Pre-sarcopenia Among Postmenopausal Women Younger Than 65

Prevalence of Pre-sarcopenia Among Postmenopausal Women Younger Than 65 Years

Nalina Orprayoon, MD; Peerapraut Wainipitapong, MD; Jirapa Champaiboon, MD; Lalita Wattanachanya, MD; Unnop Jaisamrarn, MD, MHS; Sukanya Chaikittisilpa, MD, MSc

Disclosures

Menopause. 2021;28(12):1351-1357.

Abstract and Introduction

Abstract

Objective: Sarcopenia is associated with high morbidity and mortality in older women. Early detection and intervention during the postmenopausal period were hypothesized to help maintain muscle mass and performance. Although the Asian Working Group has developed guidelines for sarcopenia management, the condition has not been sufficiently investigated in the middle-aged cohort of the Asian population. This study aimed to measure the prevalence of pre-sarcopenia and sarcopenia in middle-aged postmenopausal women and to determine the factors associated with low muscle mass.

Methods: In this cross-sectional study conducted in the Menopause Clinic, King Chulalongkorn Memorial Hospital, we used the bioelectrical impedance analysis method to determine the appendicular muscle mass using a body composition analyzer (TANITA MC980 Plus). Appendicular muscle mass index, handgrip strength, and 6-m gait speed were measured in 340 women aged 45 to 65 years. Hormonal profiles, anthropometric data, and relevant history were recorded.

Results: The mean age of the study participants and time since menopause were 57.8 ± 4.5 years and 9.4 ± 5.5 years, respectively. The proportion of pre-sarcopenic, sarcopenic, and nonsarcopenic women were 11.8%, 2.7%, and 85.6%, respectively. A body mass index ≤ 20 kg/m²had the strongest correlation with low muscle mass (odds ratio 7.1; 95% confidence interval 3.0–16.8,

Abstract and Introduction
Methods
Results
Discussion
Conclusion
References

Table 1. Demographic data of participants (n = 340)
Characteristic	Value
Age (y)	57.8 ± 4.6
Year since menopause (y)	9.4 ± 5.5
BMI (kg/m²)	23.8 ± 4.2
Waist-to-hip ratio	0.9 ± 0.1
BMI group, n (%)
<25 kg/m²	238 (70)
≥25 kg/m ²	102 (30)
Gait speed (m/s)	3.3 ± 0.5
Hand grip strength (kg)	22.8 ± 3.8
Menopausal hormone treatment, n (%)
Never	323 (95)
Ever	17 (5)
Serum 25OHD level (ng/mL)	21.9 ± 8.2
Vitamin D status, n (%)
Sufficiency	53 (15.6)
Insufficiency	136 (40)
Deficiency	151 (44.4)
Estradiol level (pg/mL), median (IQR)	0 (6.1)
Free androgen index (%), median (IQR)	0.3 (0.7)
Total testosterone level (nmol/L), median (IQR)	0.2 (0.4)
Free testosterone level (ng/dL), median (IQR)	0.1 (0.1)
Bioavailable testosterone (ng/dL), median (IQR)	1.5 (3.2)
SHBG (nmol/L), median (IQR)	62.9 (51.8)
Fat mass (%)	34.2 ± 6.7
ASMI	6.4 ± 1.0
ASMI status, n (%)
<5.7 kg/m²	49 (14.4)
≥5.7 kg/m²	291 (85.6)
Exercise, n (%)
No (<3 d)	186 (54.7)
Yes (≥3 d)	154 (45.3)
Exercise duration per session, n (%)
<30 min	32 (16.3)
30–60 min	139 (70.9)
>60 min	25 (12.8)
Sunscreen used, n (%)
None	110 (32.4)
Face only	177 (52.1)
Face and body	53 (15.6)
Alcohol consumption, n (%)
No	320 (94.1)
Yes	20 (5.9)
Vasomotor symptoms, n (%)
None	167 (49.1)
Mild	103 (30.3)
Moderate	45 (13.2)
Severe	25 (7.4)

Continuous data were normally distributed, mean ± SD is reported.Continuous data were not normally distributed, median (interquartile range [IQR]) is reported.
ASMI, appendicular skeletal muscle mass index; BMI, body mass index; 25OHD, 25-hydroxyvitamin D; SHBG, sex hormone-binding globulin.

Table 2. Characteristic data comparing women with normal ( n = 291) and low muscle mass ( n = 49)
	Normal (n = 291)	Low muscle mass (n = 49)	P value
Age (y)	57.8 ± 4.6	58.3 ± 4.4	0.5
Year since menopause (y)	9.3 ± 5.5	10.1 ± 5.4	0.4
Year since menopause, n (%)			0.6
<6 y	89 (30.6)	13 (26.5)
≥6 y	202 (69.4)	36 (73.5)
Waist-to-hip ratio	0.9 ± 0.1	0.8 ± 0.1	0.07
BMI (kg/m²)	24.3 ± 4.1	20.4 ± 3.3	<0.001^a
BMI group, n (%)			<0.001^a
<25 kg/m²	193 (66.3)	45 (91.8)
≥25 kg/m ²	98 (33.7)	4 (8.2)
Menopausal hormone therapy, n (%)			0.72
Never	277 (95.2)	46 (93.9)
Ever	14 (4.8)	3 (6.1)
Exercise, n (%)			0.12
No ( <3 d)	154 (52.9)	32 (65.3)
Yes (≥3 d)	137 (47.1)	17 (34.7)
Alcohol, n (%)			0.05
No	277 (95.2)	43 (87.8)
Yes	14 (4.8)	6 (12.2)
Vasomotor symptoms, n (%)			0.75
None	145 (49.8)	22 (44.9)
Mild	87 (29.9)	16 (32.7)
Moderate	39 (13.4)	6 (12.2)
Severe	20 (6.9)	5 (10.2)
Serum total 25 (OHD) (ng/mL)	21.6 ± 7.7	24.1 ± 10.2	0.10
Vitamin D, n (%)			0.22
No deficiency (≥20)	156 (53.6)	31 (63.3)
Deficiency ( <20)	135 (46.4)	18 (36.7)
Free androgen index (%), median (IQR)	0.4 (0.8)	0.2 (0.3)	<0.001^a
Testosterone (nmol/L), median (IQR)	0.2 (0.4)	0.1 (0.2)	0.04^b
Free testosterone (ng/dL), median (IQR)	0.08 (0.15)	0.04 (0.05)	<0.001^a
Bioavailable testosterone (ng/dL), median (IQR)	1.8 (3.5)	0.8 (1.2)	<0.001^a
ASMI (kg/m²)	6.6 ± 0.8	4.9 ± 1.2	<0.001^a
Fat (%)	35.0 ± 6.6	29.3 ± 5.1	<0.001^a
Fat mass	21.1 ± 7.8	14.7 ± 4.9	<0.001^a
Gait speed (m/s)	3.3 ± 0.5	3.2 ± 0.4	0.03^b
Handgrip strength (kg)	23.1 ± 3.8	21.4 ± 3.8	0.005^a

Categories data, Chi-square test, and Fisher's exact test are reported.
Continuous data were normally distributed, mean ± SD and two independent sample t test statistics are reported.
Continuous data were not normally distributed, median (interquartile range [IQR]), and Wilcoxon Mann-Whitney test statistics are reported.
ASMI, appendicular skeletal muscle mass index; BMI, body mass index; 25OHD, 25-hydroxyvitamin D.
^aSignificant level at 0.01 (2-tailed).
^bSignificant level at 0.05 (2-tailed).

Table 3. Factors associated with low muscle mass (n = 49)
Variable	OR 95% CI	P value	Adjusted OR 95% CI	P value
Age (y)	1.03 (0.96–1.10)	0.45	1.03 (0.95–1.12)	0.45
Year since menopause (y)
≥6 y	1.2 (0.6–2.4)	0.57
BMI
≤20 kg/m²	12.7 (6.3–25.9)	<0.001^a	7.1 (3.0–16.8)	<0.001^a
Waist-to-hip ratio
Abdominal obesity	0.2 (0.1–0.4)	<0.001^a	0.5 (0.2–1.1)	0.1
Gait speed (m/s)	0.5 (0.3–1.0)	0.06	0.5 (0.2–1.1)	0.07
Hand grip strength (kg)	0.89 (0.82–0.97)	0.006^a	0.9 (0.82–1.0)	0.039^b
MHT use
Yes	1.3 (0.4–4.7)	0.7
Vitamin D status
Deficiency ( <20)	0.7 (0.4–1.3)	0.2
Free testosterone (ng/dL)	0.003 (0–0.16)	0.004^a	0.077 (0–3.8)	0.2
Exercise
Yes	0.6 (0.3–1.1)	0.1	0.5 (0.2–1.1)	0.09

BMI, body mass index; MHT, menopausal hormone therapy; OR 95% CI, odds ratio 95% confidence intervals.
^aSignificant level at 0.01 (2-tailed).
^bSignificant level at 0.05 (2-tailed).

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Prevalence of Pre-sarcopenia Among Postmenopausal Women Younger Than 65 Years

Abstract and Introduction

Abstract

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Tables

Tables

References

Authors and Disclosures

Authors and Disclosures

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