Understanding Sarcopenic Obesity and Fracture Risk in Ageing Indian Men: A Step Toward Gender-Responsive Healthy Ageing
1
South Asian Institute of Health Promotion, New Delhi, India
2
Indian Council of Medical Research, New Delhi, India
3
WHO NTEP Technical Support Network, New Delhi, India
Popul. Med. 2026;8(Supplement Supplement 1):A48
ABSTRACT
BACKGROUND:
Fragility fractures (FF) are a major cause of disability in later life and are influenced by bone health, muscle strength, and body composition. Sarcopenic obesity (SO), characterized by low muscle strength and excess adiposity, may increase fracture risk through impaired balance, mobility, and fall susceptibility. However, its relevance appears gender-specific. In women, pre-menopausal protection followed by a high prevalence of SO in later life may limit its ability to discriminate fracture risk. In contrast, SO in men may represent disproportionate muscle loss and accelerated functional decline, increasing vulnerability to FFs. Despite this biological plausibility, gender-specific evidence from India is scarce. This study therefore examines the relationship between SO and FFs among older men in India.
METHODS:
This case-control study used data from Wave-1 (2017–18) of the Longitudinal Ageing Study in India (LASI), including 66,406 respondents aged ≥45 years. Individuals reporting fall-related fractures with available SO data were identified and classified into fragility and non-fragility fracture groups. Descriptive statistics and bivariate analyses were conducted to examine associations between SO and FFs overall and stratified by gender.
RESULTS:
A total of 2,480 respondents(45.5%) sustained fractures, including 1,274(51.4%) classified as FFs and 1,206 (48.6%) as non-FFs. Overall, the prevalence of SO was similar among individuals with and without FFs (52.5%vs.52.4% χ²=0.001,p=0.975). In gender-stratified analyses, SO was significantly associated with FFs among men. Among men, 25.0% (65/260) of those with FFs had sarcopenic obesity compared with 38.5% (72/187) among those without FFs (χ²=9.33,p=0.002). In contrast, no significant association was observed among women, among whom SO prevalence remained high in both FF (63.2%; 422/668) and non-FF groups (67.6%; 115/170) (χ² = 1.18, p = 0.278).
CONCLUSIONS:
SO may serve as a relevant marker of FF risk among older men, underscoring the need for gender-targeted fracture prevention strategies in India.
Fragility fractures (FF) are a major cause of disability in later life and are influenced by bone health, muscle strength, and body composition. Sarcopenic obesity (SO), characterized by low muscle strength and excess adiposity, may increase fracture risk through impaired balance, mobility, and fall susceptibility. However, its relevance appears gender-specific. In women, pre-menopausal protection followed by a high prevalence of SO in later life may limit its ability to discriminate fracture risk. In contrast, SO in men may represent disproportionate muscle loss and accelerated functional decline, increasing vulnerability to FFs. Despite this biological plausibility, gender-specific evidence from India is scarce. This study therefore examines the relationship between SO and FFs among older men in India.
METHODS:
This case-control study used data from Wave-1 (2017–18) of the Longitudinal Ageing Study in India (LASI), including 66,406 respondents aged ≥45 years. Individuals reporting fall-related fractures with available SO data were identified and classified into fragility and non-fragility fracture groups. Descriptive statistics and bivariate analyses were conducted to examine associations between SO and FFs overall and stratified by gender.
RESULTS:
A total of 2,480 respondents(45.5%) sustained fractures, including 1,274(51.4%) classified as FFs and 1,206 (48.6%) as non-FFs. Overall, the prevalence of SO was similar among individuals with and without FFs (52.5%vs.52.4% χ²=0.001,p=0.975). In gender-stratified analyses, SO was significantly associated with FFs among men. Among men, 25.0% (65/260) of those with FFs had sarcopenic obesity compared with 38.5% (72/187) among those without FFs (χ²=9.33,p=0.002). In contrast, no significant association was observed among women, among whom SO prevalence remained high in both FF (63.2%; 422/668) and non-FF groups (67.6%; 115/170) (χ² = 1.18, p = 0.278).
CONCLUSIONS:
SO may serve as a relevant marker of FF risk among older men, underscoring the need for gender-targeted fracture prevention strategies in India.
| eISSN: | 2654-1459 |
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