ArticleArchives of osteoporosis2020
Loss in DXA-estimated total body lean mass but not fat mass predicts incident major osteoporotic fracture and hip fracture independently from FRAX: a registry-based cohort study.
Article in Archives of osteoporosis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Body composition changes at 12 months following different surgical weight loss interventions in adults with obesity: A systematic review and meta-analysis of randomized control trials.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2022Pooled it
- Exercise attenuates bone mineral density loss during diet-induced weight loss in adults with overweight and obesity: A systematic review and meta-analysis.Journal of sport and health science · 2021Pooled it
- AI for Opportunistic Identification of BMD and Bone Microarchitecture: A Narrative Review.Calcified tissue international · 2026Review
- Regional fat distribution as a novel predictor of fracture risk in inflammatory bowel disease: a DXA-based cohort study.BMJ open gastroenterology · 2026Article
- Interorgan Communications in Skeletal Pathophysiology: From Molecular Pathways to Multidisciplinary Therapies.Research (Washington, D.C.) · 2026Review
- Associations between total and regional fat-to-muscle mass ratio and fracture risk in elderly population: a prospective cohort study in UK Biobank.Frontiers in medicine · 2026Article
- Is trabecular bone score associated with appendicular lean mass?Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- The Association Between Malnutrition, Sarcopenia, and Fracture Risk in Older Adults with Osteoporosis.Sisli Etfal Hastanesi tip bulteni · 2025Article
- Among people on osteoporosis medication, loss of appendicular or total body lean mass is an independent risk factor for hip and major osteoporotic fractures.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- Muscle parameters in fragility fracture risk prediction in older adults: A scoping review.Journal of cachexia, sarcopenia and muscle · 2024Article
- Bone damage and health-related quality of life in Hodgkin lymphoma survivors: closing the gaps.Frontiers in oncology · 2024Review
- Muscle strength is associated with fracture risk obtained by fracture risk assessment tool (FRAX) in women with breast cancer.BMC cancer · 2022Article
- Weight Loss Interventions and Skeletal Health in Persons with Diabetes.Current osteoporosis reports · 2022Review
- Review
- Reverse engineering the FRAX algorithm: Clinical insights and systematic analysis of fracture risk.Bone · 2022Article
- Computed Tomography-Based Stiffness Measures of Trabecular Bone Microstructure: Cadaveric Validation and In Vivo Application.JBMR plus · 2022Article
- Association of sarcopenia with incident osteoporosis: a prospective study of 168,682 UK biobank participants.Journal of cachexia, sarcopenia and muscle · 2021Article
- Betaine, a component ofFood science & nutrition · 2021Article
- Association of muscle health impairment and atherosclerosis with major osteoporotic fracture risk in Taiwanese Vegetarians.Tzu chi medical journalArticle
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 4 countries.
Funding
Abstract
During median follow-up 6.0 years in 9622 individuals, prior loss in estimated total body lean mass (TBLM), but not total body fat mass loss (TBFM), was associated with increased fracture risk, particularly for hip fracture.
introductionWeight loss, and especially muscle loss, adversely affects skeletal health. The FRAX® tool considers baseline body mass index, but not body composition nor changes in its components over time. Our aim was to compare the independent associations between prior loss in DXA-estimated TBLM and TBFM and subsequent fracture risk.
methodsWe identified women and men age 40 years or older with two DXA assessments at least 1 year apart (median interval 3.3 years). TBLM and TBFM were estimated from weight, sex, and DXA of the spine and hip. Incident fractures and deaths were ascertained from linked population-based health service data after the date of the second DXA. Hazard ratios (HRs) from Cox regression models were used to study time to fracture from prior loss in TBLM and TBFM adjusted for FRAX-related covariates.
resultsThe study population consisted of 9622 individuals (mean age 67 [SD 10] years, 95% female). We identified 692 subjects with incident major osteoporotic fracture [MOF] and 194 with hip fracture. Mean TBLM loss was significantly greater in those with incident MOF and hip fracture (P < 0.001) while TBFM loss was only significantly greater in those with incident hip fracture (P < 0.001). Each SD greater TBLM loss was associated with 10-13% increased MOF risk and 29-38% increased hip fracture risk, adjusted for TBFM loss and other covariates. Prior TBFM loss was not associated with fractures when adjusted for TBLM loss.
conclusionsPrior loss in total body lean mass, but not in fat mass, is associated with increased fracture risk, particularly hip fracture, independent of other risk factors. This is consistent with the hypothesis that muscle loss (sarcopenia) adversely impacts skeletal health and fracture risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.