Association of sarcopenia and fractures in community-dwelling older adults: a systematic review and meta-analysis of cohort studies

To our knowledge, no comprehensive meta-analysis has examined the association between sarcopenia and the risk of fractures. This systematic review and meta-analysis of prospective cohort studies aims to summarize whether sarcopenia is a risk factor for fractures among community-dwelling older adults. We searched four electronic literature databases (Ovid MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, PubMed) for relevant publications from inception to December 2017, using relevant keywords. We conducted a pooled analysis of the association between sarcopenia and the risk of fractures by employing a random-effects model. Subgroup analyses were conducted based on definitions of sarcopenia and gender. In total, nine studies were included in our systematic review and meta-analysis. The prevalence of sarcopenia ranged from 4.3 to 33.1%. The pooled RR of fractures for the sarcopenic versus the nonsarcopenic was 1.34 (95% CI = 1.13-1.58, P = 0.001, I (2) = 5.5%, P-heterogeneity = 0.391). Subgroup analyses showed that associations between sarcopenia and fractures were significant when using the AWGS definition (combined effect size = 1.78, 95% CI = 1.25-2.54, P = 0.001), and studies in males (combined effect size = 1.39, 95% CI = 1.13-1.71, P = 0.002). In conclusion, we found that compared to nonsarcopenic, the association between sarcopenia and fractures among community-dwelling older people was significant when using the AWGS definition, and only for males. Future studies are needed to establish a possible association between sarcopenia definitions and risk of fractures of different sites.