Abstract
SummaryIn 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.IntroductionTo 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.MethodsData 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.ResultsIn 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.ConclusionsLean 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.
Highlights
Sarcopenia, a common disorder of older age characterised by low lean mass plus low muscle strength and/or low physical performance [1], is associated with increased mortality [2] and considerable economic burden [3]
There was a trend of lower total hip bone mineral density (BMD) across EWGSOP groups such that the pre-sarcopenia and sarcopenia groups had lower BMD than the group without sarcopenia higher (Fig. 2)
Our findings showed that lean mass and lower limb peak muscle force were positively associated with total hip BMD and femoral neck BMD and inversely associated with femoral neck fracture risk index
Summary
Sarcopenia, a common disorder of older age characterised by low lean mass plus low muscle strength and/or low physical performance [1], is associated with increased mortality [2] and considerable economic burden [3]. There has been increasing interest in the effects of sarcopenia and frailty on bone mineral density (BMD) and hip fractures. Physical performance measures which reflect frailty (e.g. grip strength, gait speed, chair rise time) have been shown to predict hip fracture risk in older individuals [4, 5]. Low muscle mass has been related to reduced hip BMD [6] and weaker hip strength based on estimates from hip structural analysis [7]. Lower limb muscle strength, assessed using a range of methods, has been related
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