Context High fracture risk in subjects with low muscle strength is attributed to high risk of fall. Objective To study the association of muscle mass and physical performance with bone microarchitecture decline and risk of fall and nonvertebral fracture in men. Design Prospective 8-year follow-up of a cohort. Setting General population. Participants 821 volunteer men aged ≥60. Interventions Hip areal bone mineral density (aBMD) and appendicular lean mass (ALM) were assessed at baseline by DXA. Lower limb relative ALM (RALM-LL) is ALM-LL/(leg length) 2. The physical performance score reflects ability to perform chair stands and static and dynamic balance. Bone microarchitecture was assessed by high resolution peripheral QCT (HR-pQCT) at baseline, after 4 and 8 years. Statistical analyses were adjusted for shared risk factors. Outcomes Rate of change in the HR-pQCT indices, incident falls and fractures. Results Cortical bone loss and estimated bone strength decline were faster in men with low vs. normal RALM-LL (failure load: -0.74±0.09 vs. -0.43±0.10%/year; p<0.005). Differences were similar between men with poor and those with normal physical performance (failure load: -1.12 ±0.09 vs. -0.40±0.05%/year; p<0.001). Differences were similar between men having poor performance and low RALM-LL and men having normal RALM-LL and performance (failure load: -1.40±0.17 vs. -0.47±0.03%/year; p<0.001). Men with poor physical performance had higher risk of fall (HR=3.52, 95%CI: 1.57–7.90, p<0.05) and fracture (HR=2.68, 95%CI: 1.08–6.66, p<0.05). Conclusion Rapid decline of bone microarchitecture and estimated strength in men with poor physical performance and low RALM-LL may contribute to higher fracture risk.
Data on the association between bone microarchitecture and cardiovascular disease (CVD) in men are scarce. We studied the link of bone microarchitecture and areal bone mineral density (aBMD) with the risk of major adverse coronary event (MACE) in a cohort of men aged 60 to 87 years followed prospectively for 8 years. At baseline, aBMD was measured using a Hologic Discovery‐A device. Bone microarchitecture was assessed at distal radius and tibia by high‐resolution peripheral quantitative computed tomography (XtremeCT Scanco device). During the study, 53 men had incident MACE. The analyses were adjusted for confounders related to bone and CVD. In 813 men (53 MACEs), higher aBMD at the lumbar spine, hip, whole body, and radius was associated with lower risk of MACE (hazard ratio [HR] = 0.44–0.71/SD, p < .025 to < .001). In 745 men having valid distal radius scan (47 MACEs), higher cortical density (Ct.BMD) and higher cortical thickness (Ct.Thd) were associated with lower risk of MACE. This risk was higher in men in the lowest quintile of cortical measures versus the four upper quintiles combined (Ct.BMD: HR = 2.12, 95% confidence interval [CI] 1.08–4.17, p < .025). Findings were similar in 779 men having valid distal tibia scan (48 MACEs). At both sites, higher estimated stiffness and higher failure load were associated with a lower risk of MACE. The risk of MACE was higher in men in the lowest quintile of the measures of bone strength versus four upper quintiles jointly (distal radius stiffness: HR = 2.46, 95% CI 1.27–4.74, p < .01). Similar results were obtained in 638 men without prior fragility fracture and in 689 men without ischemic heart disease at baseline. Thus, in older men followed prospectively for 8 years, higher aBMD, preserved cortical bone status, and higher estimated bone strength were associated with lower risk of MACE after adjustment for relevant confounders. © 2021 American Society for Bone and Mineral Research (ASBMR).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.