{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:07:28Z","timestamp":1790863648628,"version":"4.1.0"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T00:00:00Z","timestamp":1706313600000},"content-version":"vor","delay-in-days":1152,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T00:00:00Z","timestamp":1617840000000},"content-version":"vor","delay-in-days":128,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["asbmr.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Dual-energy X-ray absorptiometry (DXA)-derived appendicular lean mass\/height2 (ALM\/ht2) is the most commonly used estimate of muscle mass in the assessment of sarcopenia, but its predictive value for fracture is substantially attenuated by femoral neck (fn) bone mineral density (BMD). We investigated predictive value of 11 sarcopenia definitions for incident fracture, independent of fnBMD, fracture risk assessment tool (FRAX\u00ae) probability, and prior falls, using an extension of Poisson regression in US, Sweden, and Hong Kong Osteoporois Fractures in Men Study (MrOS) cohorts. Definitions tested were those of Baumgartner and Delmonico (ALM\/ht2 only), Morley, the International Working Group on Sarcopenia, European Working Group on Sarcopenia in Older People (EWGSOP1 and 2), Asian Working Group on Sarcopenia, Foundation for the National Institutes of Health (FNIH) 1 and 2 (using ALM\/body mass index [BMI], incorporating muscle strength and\/or physical performance measures plus ALM\/ht2), and Sarcopenia Definitions and Outcomes Consortium (gait speed and grip strength). Associations were adjusted for age and time since baseline and reported as hazard ratio (HR) for first incident fracture, here major osteoporotic fracture (MOF; clinical vertebral, hip, distal forearm, proximal humerus). Further analyses adjusted additionally for FRAX-MOF probability (n\u00a0=\u00a07531; calculated \u00b1 fnBMD), prior falls (y\/n), or fnBMD T-score. Results were synthesized by meta-analysis. In 5660 men in USA, 2764 Sweden and 1987 Hong Kong (mean ages 73.5, 75.4, and 72.4\u2009years, respectively), sarcopenia prevalence ranged from 0.5% to 35%. Sarcopenia status, by all definitions except those of FNIH, was associated with incident MOF (HR\u00a0=\u00a01.39 to 2.07). Associations were robust to adjustment for prior falls or FRAX probability (without fnBMD); adjustment for fnBMD T-score attenuated associations. EWGSOP2 severe sarcopenia (incorporating chair stand time, gait speed, and grip strength plus ALM) was most predictive, albeit at low prevalence, and appeared only modestly influenced by inclusion of fnBMD. In conclusion, the predictive value for fracture of sarcopenia definitions based on ALM is reduced by adjustment for fnBMD but strengthened by additional inclusion of physical performance measures. \u00a9 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).<\/jats:p>","DOI":"10.1002\/jbmr.4293","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T17:51:46Z","timestamp":1617904306000},"page":"1235-1244","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":72,"title":["Sarcopenia Definitions as Predictors of Fracture Risk Independent of FRAX\u00ae, Falls, and BMD in the Osteoporotic Fractures in Men (MrOS) Study: A Meta-Analysis"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8194-2512","authenticated-orcid":false,"given":"Nicholas C","family":"Harvey","sequence":"first","affiliation":[{"name":"NIHR Southampton Biomedical Research Centre University of Southampton and University Hospital Southampton NHS Foundation Trust Southampton UK"},{"name":"MRC Lifecourse Epidemiology Unit University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Orwoll","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University Portland OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Kwok","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics and School of Public Health The Chinese University of Hong Kong Shatin Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus K","family":"Karlsson","sequence":"additional","affiliation":[{"name":"Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmo Lund University and Department of Orthopedics, Skane University Hospital Malmo Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn E","family":"Rosengren","sequence":"additional","affiliation":[{"name":"Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmo Lund University and Department of Orthopedics, Skane University Hospital Malmo Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Ribom","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences University of Uppsala Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0752-4408","authenticated-orcid":false,"given":"Jane A","family":"Cauley","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Graduate School of Public Health University of Pittsburgh Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4938-9478","authenticated-orcid":false,"given":"Peggy M","family":"Cawthon","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California San Francisco CA USA"},{"name":"Research Institute California Pacific Medical Center San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9069-3036","authenticated-orcid":false,"given":"Kristine","family":"Ensrud","sequence":"additional","affiliation":[{"name":"Medicine and Epidemiology & Community Health University of Minnesota Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enwu","family":"Liu","sequence":"additional","affiliation":[{"name":"Mary MacKillop Institute for Health Research Australian Catholic University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso J","family":"Cruz-Jentoft","sequence":"additional","affiliation":[{"name":"Servicio de Geriatr\u00eda Hospital Universitario Ram\u00f3n y Cajal (IRYCIS) Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger A","family":"Fielding","sequence":"additional","affiliation":[{"name":"Nutrition, Exercise Physiology, and Sarcopenia Laboratory Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3510-0709","authenticated-orcid":false,"given":"Cyrus","family":"Cooper","sequence":"additional","affiliation":[{"name":"NIHR Oxford Biomedical Research Centre University of Oxford Oxford UK"},{"name":"NIHR Southampton Biomedical Research Centre University of Southampton and University Hospital Southampton NHS Foundation Trust Southampton UK"},{"name":"MRC Lifecourse Epidemiology Unit University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A","family":"Kanis","sequence":"additional","affiliation":[{"name":"Centre for Metabolic Bone Diseases University of Sheffield Sheffield UK"},{"name":"Mary MacKillop Institute for Health Research Australian Catholic University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0749-1431","authenticated-orcid":false,"given":"Mattias","family":"Lorentzon","sequence":"additional","affiliation":[{"name":"Geriatric Medicine, Institute of Medicine Sahlgrenska Academy, Sahlgrenska University Hospital M\u00f6lndal Sweden"},{"name":"Mary MacKillop Institute for Health Research Australian Catholic University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claes","family":"Ohlsson","sequence":"additional","affiliation":[{"name":"Region V\u00e4stra G\u00f6taland, Sahlgrenska University Hospital Department of Drug Treatment Gothenburg Sweden"},{"name":"Department of Internal Medicine and Clinical Nutrition, Center for Bone and Arthritis Research Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Mellstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Clinical Nutrition, Center for Bone and Arthritis Research Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Johansson","sequence":"additional","affiliation":[{"name":"Centre for Metabolic Bone Diseases University of Sheffield Sheffield UK"},{"name":"Mary MacKillop Institute for Health Research Australian Catholic University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"McCloskey","sequence":"additional","affiliation":[{"name":"Centre for Integrated research in Musculoskeletal Ageing (CIMA), Mellanby Centre for Bone Research University of Sheffield Sheffield UK"},{"name":"Centre for Metabolic Bone Diseases University of 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