T-Score and Handgrip Strength Association for the Diagnosis of Osteosarcopenia: A Systematic Review and Meta-Analysis

Abstract

Background: Osteosarcopenia is a recently identified condition caused by the coexistence of osteoporosis and sarcopenia that affects the frail elderly population, leading to an increased risk of falls and fractures. Given the recent socio-economic interest associated with osteosarcopenia, the aim of this meta-analysis is to provide an overview of the factors potentially involved in its pathogenesis, assessing its population type, prevalence, and associated variables.

Methods: A comprehensive systematic search for relevant studies, published from 2015 to 2020, was performed by using PubMed, EMBASE, and Cochrane databases. We analysed the variables of age, vitamin D, handgrip, and T-score in four different groups: healthy, osteopenic-osteoporotic, sarcopenic, and osteosarcopenic.

Results: A total of 6504 patients from 16 studies were included in the final meta-analysis. The analysis of the individual variables reveals a statistically significant correlation between the handgrip test data and T-score (p < 0.001).

Conclusions: The correlation between T-score values and handgrip strength suggests a new potential parameter in the development of predictive models that could be used in clinical practice, highlighting its importance for the diagnosis of osteosarcopenia.

Keywords: T-score; handgrip strength; meta-analysis; osteoporosis; osteosarcopenia; sarcopenia; systematic review.

Figure 1

PRISMA flow diagram of the literature search and selection process of the included studies.

Figure 2

Distribution of the variables associated with the subjects of the primary studies. (A) Age variable; (B) BMI variable; (C) T-score variable; (D) Vitamin D; (E) Handgrip variable. All subjects and male and female groups were analysed separately. Differences were considered significant when the p value was < 0.05 (* p <0.05, ** p <0.01, *** p <0.001).

Figure 3

Boxplot of the statistically significant correlation between the T-score and handgrip variables in all subjects, males, and females between groups (χ² = 188; ** p < 0.001) and within the single OSP group (χ² =2 78; ** p < 0.001).

Figure 4

Bone–muscle unit. Characteristics of sarcopenia and osteoporosis diseases, which contribute to the onset of osteosarcopenia (created with BioRender.com).