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Osteoporos Int. 2019 Jan;30(1):211-220. doi: 10.1007/s00198-018-4795-z. Epub 2018 Dec 14.

Lean mass and lower limb muscle function in relation to hip strength, geometry and fracture risk indices in community-dwelling older women.

Author information

1
Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. a.elhakeem@bristol.ac.uk.
2
MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. a.elhakeem@bristol.ac.uk.
3
Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
4
MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
5
Department of Mechanical Engineering, University of Manitoba, Winnipeg, Canada.
6
Department of Radiology, University of Manitoba, Winnipeg, Canada.
7
Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.

Abstract

In a population-based sample of British women aged over 70 years old, lean mass and peak lower limb muscle force were both independently associated with hip strength and fracture risk indices, thereby suggesting a potential benefit of promoting leg muscle strengthening exercise for the prevention of hip fractures in postmenopausal women.

INTRODUCTION:

To investigate cross-sectional associations of lean mass and physical performance, including lower limb muscle function, with hip strength, geometry and fracture risk indices (FRIs) in postmenopausal women.

METHODS:

Data were from the Cohort of Skeletal Health in Bristol and Avon. Total hip (TH) and femoral neck (FN) bone mineral density (BMD), hip geometry and total body lean mass (TBLM) were assessed by dual x-ray absorptiometry (DXA). Finite element analysis of hip DXA was used to derive FN, intertrochanteric and subtrochanteric FRIs. Grip strength, gait speed and chair rise time were measured objectively. Lower limb peak muscle force and muscle power were assessed by jumping mechanography.

RESULTS:

In total, 241 women were included (age = 76.4; SD = 2.6 years). After adjustment for age, height, weight/fat mass and comorbidities, TBLM was positively associated with hip BMD (βTH BMD = 0.36, P ≤ 0.001; βFN BMD = 0.26, P = 0.01) and cross-section moment of inertia (0.24, P ≤ 0.001) and inversely associated with FN FRI (- 0.21, P = 0.03) and intertrochanteric FRI (- 0.11, P = 0.05) (estimates represent SD difference in bone measures per SD difference in TBLM). Lower limb peak muscle force was positively associated with hip BMD (βTH BMD = 0.28, P ≤ 0.001; βFN BMD = 0.23, P = 0.008) and inversely associated with FN FRI (- 0.17, P = 0.04) and subtrochanteric FRI (- 0.18, P = 0.04). Associations of grip strength, gait speed, chair rise time and peak muscle power with hip parameters were close to the null.

CONCLUSIONS:

Lean mass and lower limb peak muscle force were associated with hip BMD and geometrical FRIs in postmenopausal women. Leg muscle strengthening exercises may therefore help prevent hip fractures in older women.

KEYWORDS:

DXA; Fracture risk index; Jumping mechanography; Physical performance; Sarcopenia

PMID:
30552442
PMCID:
PMC6331743
DOI:
10.1007/s00198-018-4795-z
[Indexed for MEDLINE]
Free PMC Article

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