Calcified Tissue International

, Volume 105, Issue 4, pp 392–402 | Cite as

Diagnostic Value of Mid-Thigh and Mid-Calf Bone, Muscle, and Fat Mass in Osteosarcopenia: A Pilot Study

  • Ebrahim Bani Hassan
  • Steven Phu
  • Sara Vogrin
  • Génesis Escobedo Terrones
  • Xaviera Pérez
  • Isabel Rodriguez-Sanchez
  • Gustavo DuqueEmail author
Original Research


Osteosarcopenia is defined as the concomitant occurrence of osteoporosis and sarcopenia. Current lack of consensus on sarcopenia definitions, combined with the low sensitivity and specificity of screening methodologies, has resulted in varying prevalences of sarcopenia, and consequently osteosarcopenia diagnosis. Previous research indicates that mid-thigh is a potential surrogate region for the assessment of bone, muscle, and fat mass in a single, efficient and low-radiation dual x-ray absorptiometry (DXA) scan. We hypothesized that muscle and bone mass measurements in the mid-thigh region can be used to evaluate bone and muscle health and function. A retrospective study was conducted on community-dwelling older subjects (> 65 y.o., n = 260) who were at risk of falls and fractures. Mid-thigh and mid-calf bone, lean muscle, and fat masses, as well as their association with muscle function, falls, and fractures were compared against conventional measures (hip/spine bone, appendicular lean, and gynoid/android fat masses). Mid-thigh bone, lean, and fat masses showed strong correlation with conventional measures. Mid-thigh lean mass showed similar associations with grip strength, gait speed, and timed up and go (TUG) test as appendicular lean mass. Appendicular, mid-thigh and mid-calf lean masses corrected for body mass index (BMI) showed stronger associations than when corrected for height2. None of the indices were associated with fractures; but fat mass was invariably associated with falls. Those with falls and fractures history had lower bone and muscle mass at mid-thigh. Mid-thigh is a potential new surrogate to study bone, muscle, and fat mass in older people, with comparable ability in predicting muscle performance and falls.


Osteosarcopenia Osteoporosis Sarcopenia Falls Fractures Appendicular lean mass 



This study was supported by the Australian Institute for Musculoskeletal Science (AIMSS) as the host institute. The authors would like to thank Mrs Solange Bernardo (the fracture liaison nurse) for coordinating the patient attendance and assistance in data collection. We are also grateful to Mrs Paula Casas for kindly reviewing the manuscript. Ebrahim Bani Hassan was supported by the Australian Medical Research Future Fund (MRFF) under MACH-RART Scheme.

Compliance with Ethical Standards

Conflict of interest

Ebrahim Bani Hassan, Steven Phu, Sara Vogrin, Génesis Escobedo Terrones, Xaviera Pérez, Isabel Rodriguez-Sanchez, and Gustavo Duque declare that they have no competing interest.

Human and Animal Rights and Informed Consent

This study was approved by the local Human Ethics Research Committee (DB2017.13 and QA2018.80_46205). Participant consent was waived due to use of de-identified data collected as part of standard care and to the low risk nature of the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western HealthSt. AlbansAustralia
  2. 2.Department of Medicine-Western HealthThe University of MelbourneSt. AlbansAustralia
  3. 3.Faculty of MedicineAutonomous University of San Luis PotosíSan Luis PotosíMexico
  4. 4.Geriatrics Unit, Faculty of MedicineUniversidad de ChileSantiagoChile
  5. 5.Department of GeriatricsHospital Universitario La PazMadridSpain

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