Sarcopenia as a Risk Factor for Future Hip Fracture: A Meta-Analysis of Prospective Cohort Studies

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SARCOPENIA AS A RISK FACTOR FOR FUTURE HIP FRACTURE: A META-ANALYSIS OF PROSPECTIVE COHORT STUDIES P. HUANG1,*, K. LUO2,*, J. XU2, W. HUANG2, W. YIN2, M. XIAO2, Y. WANG2, M. DING1, X. HUANG1 1. College of Nursing, Gannan Medical University, Ganzhou, Jiangxi province, China; 2. Department of medicine, Jing Gangshan University, Ji’an, Jiangxi province,China. * Authors contributed equally to this work. Corresponding author: Mei Ding, Medical College Road, Ganzhou City, Jiangxi Province 341000, China, E-mail address:[email protected]. Xiaofeng Huang, E-mail address : [email protected].

Abstract: Objective: Our study aims to determine whether sarcopenia is a predictive factor of future hip fractures. Design: Systematic review and meta-analysis. Set: We searched for potentially suitable articles in PubMed, Cochrane library, Medline and EMBASE from inception to March 2020. The quality of the research was assessed by the Newcastle-Ottawa Scale (NOS). Finally, a meta-analysis was conducted with the Stata software. Participants: Older community-dwelling residents. Measurements: Hip fracture due to sarcopenia. Results: We retrieved 2129 studies through our search strategy, and five studies with 23,359 individuals were analyzed in our pooled analyses. Sarcopenia increases the risk of future hip fractures with a pooled hazard ratio (HR) of 1.42 (95% CI: 1.18-1.71, P 65

100%

5934

Baumgartner’s definition, Newman’s definition, IWGS, EWGSOP, FNIH Definition

9.8±3.0

age, femoral neck BMD

7

Hars M 2016 (13)

Switzerland

63-67

20.1%

913

EWGSOP

3.4±0.9

gender, age, length of follow-up and FRAX probability with femoral neck BMD

7

Yu R 2014 (11)

China

>65

50%

4000

AWGS

10.2

age and femoral neck BMD

8

Harris R2017 (12)

Amercian

63±0.07

0

10937

Newman’s definition, Delmonico 1, Delmonico 2, IWGS, SCWD

15.9

age, clinic, and race

8

Scott D2018 (14)

Australia

76.7±5.4

100%

1575

EWGSOP

6±2

age, income, living alone, number of comorbidities, smoking status, psychotropic and corticosteroid use, history of fracture, physical activity and 25(OH)D

9

BMD, bone mineral density; FRAX, fracture risk assessment tool;EWGSOP ,European Working Group for Sarcopenia in Older Persons; AWGS, Asian Working Group for Sarcopenia; IWG, International Working Group; SCWD;Society on Sarcopenia, Cachexia,and Wasting Disorders; Quality of the studies were assessed with Newcastle-Ottawa Scale (NOS);

Publication bias was examined by Begg’s test and Egger’s test with funnel plots. In addition, we conducted subgroup analyses to further examine the relationship between sarcopenia and the risk of future hip fracture in males, females, patients with different definitions of sarcopenia, patients with follow-up periods of more than five years, and patients with follow-up periods of less than five years.

clear definition of sarcopenia. We excluded studies when it was a review or conference abstract, an original study with insufficient data or the manuscript was written in other languages (non-English). Data extraction Data in the include