Poster Presentation 29th Australian and New Zealand Bone and Mineral Society Annual Scientific Meeting 2019

Hemoglobin levels are low in osteosarcopenic older patients (#114)

Ebrahim Bani Hassan 1 2 , Sara Vogrin 1 2 , Pushba Suriyaarachchi 3 4 , Idaira Hernandez Viña 5 , Derek Boersma 4 , Gustavo Duque 1 2
  1. AIMSS (Australian Institute for Musculoskeletal Science), The University of Melbourne, St. Albans, VIC, Australia
  2. Department of Medicine-Western Health, The University of Melbourne,, St. Albans, VIC, Australia
  3. Sydney Medical School Nepean, The University of Sydney, Sydney, NSW, Australia
  4. Falls and Fractures Clinic, Department of Geriatric Medicine, Nepean Hospital, Penrith, NSW, Australia
  5. Javea Health Centre, Denia Hospital, Alicante, , Spain

Background: Anemia is commonly associated with osteoporosis and sarcopenia in older persons.  However, there is a subset of patients identified as osteosarcopenic at a higher risk of adverse outcomes. Whether these patients are also at a higher risk of anemia remains unknown.

Objectives: We aimed to compare hemoglobin (Hb) levels in osteosarcopenic older subjects versus those with sarcopenia or osteopenia/osteoporosis alone.

Methods: Cross-sectional study of community-dwelling participants from Western Sydney. Participants were able to mobilize independently, reported a risk/history of falls and were not cognitively impaired. Associations of anemia with sarcopenia, osteopenia/osteoporosis and osteosarcopenia were assessed. We used the original (EWGOP) and revised (EWGSOP2) European consensus on definition of sarcopenia. Between group differences were examined using Fisher’s Exact and Kruskal-Wallis tests. Linear regression was used to explore the differences in haemoglobin levels between groups (unadjusted and adjusted for confounders). The effect of anaemia on number of falls was evaluated in each group separately, using negative binomial regression.

Results: n=558 subjects, 65 and over (mean age 79 ± 7.5 years) were included. Based on both definitions of sarcopenia (EWGSOP[EWGSOP2]) prevalence of anemia was the highest among sarcopenic patients (39 [40]%), followed by osteosarcopenic (34 [34]%), osteoporotic/penic (26 [25]%) and controls (24 [24]%). Osteosarcopenic patients on average had 6 [6.3] g/L lower Hb levels compared to controls (p=0.001), and 4 [3.7] g/L lower Hb than patients with osteoporosis/osteopenia (p<0.026; Figure). Levels of Hb did not differ between sarcopenic vs osteosarcopenic patients (p=0.817), and between osteoporotic/osteopenic patients vs controls (p>0.259; Figure). Only osteoporotic/penic patients with low Hb had 50% higher incidence of falls compared to those with normal Hb (IRR 1.5, p=0.020).

Conclusions: The previously reported associations between osteoporosis and anemia were not confirmed and are likely to be due to inclusion of osteosarcopenic subjects as osteoporotic in those studies.

 

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