Accumulation of fat in the liver and skeletal muscle is associated with obesity and poor health outcomes. Liver steatosis is a characteristic of non-alcoholic fatty liver disease (NAFLD) and myosteatosis, of poor muscle quality in sarcopenia. In this study of 403 men (33–96 years), we investigated associations between the fatty liver index (FLI) and muscle density, as markers of fat accumulation in these organs. We also investigated associations between the FLI and parameters of sarcopenia, including DXA-derived appendicular lean mass (ALM) and handgrip strength by dynamometry. Muscle density was measured using pQCT at the radius and tibia. FLI was calculated from BMI, waist circumference, and levels of triglycerides and gamma-glutamyltransferase. There was a pattern of decreasing muscle density across increasing quartiles of FLI. After adjusting for age and lifestyle, mean radial muscle density in Q4 was 2.1% lower than Q1 (p < 0.001) and mean tibial muscle density was 1.8% lower in Q3 and 3.0% lower in Q4, compared to Q1 (p = 0.022 and < 0.001, respectively). After adjusting for age and sedentary lifestyle, participants in the highest FLI quartile were sixfold more likely to have sarcopenia. In conclusion, our results suggest that fat accumulation in the liver co-exists with fat infiltration into skeletal muscle.

The important trace elements, copper and selenium, have diverse effects on human health. As well as other important roles in living tissues, these trace elements are toxic at high levels but are key constituents of various enzymes and proteins essential for maintaining physiological health. However, links between dietary intakes of these elements, particularly copper, and bone mineral density (BMD) in humans remain uncertain. This study aimed to investigate whether dietary intakes of copper and selenium are associated with BMD in women. Dietary intakes of copper and selenium were assessed for 575 women in the Geelong Osteoporosis Study, using a detailed semi-quantitative food frequency questionnaire in conjunction with nutrition composition databases. Participants taking oral multivitamin preparations were excluded from analyses; 522 participants (ages 20–88 y) met the eligibility criteria. BMD at multiple skeletal sites was measured by dual energy X-ray absorptiometry (Lunar DPX-L). Separate multivariable regression models were developed to identify associations between copper and selenium intakes and BMD, after adjustments for age, anthropometry, other dietary factors, medication use, and lifestyle factors. Median (interquartile range) daily intake for copper was 1.5 mg (1.2–1.9) and for selenium, 72 μg (57–90). Low intakes (lowest tertile versus pooled upper tertiles) of copper and selenium were consistently associated with lower BMD at multiple skeletal sites. Fully adjusted models identified small but statistically significant differences in BMD, ranging from 1.8% to 4.0% for low copper intakes and 1.4% to 4.0% for low selenium intakes. Low dietary intakes of copper and selenium were both independently associated with lower BMD, at least in this sample of women. The results contribute to the evidence base for informing dietary recommendations for these trace elements with respect to their contributions to optimal bone health.

We aimed to determine the contribution of high alcohol intake to fracture probability, calculated using a fracture-risk assessment tool (FRAX). Participants were 262 men (ages 60–90 y) in the Geelong Osteoporosis Study. Alcohol consumption was documented via a food frequency questionnaire; 46 (17.6%) consumed three or more units per day, fulfilling the criterion for high alcohol intake. Bone mineral density (BMD) was measured by dual energy x-ray absorptiometry. We determined FRAX probabilities (%) for major osteoporotic fracture (MOF) and hip fracture (HF), calculated with and without alcohol intake. Thresholds for high FRAX probabilities, calculated with or without BMD, were ≥20% for MOF and ≥3% for HF. Proportions of men with high HF-FRAX probabilities were consistently greater for drinkers compared with non-drinkers. For drinkers, paired differences showed that median MOF-FRAX_withoutBMD probabilities calculated with and without alcohol changed by −2.3, HF-FRAX_withoutBMD by −1.7, MOF-FRAX_withBMD by −1.4, and HF-FRAX_withBMD by −0.9 (all p < 0.001). We estimated that, should drinkers lower their alcohol consumption to <3 units/d, up to 66.7% of those at high risk for MOF and up to 41.0% at high risk for HF would reduce their FRAX probabilities to below the thresholds for high fracture risk. In the context of the Australian environment, these data describe the extent to which older men with high alcohol consumption are at increased risk for fracture.

Summary Bone mineral density measured at the ultra-distal forearm site was associated with any fracture, as well as distal radius fracture in women from a longitudinal cohort study. Purpose Femoral neck (BMD_hip) and lumbar spine (BMD_spine) bone mineral density (BMD) are routinely used to assess fracture risk. More data are needed to understand how ultra-distal forearm BMD (BMD_UDforearm) may assist fracture prediction. Methods Using a Lunar DPX-L, Geelong Osteoporosis Study women (n = 1026), aged 40–90 years, had BMD measured. Incident low-trauma fractures were radiologically verified. Using Cox proportional hazard models, hazard ratios (HR) were calculated for BMD_UDforearm as a continuous variable (expressed as a one-unit decrease in T-score) and a categorical variable (normal/osteopenia/osteoporosis). Areas under receiver operating characteristics (AUROC) curves were calculated. Analyses were conducted for any fracture and distal radius fractures. Results During 14,270 person-years of follow-up, there were 318 fractures (85 distal radius). In adjusted models, continuous BMD_UDforearm was associated with any (HR 1.26;95%CI 1.15–1.39) and distal radius fractures (HR 1.59;95%CI 1.38–1.83). AUROCs for continuous BMD_UDforearm, 33% forearm(BMD_33%forearm), BMD_hip, BMD_spine, and FRAX without BMD were similar for any fracture (p > 0.05). For distal radius fracture, the AUROC for BMD_UDforearm was higher than other sites and FRAX (p < 0.05). In adjusted models, those with osteoporosis had a higher likelihood of any fracture (HR 2.12; 95%CI 1.50–2.98). For distal radius fractures, both osteopenia and osteoporosis had a higher risk (HR 4.31; 95%CI 2.59–7.15 and 4.81; 95%CI 2.70–8.58). AUROCs for any fracture were similar for categorical BMD at all sites but lower for FRAX (p < 0.05). For distal radius fractures, the AUROC for BMD_UDforearm, was higher than other sites and FRAX (p < 0.05). Conclusion Ultra-distal forearm BMD may aid risk assessments for any distal radius fractures.