THE ASSOCIATION BETWEEN BODY COMPOSITION, HANDGRIP STRENGTH AND PHYSICAL PERFORMANCE IN ELDERLY MEN WITH SARCOPENIA Asta Mastaviciute*, Vidmantas Alekna, Marija Tamulaitiene, Vaidile Strazdiene
1
1
1
2
1 Vilnius University, Faculty of Medicine; 2State Research Institute Centre For Innovative Medicine; Vilnius, Lithuania
BACKGROUND
Body composition changes with age: bone mineral density decreases, fat mass increases and redistributes fat-free mass decreases and more than 2/3 of the decline is made of muscle1. A progressive and generalized loss of skeletal muscle mass and strength, and / or low physical performance, is called sarcopenia2. The decreased muscle strength is closely correlated with functional limitation, malnutrition and mortality3.
OBJECTIVE
This study was designed to evaluate the associations between body composition, handgrip strength and physical performance in elderly men with sarcopenia.
MATERIAL AND METHODS
This case-control study included 151 men aged 60 years and older. Exclusion criteria were metabolic or endocrine disorders known to affect musculoskeletal system and restriction of movement in the upper or lower extremities. All participants answered face-to-face questionnaires addressing medical history, lifestyle habits and medications use. Written informed consent was obtained from each participant. Physical examination was performed. Dual-energy X-ray absorptiometry (iDXA, GE Lunar) was used to measure lean mass, legs and arms muscle mass separately, fat mass, body fat percentage (% BF), bone mineral content (BMC), total body bone mineral density (BMD). All par-
ticipants performed three maximum attempts for dominant handgrip strength measurements with handle dynamometer (Presision Druck, Germany) and the mean value of these trials was recorded in kilograms (kg). Physical performance was assessed by three subtasks: standing balance test (s), five repeated chair stand test (s) and the 4-m gait speed (s). Sarcopenia was defined when appendicular skeletal muscle mass divided by stature squared was less than 7.26 kg/m². Differences between groups at the 5% significance level (p < 0.05) were assessed by Student t-test and Pearson correlation coefficients were calculated.
RESULTS
Forty seven men with sarcopenia and 104 controls (mean age 75.9 ± 7.7 y and 72.9 ± 7.1 y, p=0.18) were included. Body mass index, total and regional lean mass, total fat mass, % BF, BMC, total body BMD, hangdrip strength were lower and standing balance time was shorter in sarcopenic men, although there were no differences in time performing five repeated chair stand test and the 4-m gait speed test (table 1). Table 1. Body composition characteristics, handgrip strength and physical performance of study participants, mean ± SD
Characteristics, units of measurements
Sarcopenia (n=47)
Control (n=104)
p
Age (year)
75.9 ± 7.7
72.9 ± 7.1
0.18
BMI (kg/m2)
25.3 ± 4.4
28.4 ± 3.6
0.001
Fat mass (kg)
20.9 ± 9.7
26.4 ±7.8
0.001
BF (%)
27.4 ± 9.6
31.5 ± 5.9
0.002
BMC (kg)
2.7 ± 0.5
3.1 ± 0.4
0.001
1.088 ± 0.209
1.227 ± 0.132
0.001
Handgrip strength (kg)
26.9 ± 9.9
33.2 ± 10.4
0.001
Standing balance test (s)
9.1 ± 1.6
9.8 ± 0.7
0.005
Five repeated chair stand test (s)
15.2 ± 5.3
14.9 ± 6.1
0.7
4-m gait speed test (s)
5.4 ± 1.9
4.8 ± 2.3
0.08
Total body BMD (g/cm2)
There were moderate correlations of arm muscle mass (r = 0.6, p = 0.001), leg muscle mass (r = 0.5, p = 0.001), lean mass (r = 0.5, p = 0.001), BMC (r = 0.5, p = 0.002) with handgrip strength in sarcopenic men. The positive correlation was found between total body BMD and handgrip strength in sarcopenic men (picture 1).
Physical performance
SD – standard deviation; BMI – body mass index; BF – body fat; BMD – bone mineral density
Picture 1. Correlation between total body bone mineral density and handgrip strength in sarcopenic men
We haven‘t found significant relationship between total body fat mass, % BF and handgrip strength in sarcopenic men. Standing balance test was related to arm muscle mass (r = 0.3, p = 0.001), leg muscle mass (r = 0.4, p = 0.01), BMC (r = 0.3, p = 0.03) in sarcopenic men, no such association was found with fat mass, %BF, lean mass, total body BMD.
CONCLUSION
This study revealed positive correlations between total and regional muscle mass, bone mineral content and handgrip strength, and standing balance in sarcopenic men. There was negative correlation between bone mineral content, total body bone mineral density and gait speed in sarcopenic men. ACNOWLEDGMENTS We would like to thank Audrone Misiunaite, Edita Merkeliuniene for the skillful performing of the body composition measurements and Elvyra Stapcinskiene for valuable assistance in this study. REFERENCES: 1. Morley JE. Family Practice 2012; 29: i44–i48 2. Cruz-Jentoft AJ, et al. Age Ageing 2010; 39(4): 412–423 3. Gale Catharine R, et al. International Journal of Epidemiology 2007; 36(1): 228–235 *Contact address: asta.mastaviciute@osteo.lt