Background. Along with increasing life expectancy, the prevalence of age-associated diseases and geriatric syndromes is increasing. Sarcopenic obesity (SO) is one example of pathological changes in body composition associated with aging. However, the relationship of this pathology with bone density in elderly people has not been fully studied.
Objective. Evaluation of the relationship between SO and bone density in elderly people.
Methods. The study included 568 elderly people (mean age 66.5±5.6 years) with obesity who signed informed consent to participate. Complaints and medical history were collected for all study participants, and anthropometric indicators (height, weight, body mass index [BMI]) were determined. Body composition was determined by bioimpedance analysis, bone mineral density [BMD] was determined by the bone mineral density (BMD) criterion using dual-energy x-ray absorptiometry (DEXA), and hand grip strength was determined using hand dynamometry. Walking speed over a distance of 4 meters was measured using standard methods. Patients were divided into two groups: with SO and without SO. Osteosarcopenic obesity (OSO) was defined as a combination of SO and low BMD.
Results. Participants with SO (197 people, 34.7%) were significantly older (p<0.001), predominantly female (51.6 vs 48.4%), with higher BMI (p<0.001), higher fat mass (p= 0.015) and a higher proportion of fat mass (p<0.001). People with SO had lower values of BMD (p<0.001) and BMD/height ratio (p<0.001) compared to people without SO. The SO group included more participants with low BMD (47.3 vs. 25.9%) than the non-SO group. Logistic regression analysis revealed a 2.5-fold higher risk of low BMD (HR=2.57; 95% CI: 2.17–3.04; p<0.05) in the SO group. The association persisted after adjustment for age, weight, and fat mass proportion, reflecting an almost twofold higher risk of low BMD in the presence of SO (HR=1.92; 95% CI: 1.60–2.31; p<0.05). 93 (16.4%) participants had OSO.
Conclusion. Osteosarcopenic obesity in our study occurred in 16.4% of patients. Sarcopenic obesity was associated with low bone mineral density (RR=2.57; 95% CI: 2.17–3.04; p<0.05). To form an individual complex of treatment, preventive and rehabilitation measures for elderly patients with obesity, it is necessary to conduct a study of the body composition and bone mineral density.

Keywords: bioimpedance analysis, DEXA, dual-energy X-ray absorptiometry, sarcopenic obesity, body composition, sarcopenia, bone density, osteoporosis, elderly age, obesity