Dual-energy X-ray absorptiometry-measured lean mass and clinical bone fracture in elderly Japanese men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) cohort study.

The FORMEN cohort study enrolled 780 elderly Japanese men with complete data for analysis from an initial source population of 948.

• Source population consisted of 948 elderly men who underwent lean mass measurement by DXA at the time of the 2017-2019 survey.
• 780 participants provided complete information regarding clinical fracture experience in the follow-up survey conducted in 2022-2023.
• Mean age at the time of the 2017-2019 survey was 80.2 years (standard deviation, 3.8).
• Participants were community-dwelling elderly Japanese men from the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) cohort study.

52 participants experienced one or more clinical bone fractures during the follow-up period from the 2017-2019 survey to the 2022-2023 follow-up survey.

• 52 out of 780 participants had experienced one or more clinical bone fractures.
• Fractures included both osteoporotic and non-osteoporotic fractures.
• The follow-up period spanned approximately 3-6 years between the 2017-2019 baseline survey and the 2022-2023 follow-up survey.

Odds ratios of clinical bone fracture for arm lean mass, leg lean mass, and leg-to-trunk lean mass ratio were significantly lower than 1.0 after adjusting for potential confounding factors.

• Confounding factors adjusted for included age, nutrition intake, and physical performance.
• The association was found for arm lean mass, leg lean mass, and leg-to-trunk lean mass ratio specifically.
• Trunk lean mass was not reported as a significant predictor, suggesting appendicular lean mass is more relevant than trunk lean mass.
• The findings suggest that DXA-measured lean mass provides additional information useful for the management of bone fractures.

DXA-based appendicular lean mass predicts future clinical bone fractures in elderly Japanese men, suggesting those with low skeletal muscle mass may be prone to future clinical fractures.

• Appendicular lean mass was identified as a predictor of future clinical bone fractures.
• The authors suggest that elderly men with low skeletal muscle mass, which can be accurately estimated from appendicular lean mass, may be prone to future clinical fractures.
• DXA-measured lean mass was described as providing 'additional information useful for the management of bone fractures.'
• Prior evidence regarding the relationship between DXA-measured lean mass and fractures was noted to be inconsistent, which this study sought to address.