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Association between opium consumption and sarcopenia in middle-aged and older adults: findings from the Fasa Adults Cohort Study (FACS)
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  • Published: 25 February 2026

Association between opium consumption and sarcopenia in middle-aged and older adults: findings from the Fasa Adults Cohort Study (FACS)

  • Sina Bazmi  ORCID: orcid.org/0000-0002-2128-09241 na1,
  • Fatemeh Masrour2 na1,
  • Mojtaba Farjam1,
  • Reza Homayounfar3,
  • Mohammad Mehdi Naghizadeh1,
  • Nematollah Jaafari4 &
  • …
  • Bahareh Fakhraei1,5 

Scientific Reports , Article number:  (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Diseases
  • Health care
  • Medical research
  • Risk factors

Abstract

Sarcopenia, a condition linked to disability, frailty, and mortality, is influenced by multiple lifestyle and metabolic factors, but its association with opium consumption has not been evaluated. We conducted a cross-sectional analysis of adults aged 35–70 years in the Fasa Adult Cohort Study (FACS). Sarcopenia was defined as skeletal muscle mass index (SMI) in the lowest two quantiles (lowest 40%), and opium use, including dose, was measured using standardized questionnaires. Logistic regression models estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs), with subgroup analyses performed across demographic, dietary, and clinical factors. Opium use was associated with 76% higher odds of sarcopenia (OR = 1.76, 95% CI 1.31–2.36, p < 0.001). The association was consistent across physical activity, socioeconomic status, and protein intake strata, but significant only in males (OR = 1.69, 95% CI 1.22–2.34, p = 0.002). It was also evident among participants with low dietary inflammatory index, low alcohol intake, and without major chronic conditions. Within users, higher opium dose showed a modest dose-related relationship with sarcopenia risk (OR = 1.01 per mesghal/year, 95% CI 1.00–1.01, p = 0.040). These findings demonstrate a strong and independent association between opium use and sarcopenia, especially in men and otherwise healthy individuals, underscoring the need for routine muscle assessment in opium users and integration of sarcopenia prevention into cessation strategies.

Data availability

In our institutional policy, it is not stated that the data should be made public, and a data and material transfer agreement should not allow further transfer of data without the provider’s prior written consent. However, the data can be made available upon request from the corresponding author, who is a member of this team. Additionally, the dataset generated for this study is available upon request to the Fasa Non-Communicable Diseases Research Center management team. They can be contacted via telephone at +987153314068 or via email at ncdrc.fums.ac.ir@gmail.com.

Abbreviations

ALM:

Appendicular lean mass

ALMI:

Appendicular lean mass index

BIA:

Bioelectrical impedance analysis

BMI:

Body mass index

CI:

Confidence interval

CKD:

Chronic kidney disease

CKD-EPI:

Chronic Kidney Disease Epidemiology Collaboration

COPD:

Chronic obstructive pulmonary disease

CT:

Computed tomography

DXA:

Dual-energy X-ray absorptiometry

E-DII:

Energy-adjusted Dietary Inflammatory Index

ESRD:

End-stage renal disease

EWGSOP2:

European Working Group on Sarcopenia in Older People (2nd consensus)

FACS:

Fasa Adult Cohort Study

FMI:

Fat mass index

FSH:

Follicle-stimulating hormone

FFM:

Fat-free mass

GnRH:

Gonadotropin-releasing hormone

GFR:

Glomerular filtration rate

HPG:

Hypothalamic–pituitary–gonadal

IHD:

Ischemic heart disease

LH:

Luteinizing hormone

MRI:

Magnetic resonance imaging

NAFLD:

Non-alcoholic fatty liver disease

OPIAD:

Opioid-induced androgen deficiency

OR:

Odds ratio

OA:

Osteoarthritis

PERSIAN:

Prospective Epidemiological Research Studies in Iran

PPI:

Proton pump inhibitor

ROS:

Reactive oxygen species

SARIR:

Sarcopenia in Iran Research

SES:

Socioeconomic status

SIRI:

Systemic inflammation response index

SMI:

Skeletal muscle index

SPSS:

Statistical Package for the Social Sciences

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Acknowledgements

We thank the participants of the Fasa Adult Cohort Study and its executive team.

Author information

Author notes

  1. Sina Bazmi and Fatemeh Masrour Shared co-first authorship.

Authors and Affiliations

  1. Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran

    Sina Bazmi, Mojtaba Farjam, Mohammad Mehdi Naghizadeh & Bahareh Fakhraei

  2. Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran

    Fatemeh Masrour

  3. National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Reza Homayounfar

  4. Center for Research on Cognition and Learning CNRS 7295, Clinical Research Unit in Psychiatry of the Center Hospitalier Henri Laborit, University of Poitiers, Poitiers, France

    Nematollah Jaafari

  5. Department of Psychiatry, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran

    Bahareh Fakhraei

Authors
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Contributions

Conceptualization: S.B., M.F.; Methodology: S.B.; Software: S.B.; Validation: M.F., MM.NZ., B.F., N.J.; Formal analysis: S.B.; Investigation: S.B., F.M.; Resources: M.F., R.H.; Data curation: M.F., R.H., S.B.; Writing (original draft preparation): S.B., F.M.; Writing (review and editing): S.B., M.F., B.F.,N.J.; Supervision: M.F., S.B.; Project administration: M.F., S.B.; All authors have read and approved the final version. All authors confirm that they had full access to all the data in the study and accept responsibility to submit it for publication.

Corresponding author

Correspondence to Bahareh Fakhraei.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

Our study complied with the standards set forth in the Helsinki Declaration, and all participants were informed of the research objectives and provided written consent before their participation. The research protocol received approval from the research ethics committees of Fasa University of Medical Sciences (IR.FUMS.REC.1404.083), which function similarly to institutional review boards.

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Bazmi, S., Masrour, F., Farjam, M. et al. Association between opium consumption and sarcopenia in middle-aged and older adults: findings from the Fasa Adults Cohort Study (FACS). Sci Rep (2026). https://doi.org/10.1038/s41598-026-40992-8

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  • Received: 22 September 2025

  • Accepted: 17 February 2026

  • Published: 25 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-40992-8

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Keywords

  • Sarcopenia
  • Muscle, skeletal
  • Opium
  • Cross-sectional studies
  • Risk factors
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