861 were significantly higher, whereas miR-21, miR-23 and miR-29 were lower in patients compared with controls. In a sub-group analysis of the patient population, the expression of miR-21-5p was significantly lower among osteoporotic/osteopenic women with VFs, showing 66% sensitivity and 77% specificity in distinguishing women with a vertebral fracture. Conclusion This study identifies a differential expression pattern of miR-21-5p in the serum of women with low BMD and VFs.

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