Hip In Postmenopausal Women Research Articles

Effect of Tibolone on Bone Mineral Density in Postmenopausal Women: Systematic Review and Meta-Analysis.

Simple SummaryLow bone mineral density (osteoporosis) is associated with vertebral and nonvertebral fractures in postmenopausal women. Tibolone is a low-risk hormone replacement therapy alternative to estrogen therapy, effective in the treatment of menopausal symptoms and prevention of bone loss, but the evidence is controversial. This systematic review with meta-analysis summarizes the clinical trials of the tibolone effect on percentage change of bone mineral density in the lumbar spine, femoral neck, and total hip in postmenopausal women. The results show that tibolone 2.5 mg dose increases the percent change in bone mineral density compared with non-active controls at 24 months in lumbar spine and femoral neck, regardless of the scanner used to evaluate the bone mineral density. No difference was observed when 2.5 mg tibolone dose was compared with estrogen therapy at 24 months, and both treatments have a positive effect on the bone mineral density. In conclusion, tibolone increases bone mineral density compared to non-active controls, and there was no difference when it is compared to estrogenic therapy; thus, tibolone is an alternative treatment for menopausal symptoms and bone protection.Low bone mineral density (BMD) on postmenopausal women causes bone fragility and fracture risk. Tibolone seems to prevent bone loss. Therefore, this systematic review with meta-analysis synthesizes the tibolone effect on BMD percent change in lumbar spine (LS), femoral neck (FN), and total hip (TH) in postmenopausal women. Controlled trials that provided tibolone evidence on the efficacy of tibolone in preventing loss of BMD were included. Regarding the included studies, a pooled mean difference (MD) with 95% confidence intervals (95%CI) was estimated to determine the BMD percentage change. Eleven studies were identified and eight were included in the quantitative analysis. Tibolone at a dose of 2.5 mg increased BMD compared with non-active controls at 24 months in LS (MD 4.87%, 95%CI: 4.16–5.57, and MD 7.35%, 95%CI: 2.68–12.01); and FN (MD 4.85%, 95%CI: 1.55–8.15, and 4.21%, 95%CI: 2.99–5.42), with Hologic and Lunar scanners, respectively. No difference was observed when tibolone 2.5 mg dose was compared with estrogen therapy (ET) at 24 months, LS (MD −0.58%, 95%CI: −3.77–2.60), FN (MD −0.29%, 95%CI: −1.37–0.79), and TH (MD −0.12%, 95%CI: −2.28–2.53). Therefore, tibolone increases BMD in LS and FN compared to non-active controls, and there was no showed difference with ET.

Serum resistin levels as predictor of low bone mineral density in postmenopausal women

Resistin, a novel adipokine may play an important role in bone metabolism. The study is designed to discover the association of bone mineral density (BMD) with serum resistin levels, anthropometric measures and to elucidate serum resistin as a predictor of BMD in postmenopausal women. Postmenopausal women (n = 160) were recruited and divided into two groups, non-osteoporotic (n = 70) and osteoporotic (n = 90). BMD was evaluated by DXA scan. High serum resistin levels and low weight are independent contributors to low BMD and can influence BMD at lumbar spine, right femoral neck, right hip, left femoral neck, and left hip in postmenopausal women.

The influence of antiresorptive bone medication on the effect of high-intensity resistance and impact training on osteoporotic fracture risk in postmenopausal women with low bone mass: protocol for the MEDEX-OP randomised controlled trial

IntroductionAntiresorptive medications increase bone density and decrease vertebral fracture, while high-intensity resistance and impact training (HiRIT) increases balance, bone and muscle strength decreasing risk for falls and fractures. Medications are...

Influence of Thyroid-stimulating Hormone Suppression Therapy on Bone Mineral Density in Patients with Differentiated Thyroid Cancer: A Meta-analysis.

BackgroundThe effects of subclinical hyperthyroidism on bone mineral density (BMD) induced by thyroid-stimulating hormone (TSH) suppression therapy in patients with differentiated thyroid cancer (DTC) remains unclear. We conducted a meta-analysis to determine the influence of TSH suppression therapy on BMD.MethodsWe performed a systematic search to identify studies which included BMD measurement of femoral neck, total hip or lumbar spine in patients on TSH suppression therapy for DTC. Main outcome measures were difference of BMD of femoral neck, total hip or lumbar spine measured by dual energy X-ray absorptiometry between patients and controls.ResultsA systematic search yielded a total of 11 published controlled cross-sectional studies (including about 571 patients and 836 controls). TSH suppression therapy was associated with the lower BMD of total hip (weighted mean difference [WMD], −0.023; 95% confidence interval [CI], −0.047 to 0.000; P=0.050) and spine (WMD, −0.041; 95% CI, −0.057 to −0.026; P<0.001) in postmenopausal women with DTC, while it was not associated with that in premenopausal women and men with DTC.ConclusionsAlthough the included studies were limited by small numbers, results suggested possible association between chronic TSH suppression therapy and the lower BMD of spine and total hip in postmenopausal women (but not in premenopausal women and men) with DTC. A large, well-designed study with long-term follow-up would provide further insight into the influence of TSH suppression therapy and loss of BMD.

Longitudinal changes in bone mineral density, bone mineral content and bone area at the lumbar spine and hip in postmenopausal women, and the influence of abdominal aortic calcification

Longitudinal studies often report that spine bone mineral density (BMD), measured by DXA, is stable in older adults, which has been attributed to osteophyte development and the presence of aortic calcification. A decline in projected spine area as a result of loss of intervertebral disc height might also contribute to higher BMD. We utilised data from 297 postmenopausal women (mean 73 years) who had DXA measurements of the lumbar spine, total hip and femoral neck 5 years apart, and abdominal aortic calcification scoring from vertebral morphometry. BMD declined by −4.4% at the total hip and −3.9% at the femoral neck (p < 0.001), but did not change at the spine (−0.5%, p = 0.12). In contrast, bone mineral content (BMC) declined by −4.0% at the total hip, −2.5% at the femoral neck and −1.7% at the spine (all p < 0.001). Bone area increased by 0.5% at the hip and 1.6% at the femoral neck but declined by −1.2% at the spine (all p < 0.001). 43% of the cohort had abdominal aortic calcification (AAC) present at baseline. The presence of AAC at baseline was not related to changes in BMD or BMC at the total hip or femoral neck, nor to BMD at the spine. However, women with AAC present had a smaller loss of BMC at the spine than those without (−0.8% versus −2.4%, p = 0.03). AAC score increased more over 5 years among those with AAC at baseline than those without (0.28 versus 0.16, p = 0.036). Thus, the stability of spine BMD is the result of both a loss of projected bone area (as a result of intervertebral disc changes and/or a decrease in projected area of the vertebral bodies) and the effects of aortic calcification. Future clinical trials should consider assessing changes in spine BMC as a more informative index of spine mineral status.

Association of serum uric acid with bone mineral density and clinical fractures in Chinese type 2 diabetes mellitus patients: A cross-sectional study

BackgroundWe evaluate the associations of serum uric acid (UA) with bone mineral density (BMD) and prevalence of clinical fractures in type 2 diabetes mellitus (T2DM) patients. Methods1562 T2DM patients undergoing BMD measurement and clinical fractures assessment were enrolled andserum UA concentrations were measured. ResultsT2DM patients with osteoporosis had lower serum UA concentrations compared with those with normal BMD values and osteopenia. Serum UA concentration was significantly correlated with BMD values at the lumbar spine, femoral neck, and total hip in postmenopausal women, and serum UA concentration was positively associated with BMD values at the lumbar spine in men. Moreover, patients with clinical fractures had lower serum UA than those without. Multiple logistic regression analysis showed that serum UA concentrations were significantly and inversely associated with the presence of clinical fractures after adjustment for age, BMI, diabetes duration, fasting blood glucose (FBG), Glycated hemoglobin A1c (HbA1c), alkaline phosphatase (ALP), creatinine (Cr), neutrophil to lymphocyte ratio (NLR), diabetic vascular complications [men: OR = 0.996, 95% CI = 0.993–1.000, P = 0.039; women: OR = 0.996,95% CI = 0.994–0.998, P = 0.001]. The results were not statistically significant when models were further adjusted for BMD values at each site. ConclusionsLower serum UA concentrations may be associatedwith lower BMD values and higher prevalence of clinical fractures independent of potential confounders except for BMD values at each site. These findings need to be confirmed by further prospective studies.

Association of Vitamin D Receptor (FokI and BsmI) Gene Polymorphism with Bone Mineral Density and Their Effect on 25-Hydroxyvitamin D Level in North Indian Postmenopausal Women with Osteoporosis.

Osteoporosis is a systemic disease with a strong genetic component. Vitamin D receptor (VDR) has been suggested as a candidate gene for osteoporosis. Therefore the present study was aimed to investigate the pattern of allelic variants of VDR gene polymorphism (FokI and BsmI), its influence on vitamin D levels and bone mineral density (BMD) in North Indian postmenopausal women with osteoporosis for possible genetic association. 254 postmenopausal osteoporotic women and 254 postmenopausal non osteoporotic women were included in the study. VDR FokI and BsmI gene polymorphism gene were assessed by the PCR-RFLP method. Serum 25-hydroxyvitamin D was measured by the ELISA. BMD at the L1-L4 lumbar spine, hip, forearm and femoral neck was assessed by dual energy X-ray absorptiometry. The average BMD at spine and hip in postmenopausal women with bb and spine, hip, femoral neck and forearm with ff genotype had significantly low BMD. The frequency of ff genotype and f allele was significantly higher in postmenopausal osteoporotic women when compared with postmenopausal non osteoporotic women. However, no significant association was found between the genotypes and vitamin D levels. Our study reveals that VDR gene FokI and BsmI polymorphism is significantly associated with low bone mineral density. Therefore the ff genotype and f allele of VDR FokI gene may be used as an important risk factor for osteoporosis.

Establishing Reference Intervals for Bone Turnover Markers in the Healthy Shanghai Population and the Relationship with Bone Mineral Density in Postmenopausal Women

The reference ranges of bone turnover markers (BTMs) were important during the treatment of osteoporosis, and the associations with bone mineral density (BMD) were controversial. The aim of this study was to establish the reference ranges of N-terminal procollagen of type l collagen (P1NP), osteocalcin (OC), and beta C-terminal cross-linked telopeptides of type I collagen (β-CTX) in Shanghai area and to investigate the relationships between BTMs and BMD in postmenopausal women. 2,799 subjects recruited in Shanghai City were measured BTMs to establish the reference ranges. Additional 520 healthy postmenopausal women were also measured BTMs, these women measured BMD in addition. BTMs were measured using the Roche electrochemiluminescence system. We used the age range of 35 to 45-year-olds to calculate reference intervals. The reference range of OC was 4.91 to 13.90 ng/mL for women and 5.58 to 16.57 ng/mL for men, P1NP was 13.72 to 32.90 ng/mL for women and 16.89 to 42.43 ng/mL for men, and β-CTX was 0.112 to 0.210 ng/mL for women and 0.100 to 0.378 ng/mL for men. BTMs significantly negatively correlated with lumbar spine and femoral and total hip in postmenopausal women (Betastd = −0.157 ~ −0.217, P < 0.001). We established the normal reference ranges of P1NP, OC, and β-CTX in the Shanghai area. This study also found that BTMs correlated with BMD and suggested that BTMs were the key determining factors of early BMD decreases.

Mechanical stimuli and bone health

With the recent emergence of associations of bisphosphonate therapy with atypical fractures and osteonecrosis of the jaw, there is renewed interest among clinicians and patients for nonpharmacological approaches to bone health. Here, we review the new studies published in the past year or two that advance our knowledge of the effect of mechanical stimuli on bone health. Physical activity is associated with serum sclerostin levels; the most physically active individuals have the lowest serum sclerostin levels. Observational trials suggest that physical activity participation results in higher bone mass, but clinical trials suggest that the effects of exercise on areal bone mineral density are small, and vary with the site measured and the type of exercise. Based on current data, it may be best to combine progressive resistance training with interventions such as walking or aerobic dancing if the desire is to improve both spine and hip in postmenopausal women. Low-magnitude high-frequency whole body vibration does not improve bone mineral density and bone structure in postmenopausal women. Physical activity and exercise are important for the maintenance of musculoskeletal health as we age. Future studies need to investigate the effects of exercise in older populations with rheumatological diseases and those with a history of fragility fractures.

Denosumab Densitometric Changes Assessed by Quantitative Computed Tomography at the Spine and Hip in Postmenopausal Women With Osteoporosis

FREEDOM was a phase 3 trial in 7808 women aged 60–90yr with postmenopausal osteoporosis. Subjects received placebo or 60 mg denosumab subcutaneously every 6mo for 3yr in addition to daily calcium and vitamin D. Denosumab significantly decreased bone turnover; increased dual-energy X-ray absorptiometry (DXA) areal bone mineral density (aBMD); and significantly reduced new vertebral, nonvertebral, and hip fractures. In a subset of women (N=209), lumbar spine, total hip, and femoral neck volumetric BMD (vBMD) were assessed by quantitative computed tomography at baseline and months 12, 24, and 36. Significant improvement from placebo and baseline was observed in aBMD and vBMD in the denosumab-treated subjects at all sites and time points measured. The vBMD difference from placebo reached 21.8%, 7.8%, and 5.9%, respectively, for the lumbar spine, total hip, and femoral neck at 36mo (all p≤0.0001). Compared with placebo and baseline, significant increases were also observed in bone mineral content (BMC) at the total hip (p<0.0001) largely related to significant BMC improvement in the cortical compartment (p<0.0001). These results supplement the data from DXA on the positive effect of denosumab on BMD in both the cortical and trabecular compartments.

Effects of polymorphisms of the sex hormone-binding globulin (SHBG) gene on free estradiol and bone mineral density

Background Polymorphisms of the sex hormone-binding globulin (SHBG) gene are associated with differences in SHBG levels, influencing the risk for breast cancer and polycystic ovarian syndrome, but no association has been reported for osteoporosis in postmenopausal women. Objective To determine the effect of G to A substitution in the 5′UTR (rs1799941) and the Asp356Asn (rs6259) polymorphisms of the SHBG gene on bone mineral density (BMD). Methods This is a cross-sectional study in a university-based research center from May, 2002 to December, 2007. A total of two hundred and thirteen healthy postmenopausal Caucasian women ≥ 1 year from last menstrual period participated to this study. Serum estradiol by ultrasensitive radioimmnunoassay, serum sex hormone-binding globulin by immunoradiometric assay, and urinary NTx by enzyme-linked immunoassay were measured. BMD measurements were performed by dual energy X-ray absorptiometry and genotyping by Pyrosequencing. Results There were no significant differences in SHBG levels associated with either rs1799941 or rs6259. Using a p value of < 0.00625 for significance, we found that subjects with the A allele (GA+AA) for the rs1799941, had a trend for lower free estradiol index (FEI) compared to the GG genotype ( p = 0.04). They also had significantly lower BMD at the intertrochanter ( p = 0.003) and trend for lower BMD at the total hip ( p = 0.02). There was no significant difference in FEI levels between the genotypes for the rs6259 polymorphism, but women with the Asn allele (Asp/Asn+Asn/Asn), had significantly lower BMD in the total femur ( p = 0.004) and intertrochanter (0.002) compared to those with the Asp/Asp genotype. Conclusions Our data suggest that polymorphisms of the SHBG gene are associated with significant differences in BMD at the proximal femur sites. Thus, genetic variations in the SHBG gene may influence BMD at the hip in postmenopausal women.

Unipedal standing exercise and hip bone mineral density in postmenopausal women: a randomized controlled trial

The aim of this study was to test the effect of unipedal standing exercise on bone mineral density (BMD) of the hip in postmenopausal women. Japanese postmenopausal women (n = 94) were assigned at random to an exercise or control group (no exercise). The 6-month exercise program consisted of standing on a single foot for 1 min per leg 3 times per day. BMD of the hip was measured by dual-energy X-ray absorptiometry. There was no significant difference in age and baseline hip BMD between the exercise group (n = 49) and control group (n = 45). Exercise did not improve hip BMD compared with the control group. Stepwise regression analysis identified old age as a significant determinant (p = 0.034) of increased hip total BMD at 6 months after exercise. In 31 participants aged >/=70 years, the exercise group (n = 20) showed significant increase in the values of hip BMD at the areas of total (p = 0.008), intertrochanteric (p = 0.023), and Ward's triangle (p = 0.032). The same parameters were decreased in the control group (n = 11). The percent changes in hip BMD of the exercise group were not significantly different from those of the control group either in the participants with low baseline hip total BMD (<80% of the young adult mean) or high baseline hip total BMD (> or =80% of the young adult mean). In conclusion, unipedal standing exercise for 6 months did not improve hip BMD in Japanese postmenopausal women. Effect of exercise on hip total BMD was age dependent. In participants aged > or =70 years, the exercise significantly increased hip total BMD.

Association between LRP5 polymorphism and bone mass at the hip in postmenopausal women with osteoporosis

Association between LRP5 polymorphism and bone mass at the hip in postmenopausal women with osteoporosis

Presence of vasomotor symptoms is associated with lower bone mineral density

To determine whether women with vasomotor symptoms (VMS) have lower bone mineral density (BMD) than do women without VMS. We analyzed data from baseline to annual follow-up visit 5 for 2,213 participants in the bone substudy of the Study of Women's Health Across the Nation. At baseline, women were aged 42 to 52 years, had an intact uterus and one or more ovaries, were not using exogenous hormones, were not pregnant or lactating, and were premenopausal or early perimenopausal. Menopausal stage and VMS were assessed by annual questionnaire. Menopausal stages were premenopausal, early perimenopausal, late perimenopausal, and postmenopausal. Using repeated-measures mixed models, we determined the association between VMS (any vs none) and BMD (by dual x-ray absorptiometry) within each menopause status category. After controlling for age, time within each menopausal stage, race/ethnicity, study site, and baseline menopausal stage, postmenopausal women with any VMS had lower lumbar (0.008 g/cm lower, P = 0.001) and lower total hip (0.005 g/cm lower, P = 0.04) BMD than did postmenopausal women without VMS. Compared with early perimenopausal women without VMS, early perimenopausal women with any VMS had lower femoral neck BMD (0.003 g/cm lower, P = 0.0001). Premenopausal women with any VMS had lower femoral neck BMD (0.003 g/cm lower, P = 0.03) compared with premenopausal women without VMS. Even in the earliest menopausal transition stages, women with VMS had lower BMD than did women without VMS. Effects varied by anatomical site, being most evident at the lumbar spine and total hip in postmenopausal women and at the femoral neck among premenopausal and early perimenopausal women.

Using Radon transform of standard radiographs of the hip to differentiate between post-menopausal women with and without fracture of the proximal femur

Texture features based on the Radon transform were extracted from clinical radiographs of the hip in post-menopausal women. The novel algorithm allowed us to identify patients with fracture of the proximal femur and may provide an alternative to measuring bone mineral density in predicting the fracture-risk in osteoporosis, especially where densitometry is regionally unavailable. The aim of this study is to introduce an algorithm for differentiation between patients with and without fracture of the hip using parameters based on the Radon transform (RT) and applied to standard radiographs of the proximal femur and to compare the results with bone mineral density (BMD). The study comprised 50 post-menopausal women (78.6 +/- 11.5 years of age), including 25 patients with hip fracture and 25 age-matched controls. We obtained lumbar and femoral BMD and standard femoral radiographs. In the radiographs we analysed trabecular patterns of the hip in a region-of-interest of 57 x 29 mm using the RT. From the histogram-representation of the RT, we extracted several characteristic parameters. By ROC and discriminant-analysis, we assessed the statistical power of both methods. For correct differentiation between fracture and non-fracture cases by femoral BMD, area-under-the-curve (AUC) was 0.78; AUC for the RT-based parameters ranged from 0.73 to 0.8. By combination of densitometric and textural information in a multivariate model the fracture status of 84% of subjects was predicted correctly, identification of fracture cases rose to 88%. Identification of fracture patients by RT applied to femoral radiographs was feasible and seemed to have a discriminative potential comparable to that of standard densitometry. In the future, the new method may provide an alternative to DXA or in conjunction with conventional densitometry may enhance the detection of patients with elevated risk of hip fracture.

Impact of Smoking Cessation on Bone Mineral Density in Postmenopausal Women

Although clinical guidelines recommend smoking cessation to improve bone health, the impact of short-term smoking cessation (i.e., 1 year) on bone mineral density (BMD) is not known. We examined the effects of smoking cessation on BMD measurements, markers of bone turnover, and hormone profiles in postmenopausal women. Postmenopausal women (n = 152) who smoked at least 10 cigarettes per day were randomly assigned to behavioral counseling and either nicotine or placebo patch for smoking cessation (3-month treatment with a 1-month taper) and followed for an additional year. The BMD at various sites (hip, spine, wrist, and total body), serum and urine biochemical markers of bone turnover, and sex hormones were measured at baseline and again 1 year after smoking treatment. Women who continuously abstained from smoking between the end of treatment and 1 year later (quitters) (n = 42) were compared with women who completed the study and continued to smoke (n = 77). Femoral trochanter BMD increased by 2.9% among quitters vs. 0.6% among continued smokers (p = 0.02). Total hip BMD increased by 1.52% among quitters vs. 0.43% among continued smokers (p = 0.03). Changes in BMD at the femoral neck, radius, spine, and total body did not significantly differ between groups. The effects of smoking cessation on bone were mediated in part by weight gain. Smoking cessation was also associated with an increase in bone alkaline phosphatase. Smoking cessation, relative to continued smoking, increases BMD at the femoral trochanter and total hip in postmenopausal women.

Aerobic Exercise and Bone Density at the Hip in Postmenopausal Women: A Meta-Analysis

Background. The effects of aerobic exercise on bone density at the hip in postmenopausal women in the absence of estrogen replacement therapy are not currently known. The purpose of this study was to examine the effects of aerobic exercise on bone density at the hip in postmenopausal women.Methods. Using the meta-analytic approach, studies dealing with the effects of aerobic exercise on bone density at the hip in postmenopausal women were searched for using computerized literature searches (MEDLINE, January 1978 to December 1995) as well as cross-referencing from retrieved review articles and original investigations.Results. A total of 18 effect sizes were derived from six studies. Using a fixed-effects model and bootstrap resampling (5,000 iterations) overall changes in bone density at the hip yielded an average effect size of 0.43 (95% CI = 0.04 to 0.81), equivalent to an overall change of approximately 2.42% (exercise = 2.13%; nonexercise = −0.29%). Statistically significant differences were observed when effect sizes were partitioned by country in which studies were conducted (United States,x̄= 1.03, 95% CI = 0.48 to 1.68; other countries,x̄= 0.18, 95% CI = −0.27 to 0.54;Qb= 5.44,P= 0.04) and calcium intake (≥1,000 mg/day,x̄= 0.83, 95% CI = 0.49 to 1.23; <1,000 mg/day = −0.23, 95% CI = −0.85 to 0.21;Qb= 10.64,P= 0.002).Conclusions. The overall results of this study suggest that site-specific aerobic exercise has a moderately positive effect on bone density at the hip in postmenopausal women. However, a need exists for additional, well-designed studies before a final recommendation can be made regarding the efficacy of aerobic exercise as a nonpharmacologic intervention for optimizing bone density at the hip in postmenopausal women.

AEROBIC EXERCISE AND BONE DENSITY AT THE HIP IN POSTMENOPAUSAL WOMEN: A META-ANALYSIS

Background. The effects of aerobic exercise on bone density at the hip in postmenopausal women in the absence of estrogen replacement therapy are not currently known. The purpose of this study was to examine the effects of aerobic exercise on bone density at the hip in postmenopausal women. Methods. Using the meta-analytic approach, studies dealing with the effects of aerobic exercise on bone density at the hip in postmenopausal women were searched for using computerized literature searches (MEDLINE, January 1978 to December 1995) as well as cross-referencing from retrieved review articles and original investigations. Results. A total of 18 effect sizes were derived from six studies. Using a fixed-effects model and bootstrap resampling (5,000 iterations) overall changes in bone density at the hip yielded an average effect size of 0.43 (95% CI = 0.04 to 0.81), equivalent to an overall change of approximately 2.42% (exercise = 2.13%; nonexercise = −0.29%). Statistically significant differences were observed when effect sizes were partitioned by country in which studies were conducted (United States,x= 1.03, 95% CI = 0.48 to 1.68; other countries,x= 0.18, 95% CI = −0.27 to 0.54;Qb= 5.44,P= 0.04) and calcium intake (≥1,000 mg/day,x= 0.83, 95% CI = 0.49 to 1.23; <1,000 mg/day = −0.23, 95% CI = −0.85 to 0.21;Qb= 10.64,P= 0.002). Conclusions. The overall results of this study suggest that site-specific aerobic exercise has a moderately positive effect on bone density at the hip in postmenopausal women. However, a need exists for additional, well-designed studies before a final recommendation can be made regarding the efficacy of aerobic exercise as a nonpharmacologic intervention for optimizing bone density at the hip in postmenopausal women.

Relationship of extremity muscle torque and bone mineral density in postmenopausal women : Phys. Ther. 1990 70/5 (302–309)

The purpose of this study was to examine the correlations between the torque of four extremity muscle groups and the bone mineral density (BMD) of the lumbar spine and hip in postmenopausal women. Fifty-six postmenopausal women (X age = 55.4 years, s = 7.1; X height = 162.6 cm, s = 6.4; X weight = 65.9 kg, s = 9.3) served as subjects. Bone mineral density was measured from the L2-L4 vertebral bodies, greater trochanter, femoral neck, and Ward's triangle using dual-photon absorptiometry. Hip abduction, knee extension, hip flexion, and grip force were assessed using the Spark Muscle Examination and Exercise Dosimeter (MEED) 3000 system. The Pearson product-moment correlations between muscle torque and BMD ranged from .07 to .42. The significant ( p < .05) correlations between torque and BMD ( r = .27–.42) occurred in functionally and anatomically related areas. Results of this study demonstrate a statistically significant relationship between torque and BMD in anatomically related areas in postmenopausal women. This relationship, however, is not sufficiently strong to allow for prediction of BMD from the four muscle groups tested in this study. The relationship does suggest that strength may be a factor in the determination of BMD. Maintenance of strength in those muscle groups with anatomical or functional relationships to the hip and lumbar spine may play a role in the prevention and cessation of the osteoporotic changes that occur.

Relationship of Extremity Muscle Torque and Bone Mineral Density in Postmenopausal Women

The purpose of this study was to examine the correlations between the torque of four extremity muscle groups and the bone mineral density (BMD) of the lumbar spine and hip in postmenopausal women. Fifty-six postmenopausal women (means age = 55.4 years, s = 7.1; means height = 162.6 cm, s = 6.4; means weight = 65.9 kg, s = 9.3) served as subjects. Bone mineral density was measured from the L2-L4 vertebral bodies, greater trochanter, femoral neck, and Ward's triangle using dual-photon absorptiometry. Hip abduction, knee extension, hip flexion, and grip force were assessed using the Spark Muscle Examination and Exercise Dosimeter (MEED) 3000 system. The Pearson product-moment correlations between muscle torque and BMD ranged from .07 to .42. The significant (p less than .05) correlations between torque and BMD (r = .27-.42) occurred in functionally and anatomically related areas. Results of this study demonstrate a statistically significant relationship between torque and BMD in anatomically related areas in postmenopausal women. This relationship, however, is not sufficiently strong to allow for prediction of BMD from the four muscle groups tested in this study. The relationship does suggest that strength may be a factor in the determination of BMD. Maintenance of strength in those muscle groups with anatomical or functional relationships to the hip and lumbar spine may play a role in the prevention and cessation of the osteoporotic changes that occur.