{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T13:27:18Z","timestamp":1775309238610,"version":"3.50.1"},"reference-count":67,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Sao Paulo Research Foundation","award":["2020\/07098-0"],"award-info":[{"award-number":["2020\/07098-0"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Age-related muscle loss and obesity are linked to poor bone health and increased fracture risk, though findings in frail populations are inconsistent. This study examined differences in bone microarchitecture across body composition phenotypes in frail older women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, 280 older women were included, 109 of whom met Fried frailty criteria. Body composition was assessed using dual-energy X-ray absorptiometry and classified into four groups: low appendicular lean mass (LALM; &amp;lt;20th percentile of residuals), obesity (fat mass index &amp;gt;13 kg\/m\u00b2), obesity with LALM, or neither. Bone microarchitecture was measured by high-resolution peripheral quantitative computed tomography (HR-pQCT). Analyses used generalized estimating equations with Bonferroni correction, \u03c7\u00b2 tests, and Fisher\u2019s exact tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with the obesity group, women with LALM had smaller cortical area and thinner cortex at both the tibia and radius. At the radius, the LALM group also showed lower cortical area and thickness, total volumetric bone mineral density, and trabecular number, as well as greater trabecular area and separation, compared with the obesity plus LALM group. Bone strength was significantly lower in the LALM group than in the obesity and obesity plus LALM groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among pre-frail and frail older women, obesity was associated with more favorable cortical and trabecular bone microarchitecture compared with low muscle mass without obesity. Excess adiposity may partially mitigate skeletal deterioration. Longitudinal studies are needed to clarify the impact of body composition on fracture risk in frail older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/gerona\/glag013","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T12:22:15Z","timestamp":1768825335000},"source":"Crossref","is-referenced-by-count":0,"title":["Bone health and body composition in pre-frail and frail older adult women: insights from high-resolution peripheral quantitative computed tomography (HR-pQCT)"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6786-3922","authenticated-orcid":false,"given":"Alan L","family":"Fernandes","sequence":"first","affiliation":[{"name":"Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo , S\u00e3o Paulo,","place":["Brazil"]},{"name":"Graduate Program in Nursing and Health, School of Nursing, Federal University of Bahia , Salvador,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7991-0231","authenticated-orcid":false,"given":"Diogo S","family":"Domiciano","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo , S\u00e3o Paulo,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria F","family":"Caparbo","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo , S\u00e3o Paulo,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camila S","family":"Figueredo","sequence":"additional","affiliation":[{"name":"Acreditando Centro Integrado , S\u00e3o Paulo,","place":["B razil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline de Freitas","family":"Gomes","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo , S\u00e3o Paulo,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo F B","family":"Neto","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo , S\u00e3o Paulo,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"2026040408385862600_glag013-B1","doi-asserted-by":"publisher","first-page":"M146","DOI":"10.1093\/gerona\/56.3.m146","article-title":"Frailty in older adults: evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci."},{"key":"2026040408385862600_glag013-B2","doi-asserted-by":"publisher","first-page":"e323","DOI":"10.1016\/S2468-2667(18)30091-4","article-title":"Frailty and pre-frailty in middle-aged and older adults and its association with multimorbidity and mortality: a prospective analysis of 493 737 UK Biobank participants","volume":"3","author":"Hanlon","year":"2018","journal-title":"Lancet Public Health"},{"key":"2026040408385862600_glag013-B3","doi-asserted-by":"publisher","first-page":"965562","DOI":"10.3389\/fmed.2022.965562","article-title":"Frailty in the context of COVID-19 pandemic: a life-threatening condition","volume":"9","author":"Fernandes","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"2026040408385862600_glag013-B4","doi-asserted-by":"publisher","first-page":"e650","DOI":"10.1016\/S2468-2667(20)30113-4","article-title":"Frailty index and all-cause and cause-specific mortality in Chinese adults: a prospective cohort study","volume":"5","author":"Fan","year":"2020","journal-title":"Lancet Public Health"},{"key":"2026040408385862600_glag013-B5","doi-asserted-by":"publisher","first-page":"2825","DOI":"10.1007\/s00198-014-2828-9","article-title":"A Frailty Index predicts 10-year fracture risk in adults age 25 years and older: results from the Canadian Multicentre Osteoporosis Study (CaMos)","volume":"25","author":"Kennedy","year":"2014","journal-title":"Osteoporos Int"},{"key":"2026040408385862600_glag013-B6","doi-asserted-by":"publisher","first-page":"2181","DOI":"10.1007\/s00198-018-4596-4","article-title":"Do sarcopenia and\/or osteoporosis increase the risk of frailty? 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