Very high prevalence of osteosarcopenia in hip fracture patients: risk and protective factors

Abstract Background Hip fractures are one of the most serious forms of osteoporotic fractures. Osteosarcopenia is a growing geriatric giant with increased risk of falls, fractures, disability and mortality. The objective of this cross-sectional study was to determine the prevalence and risk factors...

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Main Authors: Ronald Man Yeung Wong, Pui Yan Wong, Wai Wang Chau, Chaoran Liu, Ning Zhang, Wing Hoi Cheung
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-025-05828-7
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author Ronald Man Yeung Wong
Pui Yan Wong
Wai Wang Chau
Chaoran Liu
Ning Zhang
Wing Hoi Cheung
author_facet Ronald Man Yeung Wong
Pui Yan Wong
Wai Wang Chau
Chaoran Liu
Ning Zhang
Wing Hoi Cheung
author_sort Ronald Man Yeung Wong
collection DOAJ
description Abstract Background Hip fractures are one of the most serious forms of osteoporotic fractures. Osteosarcopenia is a growing geriatric giant with increased risk of falls, fractures, disability and mortality. The objective of this cross-sectional study was to determine the prevalence and risk factors of osteosarcopenia amongst hip fracture patients. Methods All patients received a dual energy x-ray absorptiometry (DXA) scan for diagnosis of osteopenia and osteoporosis. For sarcopenia assessment, patients received a bioimpedance analysis (BIA) measurement, handgrip strength and 5-time chair stand test. Osteosarcopenia was defined with the presence of osteopenia/osteoporosis and sarcopenia. Risk factors for osteosarcopenia were analysed using logistic regression. Results A total of 342 hip fracture patients (n = 342) were recruited. Sarcopenia was present in 286 hip fracture patients (83.6%). 335 hip fracture patients (97.95%) had osteopenia/osteoporosis. Osteosarcopenia was present in 281 hip fracture patients (82.2%). For osteosarcopenia, patients with body mass index (BMI) < 23 kg/m2 were 4.33 (2.35 to 7.95; p < 0.001) times more likely to have osteosarcopenia regardless of age and gender. Males were 3.24 (1.38 to 7.58; p = 0.007) more likely to have osteosarcopenia regardless of age and BMI group. Conclusions Our study had shown a very high prevalence of osteosarcopenia amongst hip fracture patients, especially in male patients, and identified associated risk and protective factors. Given the potential clinical implications, we would recommend that in addition to bone mineral density assessment, routine sarcopenia assessment should also be incorporated into Fracture Liaison Services. Further research should be conducted on optimal body weight and BMI, and as to why male patients have more likelihood of sarcopenia.
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spelling doaj-art-1cdc0cdca1fe4030a294d23f8c63819b2025-08-20T01:47:32ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-04-012011810.1186/s13018-025-05828-7Very high prevalence of osteosarcopenia in hip fracture patients: risk and protective factorsRonald Man Yeung Wong0Pui Yan Wong1Wai Wang Chau2Chaoran Liu3Ning Zhang4Wing Hoi Cheung5Department of Orthopaedics & Traumatology, The Chinese University of Hong KongDepartment of Orthopaedics & Traumatology, The Chinese University of Hong KongDepartment of Orthopaedics & Traumatology, The Chinese University of Hong KongDepartment of Orthopaedics & Traumatology, The Chinese University of Hong KongDepartment of Orthopaedics & Traumatology, The Chinese University of Hong KongDepartment of Orthopaedics & Traumatology, The Chinese University of Hong KongAbstract Background Hip fractures are one of the most serious forms of osteoporotic fractures. Osteosarcopenia is a growing geriatric giant with increased risk of falls, fractures, disability and mortality. The objective of this cross-sectional study was to determine the prevalence and risk factors of osteosarcopenia amongst hip fracture patients. Methods All patients received a dual energy x-ray absorptiometry (DXA) scan for diagnosis of osteopenia and osteoporosis. For sarcopenia assessment, patients received a bioimpedance analysis (BIA) measurement, handgrip strength and 5-time chair stand test. Osteosarcopenia was defined with the presence of osteopenia/osteoporosis and sarcopenia. Risk factors for osteosarcopenia were analysed using logistic regression. Results A total of 342 hip fracture patients (n = 342) were recruited. Sarcopenia was present in 286 hip fracture patients (83.6%). 335 hip fracture patients (97.95%) had osteopenia/osteoporosis. Osteosarcopenia was present in 281 hip fracture patients (82.2%). For osteosarcopenia, patients with body mass index (BMI) < 23 kg/m2 were 4.33 (2.35 to 7.95; p < 0.001) times more likely to have osteosarcopenia regardless of age and gender. Males were 3.24 (1.38 to 7.58; p = 0.007) more likely to have osteosarcopenia regardless of age and BMI group. Conclusions Our study had shown a very high prevalence of osteosarcopenia amongst hip fracture patients, especially in male patients, and identified associated risk and protective factors. Given the potential clinical implications, we would recommend that in addition to bone mineral density assessment, routine sarcopenia assessment should also be incorporated into Fracture Liaison Services. Further research should be conducted on optimal body weight and BMI, and as to why male patients have more likelihood of sarcopenia.https://doi.org/10.1186/s13018-025-05828-7Hip fractureOsteosarcopeniaFracture liaison serviceOsteoporotic fracture
spellingShingle Ronald Man Yeung Wong
Pui Yan Wong
Wai Wang Chau
Chaoran Liu
Ning Zhang
Wing Hoi Cheung
Very high prevalence of osteosarcopenia in hip fracture patients: risk and protective factors
Journal of Orthopaedic Surgery and Research
Hip fracture
Osteosarcopenia
Fracture liaison service
Osteoporotic fracture
title Very high prevalence of osteosarcopenia in hip fracture patients: risk and protective factors
title_full Very high prevalence of osteosarcopenia in hip fracture patients: risk and protective factors
title_fullStr Very high prevalence of osteosarcopenia in hip fracture patients: risk and protective factors
title_full_unstemmed Very high prevalence of osteosarcopenia in hip fracture patients: risk and protective factors
title_short Very high prevalence of osteosarcopenia in hip fracture patients: risk and protective factors
title_sort very high prevalence of osteosarcopenia in hip fracture patients risk and protective factors
topic Hip fracture
Osteosarcopenia
Fracture liaison service
Osteoporotic fracture
url https://doi.org/10.1186/s13018-025-05828-7
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