{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T02:09:20Z","timestamp":1793758160409,"version":"4.6.1"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["AR049439\u201001A1"],"award-info":[{"award-number":["AR049439\u201001A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Older adults with osteosarcopenia, defined as the coexistence of osteopenia\/osteoporosis and sarcopenia, have been associated with an increased risk of fractures compared with those with normal bone mineral density (BMD) and without sarcopenia. However, the conventional definition of osteosarcopenia has led to mixed results on its predictive accuracy for hip fractures. We aimed to define osteosarcopenia by identifying sex\u2010specific cut\u2010offs for low BMD according to different sarcopenia statuses and compare its predictive performance with osteosarcopenia defined conventionally and osteoporosis alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cohort of 4000 community\u2010dwelling older adults (2000 females, mean age 72.5\u2009\u00b1\u20095.2\u2009years) was recruited. Body composition and BMD of hip, lumbar spine and femoral neck were measured using dual energy X\u2010ray absorptiometry at baseline. According to the Asian Working Group for Sarcopenia 2019 consensus, all participants were classified as non\u2010sarcopenia, possible sarcopenia and sarcopenia. Incidence of hip fractures was documented during the follow\u2010up period from 2001 to 2013. The classification and regression tree (CART) analysis was performed to identify the optimal cut\u2010off values of T\u2010scores for participants with possible sarcopenia and those with sarcopenia, respectively. Cox proportional hazards regression models were used to estimate the associations between osteosarcopenia and hip fractures. The discrimination and predictive ability of osteosarcopenia were evaluated by Uno's concordance index (C\u2010index), time\u2010dependent net reclassification improvement (NRI) and integrated discrimination improvement (IDI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During an average of 9.2\u2009years of follow\u2010up, 63 (3.2%) men and 69 (3.5%) women had at least one hip fracture. Sex\u2010 and sarcopenia\u2010specific cut\u2010offs of T\u2010scores were identified (men with possible sarcopenia: T\u2010score &lt;\u2009\u22122.2; men with sarcopenia: T\u2010score &lt;\u2009\u22122.0; women with possible sarcopenia: T\u2010score &lt;\u2009\u22122.1; women with sarcopenia: T\u2010score \u2264\u2009\u22122.5). Osteosarcopenia defined with these specific cut\u2010offs was associated with an increased risk of hip fractures independent of clinical risk factors in both men and women (HR\u2009=\u20095.232, 95% CI\u2009=\u20093.172\u20138.631, and HR\u2009=\u20093.574, 95% CI\u2009=\u20092.01\u20136.355, respectively). It had the highest Uno's C\u2010index (men: 0.774 and women: 0.750, respectively) and outperformed osteosarcopenia using conventional definition and osteoporosis alone in predicting hip fractures by using NRI and IDI approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggested that including possible sarcopenia and adopting sex\u2010 and sarcopenia\u2010specific cut\u2010offs to define osteosarcopenia could improve hip fracture prediction. Further studies are warranted to validate the cut\u2010offs of T\u2010score identified in our cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70348","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:57:07Z","timestamp":1784123827000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Improving Hip Fracture Prediction by Using Sarcopenia\u2010Specific Cut\u2010Offs of T\u2010Scores for Osteosarcopenia: A Prospective Cohort Study"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7968-6313","authenticated-orcid":false,"given":"Anjo Zhihui","family":"Lu","sequence":"first","affiliation":[{"name":"School of Nursing The Hong Kong Polytechnic University  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freddy Man Hin","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences The Hong Kong Polytechnic University  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Leung","sequence":"additional","affiliation":[{"name":"Jockey Club Centre for Osteoporosis Care and Control The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. W.","family":"Auyeung","sequence":"additional","affiliation":[{"name":"Jockey Club Institute of Ageing The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Lee","sequence":"additional","affiliation":[{"name":"Jockey Club Institute of Ageing The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"King\u2010Son","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Medicine and Geriatrics Tai Po Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Woo","sequence":"additional","affiliation":[{"name":"Jockey Club Institute of Ageing The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Kwok","sequence":"additional","affiliation":[{"name":"Jockey Club Centre for Osteoporosis Care and Control 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