Predictors of low bone mineral density in the elderly: the role of dietary intake, nutritional status and sarcopenia

• Published in: European journal of clinical nutrition Vol. 62; no. 6; pp. 802 - 809
• Main Authors: Coin, A, Perissinotto, E, Enzi, G, Zamboni, M, Inelmen, E.M, Frigo, A.C, Manzato, E, Busetto, L, Buja, A, Sergi, G
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-06-2008; Nature Publishing; Nature Publishing Group
• Subjects: Absorptiometry, Photon; Age; Aged; Aging; Aging - physiology; Albumin; Biological and medical sciences; Biomedical materials; Body Mass Index; Body size; Bone density; Bone Density - drug effects; Bone Density - physiology; Bone mass; Bone mineral density; Bones; Clinical Nutrition; Density; Development and progression; Diet; Dietary intake; Dietary Proteins - administration & dosage; disease prevalence; Dual energy X-ray absorptiometry; elderly; elderly nutrition; Energy; energy intake; Energy Intake - physiology; Epidemiology; Feeding. Feeding behavior; Female; Food and nutrition; Food intake; Fundamental and applied biological sciences. Psychology; gender differences; Hip; hip bone; hips; human diseases; Humans; Independent variables; Internal Medicine; Investigative techniques, diagnostic techniques (general aspects); Logistic Models; Male; Measurement; Medical sciences; Medicine; Medicine & Public Health; Men; Metabolic Diseases; Multiple regression analysis; Muscles; Muscular Atrophy - epidemiology; Muscular Atrophy - metabolism; Muscular Atrophy - pathology; Nutrition; Nutrition Assessment; Nutritional Status; Older people; original-article; Osteoarticular system. Muscles; Osteoporosis; Osteoporosis - epidemiology; Osteoporosis - metabolism; Osteoporosis - pathology; prediction; Predictive Value of Tests; Prevalence; protein intake; Proteins; Public Health; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Regression analysis; Risk analysis; Risk Factors; Sarcopenia; Serum albumin; Serum Albumin - metabolism; Severity of Illness Index; Sex Factors; Skeletal muscle; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Women; Italy; serum albumin; protein intake; osteoporosis; body mass index; sarcopenia; Human; Nutrition; Diseases of the osteoarticular system; Prediction; Albumin; Metabolic diseases; Protein; Body mass index; Osteoporosis; Sarcopenia; Food intake; Serum; Bone mineral density; Elderly; Nutritional status
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/sj.ejcn.1602779

Objectives: The aims of this study were to investigate the relationship between sarcopenia, dietary intake, nutritional indices and hip bone mineral density (BMD) in the elderly, and to estimate the risk of low BMD due to specific independent predictor thresholds. Subjects and methods: Body mass index (BMI), serum albumin, energy and protein intake were studied in 352 elderly outpatients (216 women aged 73.55.3 years and 136 men aged 73.95.6 years). BMD at different hip sites and appendicular skeletal muscle mass (ASMM) were assessed by dual-energy X-ray absorptiometry. Results: The prevalence of osteoporosis was 13% in men and 45% in women, while the prevalence of sarcopenia (50% ) and hypoalbuminemia (5% ) were similar in both genders. BMI, albumin and ASMM were significantly associated with BMD in both genders: so was protein intake, but only in men. By multiple regression analysis, the variables that retained their independent explanatory role on total hip BMD, were BMI and protein intake in men, and BMI and albumin in women. By logistic regression analysis, men risked having a low BMD with a BMI <22 (OR=12) and a protein intake <65.7 g/day (OR=3.7). Women carried some risk already in the BMI 25-30 class (OR=5), and a much greater risk in the BMI <22 class (OR=26). Albumin <40 g/l also emerged as an independent risk factor (OR=2.6). Conclusions: BMI in both genders, albumin in women and protein intake in men have an independent effect on BMD. BMI values <22 are normal for younger adults but carry a higher risk of osteoporosis in the elderly, particularly in women. Age-related sarcopenia does not seem to be involved in bone mass loss.