Assessing bone and muscle health and their association in a Mongolian population aged 40 and older: a pioneering observational study

Summary

This study in Mongolia reveals that weaker grip strength and higher sarcopenia risk are linked to greater fracture risk and lower bone density. It highlights the crucial interplay between muscle and bone health, emphasizing the need for integrated musculoskeletal assessments to prevent fractures, especially in aging populations.

Background

Research on the relationship between bone and muscle health in low- and middle-income countries, particularly Central Asia, remains limited.

Objectives

To explore the correlation between muscle and bone health and to estimate the FRAX risk for major osteoporotic fractures (MOF) and hip fractures in the Mongolian population, stratified by age and sex.

Methods

A cross-sectional study was conducted in Ulaanbaatar and regional Mongolia from May to August 2024. Handgrip strength, sarcopenia risk (SARC-F) and bone mineral density using peripheral DXA (BMD T-score) were assessed. Fracture risks were estimated using the FRAX model.

Results

Participants (n = 857; median age, 52 years; 53.0% women) had a median grip strength of 28 kg and a median BMD T-score of − 1.9. Most (69.5%) were at low sarcopenia risk (SARC-F < 4). SARC-F was moderately correlated with FRAX scores for MOF and hip fractures (r ≈ 0.27, p < 0.001) while grip strength was negatively correlated with FRAX scores(r =  − 0.24, p < 0.001). Grip strength positively correlated with BMD T-scores (r = 0.22, p < 0.001). Fracture risks increased with age, with women showing higher rates than men. Higher sarcopenia risk (SARC-F ≥ 4) was associated with lower BMD and increased fracture risk. Lower grip strength (< 18 kg for women, < 28 kg for men) was linked to higher fracture risk and lower BMD.

Conclusions

This study highlights the interconnected nature of muscle and bone health in the Mongolian population, demonstrating that lower grip strength and higher sarcopenia risk are significantly associated with increased fracture risk and reduced bone density. These findings underscore the importance of integrated strategies for musculoskeletal health assessment and fracture prevention, particularly in aging populations.