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Journal of Bone and Mineral Metabolism
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25-05-2024 | Sarcopenia | Original Article

The efficacy of nutritional screening indexes in predicting the incidence of osteosarcopenia and major osteoporotic fracture in the elderly

Authors: Xin-Yue Fang, Hao-Wei Xu, Hao Chen, Shu-Bao Zhang, Yu-Yang Yi, Xiao-Yong Ge, Shan-Jin Wang

Published in: Journal of Bone and Mineral Metabolism | Issue 3/2024

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Abstract

Introduction

The effect of nutritional status on osteosarcopenia (OS) and major osteoporotic fracture (MOF) among the elderly is still unclear. So we aimed to compare the efficacy of the Mini-Nutrition Assessment-Short Form (MNA-sf), the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status (CONUT) for predicting OS and MOF among the elderly.

Materials and Methods

A total of 409 participants were enrolled in this prospective study. Blood biochemical indexes, nutritional status, and bone- and muscle-related examinations were assessed at initial visit to the outpatient. Participants were divided into 4 groups: (1) control; (2) osteopenia/osteoporosis; (3) sarcopenia; (4) osteosarcopenia, and then followed for 5 years, recording the occurrence time of MOF.

Results

The frequency values of osteopenia/osteoporosis, sarcopenia, and OS, at baseline, were respectively 13.4, 16.1, and 12% among the study samples. Correlation analysis showed that nutritional status scores were associated with body mass index, handgrip strength, albumin, bone mineral density, and physical functions. According to multivariate models, poor nutritional status was significantly associated with a higher risk of OS and MOF (P < 0.05). Survival analysis showed that the MOF rate in malnutrition group was significantly higher than normal nutrition group (P < 0.05). The receiver operator characteristic curve shows that the value of MNA-sf to diagnose OS and MOF is greater (P < 0.05).

Conclusion

The poor nutritional status was associated with a higher risk of both OS and MOF. MNA-sf showed a superior diagnostic power for OS and MOF among the elderly. Early nutrition assessments and interventions may be key strategies to prevent OS and fractures.
Literature
1.
Binkley N, Buehring B (2009) Beyond FRAX: it’s time to consider “sarco-osteopenia.” J Clin Densitom 12:413–416PubMedCrossRef
2.
Paintin J, Cooper C, Dennison E (2018) Osteosarcopenia. Br J Hosp Med (London, England: 2005) 79:253–258
3.
4.
Nielsen BR, Andersen HE, Haddock B, Hovind P, Schwarz P, Suetta C (2020) Prevalence of muscle dysfunction concomitant with osteoporosis in a home-dwelling danish population aged 65–93 years—the Copenhagen Sarcopenia Study. Exp Gerontol 138:110974PubMedCrossRef
5.
Kirk B, Miller S, Zanker J, Duque G (2020) A clinical guide to the pathophysiology, diagnosis and treatment of osteosarcopenia. Maturitas 140:27–33PubMedCrossRef
6.
Mithal A, Bonjour JP, Boonen S, Burckhardt P, Degens H et al (2013) Impact of nutrition on muscle mass, strength, and performance in older adults. Osteoporos Int 24:1555–1566PubMedCrossRef
7.
Conzade R, Phu S, Vogrin S, Bani Hassan E, Sepúlveda-Loyola W et al (2019) Changes in nutritional status and musculoskeletal health in a geriatric post-fall care plan setting. Nutrients 11:1551PubMedPubMedCentralCrossRef
8.
Reiss J, Iglseder B, Alzner R, Mayr-Pirker B, Pirich C et al (2019) Sarcopenia and osteoporosis are interrelated in geriatric inpatients. Z Gerontol Geriatr 52:688–693PubMedPubMedCentralCrossRef
9.
De Rui M, Inelmen EM, Pigozzo S, Trevisan C, Manzato E, Sergi G (2019) Dietary strategies for mitigating osteosarcopenia in older adults: a narrative review. Aging Clin Exp Res 31:897–903PubMedCrossRef
10.
Vrdoljak D (2015) Malnutrition screening tools for elderly in general practice. Acta Med Croatica 69:339–345PubMed
11.
Liu C, Zhu M, Yang X, Cui H, Li Z, Wei J (2021) Controlling nutritional status score as a predictive marker of in-hospital mortality in older adult patients. Front Nutr 8:738045PubMedPubMedCentralCrossRef
12.
Dent E, Hoogendijk EO, Visvanathan R, Wright ORL (2019) Malnutrition screening and assessment in hospitalised older people: a review. J Nutr Health Aging 23:431–441PubMedCrossRef
13.
Kotera A (2019) Geriatric nutritional risk index and controlling nutritional status score can predict postoperative 180-day mortality in hip fracture surgeries. JA Clin Rep 5:62PubMedPubMedCentralCrossRef
14.
Sahadevan S, Lim PP, Tan NJ, Chan SP (2000) Diagnostic performance of two mental status tests in the older chinese: influence of education and age on cut-off values. Int J Geriatr Psychiatry 15:234–241PubMedCrossRef
15.
Kanis JA (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report WHO Study Group. Osteoporos Int 4:368–381PubMedCrossRef
16.
Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY et al (2020) Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc 21:300–7.e2PubMedCrossRef
17.
Lippuner K, Rimmer G, Stuck AK, Schwab P, Bock O (2022) Hospitalizations for major osteoporotic fractures in Switzerland: a long-term trend analysis between 1998 and 2018. Osteoporos Int 33:2327–2335PubMedPubMedCentralCrossRef
18.
Yesavage JA, Brink TL, Rose TL, Lum O, Huang V et al (1982) Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 17:37–49PubMedCrossRef
19.
Mahoney FI, Barthel DW (1965) Functional evaluation: the barthel index. Md State Med J 14:61–65PubMed
20.
Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y et al (2009) Validation of the mini nutritional assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging 13:782–788PubMedCrossRef
21.
Zhang XL, Zhang Z, Zhu YX, Tao J, Zhang Y et al (2020) Comparison of the efficacy of nutritional risk screening 2002 and mini nutritional assessment short form in recognizing sarcopenia and predicting its mortality. Eur J Clin Nutr 74:1029–1037PubMedCrossRef
22.
Bouillanne O, Morineau G, Dupont C, Coulombel I, Vincent JP et al (2005) Geriatric nutritional risk index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr 82:777–783PubMedCrossRef
23.
Cereda E, Vanotti A (2007) The new geriatric nutritional risk index is a good predictor of muscle dysfunction in institutionalized older patients. Clin Nutr (Edinburgh, Scotland) 26:78–83CrossRef
24.
Jiang Z, Ou R, Chen Y, Zhang L, Wei Q et al (2022) Prevalence and associated factors of malnutrition in patients with Parkinson’s disease using CONUT and GNRI. Parkinsonism Relat Disord 95:115–121PubMedCrossRef
25.
Drey M, Sieber CC, Bertsch T, Bauer JM, Schmidmaier R (2016) Osteosarcopenia is more than sarcopenia and osteopenia alone. Aging Clin Exp Res 28:895–899PubMedCrossRef
26.
Huo YR, Suriyaarachchi P, Gomez F, Curcio CL, Boersma D et al (2015) Comprehensive nutritional status in sarco-osteoporotic older fallers. J Nutr Health Aging 19:474–480PubMedCrossRef
27.
Chew J, Yeo A, Yew S, Tan CN, Lim JP et al (2020) Nutrition mediates the relationship between osteosarcopenia and frailty: a pathway analysis. Nutrients 12:2957PubMedPubMedCentralCrossRef
28.
Güç ZG, Altay C, Özgül HA, Ellidokuz H, Yavuzşen T (2022) GNRI and conut scores: simple predictors of sarcopenia in metastatic colorectal cancer patients. Support Care Cancer 30:7845–7852PubMedCrossRef
29.
Zhu X, Dong X, Wang L, Lao X, Li S, Wu H (2023) Screening efficacy of PhA and MNA-SF in different stages of sarcopenia in the older adults in community. BMC Geriatr 23:13PubMedPubMedCentralCrossRef
30.
31.
Silva-Fhon JR, Rojas-Huayta VM, Aparco-Balboa JP, Céspedes-Panduro B, Partezani-Rodrigues RA (2021) Sarcopenia and blood albumin: a systematic review with meta-analysis. Biomedica 41:590–603PubMedPubMedCentralCrossRef
32.
Marty E, Liu Y, Samuel A, Or O, Lane J (2017) A review of sarcopenia: enhancing awareness of an increasingly prevalent disease. Bone 105:276–286PubMedCrossRef
33.
34.
Verschueren S, Gielen E, O’Neill TW, Pye SR, Adams JE et al (2013) Sarcopenia and its relationship with bone mineral density in middle-aged and elderly European men. Osteoporos Int 24:87–98PubMedCrossRef
35.
Crepaldi G, Maggi S (2005) Sarcopenia and osteoporosis: a hazardous duet. J Endocrinol Invest 28:66–68PubMed
36.
Tagliaferri C, Wittrant Y, Davicco MJ, Walrand S, Coxam V (2015) Muscle and bone, two interconnected tissues. Ageing Res Rev 21:55–70PubMedCrossRef
37.
Yu HS, Kim JJ, Kim HW, Lewis MP, Wall I (2016) Impact of mechanical stretch on the cell behaviors of bone and surrounding tissues. J Tissue Eng 7:2041731415618342PubMedPubMedCentralCrossRef
38.
Yoshida M, Nakashima A, Doi S, Maeda K, Ishiuchi N et al (2021) Lower geriatric nutritional risk index (GNRI) is associated with higher risk of fractures in patients undergoing hemodialysis. Nutrients 13:2847PubMedPubMedCentralCrossRef
39.
Kupisz-Urbańska M, Płudowski P, Marcinowska-Suchowierska E (2021) Vitamin D deficiency in older patients-problems of sarcopenia, drug interactions management in deficiency. Nutrients 13:1247PubMedPubMedCentralCrossRef
40.
Fang XY, Xu HW, Chen H, Zhang SB, Yi YY et al (2022) Association between poor nutritional status and increased risk for subsequent vertebral fracture in elderly people with percutaneous vertebroplasty. Clin Interv Aging 17:1503–1512PubMedPubMedCentralCrossRef
41.
Eguchi Y, Toyoguchi T, Orita S, Shimazu K, Inage K et al (2019) Reduced leg muscle mass and lower grip strength in women are associated with osteoporotic vertebral compression fractures. Arch Osteoporos 14:112PubMedCrossRef
42.
Okamura H, Ishikawa K, Kudo Y, Matsuoka A, Maruyama H et al (2020) Risk factors predicting osteosarcopenia in postmenopausal women with osteoporosis: a retrospective study. PLoS ONE 15:e0237454PubMedPubMedCentralCrossRef
43.
Wilsgaard T, Jacobsen BK, Ahmed LA, Joakimsen RM, Størmer J, Jørgensen L (2011) BMI change is associated with fracture incidence, but only in non-smokers. The Tromsø Study. Osteoporos Int 22:1237–1245
44.
Johansson H, Kanis JA, Odén A, McCloskey E, Chapurlat RD et al (2014) A meta-analysis of the association of fracture risk and body mass index in women. J Bone Miner Res 29:223–233PubMedCrossRef
45.
Gillette-Guyonnet S, Nourhashemi F, Lauque S, Grandjean H, Vellas B (2000) Body composition and osteoporosis in elderly women. Gerontology 46:189–193PubMedCrossRef
46.
Mpalaris V, Anagnostis P, Goulis DG, Iakovou I (2015) Complex association between body weight and fracture risk in postmenopausal women. Obes Rev 16:225–233PubMedCrossRef
47.
Cabrerizo S, Cuadras D, Gomez-Busto F, Artaza-Artabe I, Marín-Ciancas F, Malafarina V (2015) Serum albumin and health in older people: review and meta analysis. Maturitas 81:17–27PubMedCrossRef
48.
Kunutsor SK, Voutilainen A, Whitehouse MR, Seidu S, Kauhanen J et al (2019) Serum albumin and future risk of hip, humeral, and wrist fractures in Caucasian men: new findings from a prospective cohort study. Med princ Pract 28:401–409PubMedPubMedCentralCrossRef
49.
Montalcini T, Pujia A, Donini LM, Frittitta L, Galvano F et al (2020) A call to action: now is the time to screen elderly and treat osteosarcopenia, a position paper of the Italian college of academic nutritionists MED/49 (ICAN-49). Nutrients 12:2662PubMedPubMedCentralCrossRef
50.
Clynes MA, Gregson CL, Bruyère O, Cooper C, Dennison EM (2021) Osteosarcopenia: where osteoporosis and sarcopenia collide. Rheumatology (Oxford) 60:529–537PubMedCrossRef
51.
de van der Schueren MAE, Jager-Wittenaar H (2022) Malnutrition risk screening: new insights in a new era. Clin Nutr (Edinburgh, Scotland) 41:2163–2168
Metadata
Title
The efficacy of nutritional screening indexes in predicting the incidence of osteosarcopenia and major osteoporotic fracture in the elderly
Authors
Xin-Yue Fang
Hao-Wei Xu
Hao Chen
Shu-Bao Zhang
Yu-Yang Yi
Xiao-Yong Ge
Shan-Jin Wang
Publication date
25-05-2024
Publisher
Springer Nature Singapore
Published in
Journal of Bone and Mineral Metabolism / Issue 3/2024
Print ISSN: 0914-8779
Electronic ISSN: 1435-5604
DOI
https://doi.org/10.1007/s00774-024-01514-6

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